Quick Chart
  • 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.

Tertiary Burns Centre:

  • Adults: 16 years and over - Fiona Stanley Hospital (FSH)
  • Paediatrics: 15 years and under - Perth Children's Hospital (PCH)
 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 ECG performed;
  • Hydrogel dressings can be applied in the absence of water to cool, but this is not preferred.
  • When cooling the patient, be careful to avoid hypothermia - optimal water temperature is 15°
Primary Care
Intermediate Care
  • Salbutamol as required as per CPG
  • Administer pain relief
  • Consider applying cardiac monitor if trained and authorised
  • Consider direct transfer to Tertiary Burns Centre:
    • ≥ 10% TBSA burnt or >5% TBSA burnt paediatrics
    • Airway burns
    • Burns to face, hands, feet, perineum, genitalia
  • Monitor patient closely, 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
  • Salbutamol as required as per CPG
  • Establish vascular access, administer fluid replacement as per below chart:
  • Administer pain relief
  • Consider cardiac monitoring
  • Consider debridement:
    • Perform Hand Hygiene, don clean gloves
    • Wipe away dead skin/non-viable tissue and blisters with non vigorous rubbing if patient condition allows and appropriate analgesia has been administered.
  • Consider direct transfer to Tertiary Burns Centre:
    • ≥ 10% TBSA burnt, or >5% for paediatrics
    • Airway burns
    • Burns to face, hands, feet, perineum, genitalia, joints or neck

Fluid replacement indication criteria:

Adults >15% TBSA
Children 18 months and older>10% TBSA
Children less than 18 months>8% TBSA


2ml x %TBSA burn x weight of patient 50% of total amount over the first 8 hours
 50% of total amount over next 16 hours
  • Fluid is calculated from time of burn injury, not from arrival on scene
  • Monitor patient closely, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility

Parkland Calculator

An online calculator to assist in determining fluid administration for burns.

Parkland Calculator

Critical & Extended Care
 Additional Information
  • Elevate all affected areas when possible to reduce oedema and infection risk
  • Inhalation of superheated smoke, steam or gases can induce airway oedema and rapid deterioration of airway patency.
  • The risk of inhalation injury increases if the patient was exposed to burn source within an enclosed space
  • Debridement may improve accuracy of TBSA calculation, and reduce risk of oedema and infection
  • Compartment syndrome; signs of ischaemia include:
    • Pain
    • Pallor
    • Paresthesia
    • Pulselessness or >2 seconds CRT
    • Cool or cold limb
Key Terms & Links
Extended Care:
Colour assist:


Document Control

Clinical Services

Responsible Manager
Head of Clinical Services


Published Date

Review Date

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