First Aid in Burns : Dr KK Aggarwal

• Patients with severe thermal burns have a considerable risk of death and morbidity.
• Check for evidence of respiratory distress and smoke inhalation injury, which is a common cause of death in case of acute burn injury.
• Laryngeal edema can develop suddenly.
• Fluid resuscitation and the need for transfer are guided by burn depth and size.
• Vascular collapse from burn shock is a crucial factor.
• It is important to initiate rapid, aggressive fluid resuscitation to reconstitute intravascular volume and maintain end-organ perfusion.
• The fluid requirement during the initial 24 hours of treatment is 4 mL/kg of body weight for each percent of total body surface area burned, given IV. Superficial burns are not included in this calculation. One-half of the calculated fluid need is to be given in the initial 8 hours; the remaining half is given over the next 16 hours.
• Burn patients may have been exposed to carbon monoxide and require high-flow oxygen.
• It is important to monitor urine output and to maintain hourly urine output at 0.5 mL/kg in adults.
• Cool and clean the burn wounds, but be careful to avoid inducing hypothermia.
• Any jewellery and any hot or burned clothing and obvious debris not adherent to the skin must be removed.
• Irrigation with cool water may be used.
• Topical antibiotics to be applied to all non-superficial burns.
• Give opioids for pain management; provide tetanus prophylaxis.

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