UNCONTROLLED WHEN PRINTED
Quick Chart
Introduction
  • A burn is an injury caused by thermal (e.g. heat) and non-thermal (e.g. electrical) causes. This guideline encompasses burn injuries caused by electricity, heat, chemicals, light, radiation or friction.
Clinical Presentation
  • Assess airway burns for:
    • Soot in nasal and mouth cavities
    • Cough and hoarseness
    • Black sputum
    • Difficulty in breathing and swallowing
    • Blistering around mouth and tongue
    • Scorched hair, eyebrows or facial hair
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Document the time of burn injury;
  • Assessment of the patient includes inhalation injury; % TBSA affected; site and depth of wounds; the patient’s age; the presence of other injuries, the mechanism of injury; any areas of circumferential burns, co-morbidities and psychosocial issues;
  • Reddened and intact skin areas should not be included when calculating % TBSA burnt;
  • There may be entry and exit point for electrical burn injuries;
  • Patient suffering electrocution injuries should be monitored for dysrhythmias and 12-lead performed;
  • Hydrogels gel dressings can be applied in the absence of water to cool, but this is not preferred.
Management
Primary Care
Intermediate Care (EMT / Level 2)
  • Salbutamol as required as per CPG
  • Administer pain relief
  • Consider applying cardiac monitor if trained and authorised
  • Consider direct transfer to Burns Unit:
    • ≥ 10% TBSA burnt
    • Airway burns
    • Burns to face, hands, feet, perineum, genitalia
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)

Fluid replacement formula:

Adult:

< 15% TBSA No fluid
15 – 25% TBSA and > 30 minutes for transportation to ED 1 litre over 1 hour (Max 1 litre);
> 25% TBSA 1 litre stat followed by 1 litre over 1 hour (Max 2 litres);

Paediatric:

> 10% TBSA and > 30 minutes for transportation to ED 10ml /Kg over 1 hour
Consult ASMA for advice if further fluid therapy is required.
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Critical & Extended Care (CCP, PSO)
Additional Information
  • Severe oedema
  • Inhalation of superheated smoke, stream or gases can induce airway oedema and rapid deterioration of airway patency.
  • Compartment syndrome; signs of ischaemia include:
    • Pain
    • Pallor
    • Paresthesia
    • Pulselessness or >2 seconds CRT
    • Cool or cold limb

References
References
Key Terms & Links
Rule of Nines
Colour assist:

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Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

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