View source for Burns - Thermal, Electrical, Chemical

==Section 6 - TRAUMA==
===6.02 BURNS- THERMAL, ELECTRICAL, CHEMICAL===

'''[[Initial Trauma Assessment and Care|INITIAL TRAUMA CARE]] (2.02).'''
* Initiate IV or IO ONLY if transport ETA to IRF is greater than 20 minutes.
* Evaluate depth of burn and estimate extent using Rule-of-Nines.
* Wear sterile gloves and mask until burn wounds are covered.
* Do NOT break blisters. Cover burn wounds with DRY sterile dressings.
* Open sterile sheet on stretcher before placing patient for transport.
* Cover patient with dry, sterile sheet and blanket to maintain body temperature.


'''CHEST WALL BURNS:'''
* Circumferential or near-circumferential burns 2nd degree or higher involving the chest wall affecting the patient’s ventilatory effort perform an [[Emergency Escharotomy|EMERGENCY CHEST WALL ESCHAROTOMY]] (Procedure 9.32).
* Support the airway as necessary with bag valve device, 100% oxygen and advanced airway placement as necessary to support ventilations and respiratory effort.


'''THERMAL BURNS:'''
* If < 10 % body surface area involved, apply sterile saline soaked dressings.
* If > 10 % body surface area involved, apply sterile dry dressings.


'''INHALATION BURNS:'''
* Note presence of wheezing, hoarseness, stridor, carbonaceous sputum / cough, singed nasal hair, eyebrows / lashes.
* Increase [[Oxygen|OXYGEN]] to 100% by NRB mask or assist ventilations with BVM.
* Administer updraft of [[Albuterol|ALBUTEROL]] 2.5mg, may repeat if necessary
* [[Solu-Medrol|METHYLPREDNISOLONE / SOLU-MEDROL]] 125mg IVP
* [[Intubation Nasotracheal|INTUBATE]] if severe respiratory distress, preferably nasal route.
* If intubation unsuccessful and airway not patent, consider [[Cricothyrotomy Surgical|CRICOTHYROTOMY]].


'''ELECTRICAL BURNS:'''
* Establish scene safety. Have electrical source turned-off or remove patient from source.
* Immobilize as indicated.
* Assess ECG for arrhythmias and refer to appropriate Practice Parameters
* Assess for entry and exit wounds including neurovascular status of affected part.
* Cover wounds with dry sterile dressings, (cooling not necessary).


'''CHEMICAL BURNS:'''
* If powdered chemical, brush away excess. Remove clothing if possible and place in a plastic bag.
* Irrigate with copious amounts of water or saline ASAP and while en route.
* Refer to [[Hazardous Materials|HAZ-MAT PRACTICE PARAMETER]] (5.08)



'''Refer to [[Analgesia and Sedation|ANALGESIA / SEDATION PRACTICE PARAMETERS]] (2.04).'''

[[Category:Trauma|0602]]