Action
Patient presents with burn injury
- Initiate cooling measures if not already performed and < 60 minutes from injury
- Determine if need for immediate transfer is present
Decision
Are any of the following present?
- Respiratory compromise, presence of burns to airway, or carbonaceous sputum?
- Hypotension or signs of hypoperfusion?
- Suspicion for additional significant trauma?
- Altered mental status?
- Circumferential burns with decreased distal perfusion or neurologic deficit?
- > %20 TSA involvement?
Yes
- FiO at 100% if altered mental status or inhalation injury concerns (Class Il)
- Dress burned tissue simply
- Activate EMS
Background
Obtain a careful history of the circumstances and timing of the burn. Determine whether the burn occurred in an enclosed space, if the exposure was prolonged, occurred while sleeping, or other context that would raise suspicion for smoke inhalation. In vulnerable populations, ask detailed questions about the mechanism of injury to screen for inconsistencies suggestive of abuse. Review the patient’s medical history for conditions that may influence anticipated morbidity and need for burn center referral. Ask about tetanus vaccination status.
Signs of more severe burn injury include vital sign abnormalities such as significant tachycardia, hypotension, tachypnea, and hypoxia. Hypoxia, respiratory distress, stridor, singed nasal or facial hair, carbonaceous deposits in oropharyngeal mucosa or sputum, and facial burns are indicators of inhalation injury and should raise concern for impending airway compromise or respiratory failure.
Want more?
Get the full article 👇
