eWellness: First Aid in Burns |
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eWellness: First Aid in Burns
Dr KK Aggarwal,  17 June 2020
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  • Patients with severe thermal burns have a significant risk of death and major morbidity.
  • Check for respiratory distress and smoke inhalation injury, a common cause of death in the acute burn victim.
  • 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 component.
  • 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 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.
  • It is important to monitor urine output. Hourly urine output should be maintained at 0.5 mL/kg in adults.
  • Burn patients may be exposed to carbon monoxide and require immediate treatment with high-flow oxygen.
  • Cool and clean the burn wounds, but avoid inducing hypothermia.
  • Any jewellery and any hot or burned clothing and obvious debris not densely adherent to the skin needs to be removed.
  • Irrigation with cool water may be used.
  • Topical antibiotics are applied to all non-superficial burns.
  • Give opioids to treat pain and give tetanus prophylaxis.
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