Pre-Hospital Management of Burn Injuries

Cover burn wounds with clean dry dressings and monitor urine output and titrate up on fluids ad needed

Burn Center Transfer Criteria:

Partial thickness burns involving greater than 10% TBSA

Burns to the face, hands, feet, genitalia, perineum, or major joint

Full thickness burns

Chemical burns

Electrical burns

Inhalation injury

Multiple medical co-morbidities

Extremes of age, (children, elderly)

Concomitant Traumatic injuries

Special social, emotional, or rehabilitation needs

Immediately after a burn injury most vital signs are normal, but:

Expect tachycardia

Prevent hypothermia

Be concerned about tachypnea (RR >25) and reports of feeling short of breath

For hypotension, look for other causes (trauma, medications)

Smaller burns <20% TBSA do not result in major changes

Big changes happen for larger burn injuries, >20% TBSA (total body surface area)

Destruction of normal tissue barriers

Introduces significant fluid shifts

Changes every major body system

Burn wounds evolve considerably over the first 72 hours –the severity and degree may not be immediately clear.