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EMS Assessment and Initial Care of Burn Patients
Guidelines from the American College of Surgeons and
American Burn Association
By Joe Lewis MD
EMS Assessment and Initial Care of Burn Patients
Stop Further Injury A Remove victim from sourceB Extinguish or remove buring clothingC Chemical Burns1 Continuous water rinse or lavage2 Prolonged eye irrigation scene3 Remove contaminated clothing4 Avoid injury wear clothes and PPE
EMS Assessment and Initial Care of Burn Patients
Maintain ventilationA Administer humidified 100 oxygen by mask to treat possible carbon monoxide poisoning B Examine airway for signs inhalation injury 1 Singed nasal hairs2 Carbonacious material in upper airway 3 Edema or inflammatory changes in the upper airway
EMS Assessment and Initial Care of Burn Patients
C Maintain AirwayD Consider Airway thermal injury if these signs and symptoms are displayed ndash Difficulty breathingndash Sooty expectorated sputumndash Striderndash Coughndash Nasal hair or oral mucosa burnsndash Hoarsenessndash Decreased PaO2 FiO2
EMS Assessment and Initial Care of Burn Patients
Maintenance of peripheral circulation in patients with circumferential burns
A Remove rings and braclets-give to familyB Clinical Signs of impaired circulation1 Cyanosis2 Impaireddelayed capillary filling3 Progressive neurologic signs paresthesias and paresis ie numbness and weakness4 Doppler extremity pulses
EMS Assessment and Initial Care of Burn Patients
Physical Examination
A Check for associated injuriesB Estimate extent and depth of burn -Rule of Nines- Childs head is disportionately larger than adult headC Estimate weight of the patient
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Stop Further Injury A Remove victim from sourceB Extinguish or remove buring clothingC Chemical Burns1 Continuous water rinse or lavage2 Prolonged eye irrigation scene3 Remove contaminated clothing4 Avoid injury wear clothes and PPE
EMS Assessment and Initial Care of Burn Patients
Maintain ventilationA Administer humidified 100 oxygen by mask to treat possible carbon monoxide poisoning B Examine airway for signs inhalation injury 1 Singed nasal hairs2 Carbonacious material in upper airway 3 Edema or inflammatory changes in the upper airway
EMS Assessment and Initial Care of Burn Patients
C Maintain AirwayD Consider Airway thermal injury if these signs and symptoms are displayed ndash Difficulty breathingndash Sooty expectorated sputumndash Striderndash Coughndash Nasal hair or oral mucosa burnsndash Hoarsenessndash Decreased PaO2 FiO2
EMS Assessment and Initial Care of Burn Patients
Maintenance of peripheral circulation in patients with circumferential burns
A Remove rings and braclets-give to familyB Clinical Signs of impaired circulation1 Cyanosis2 Impaireddelayed capillary filling3 Progressive neurologic signs paresthesias and paresis ie numbness and weakness4 Doppler extremity pulses
EMS Assessment and Initial Care of Burn Patients
Physical Examination
A Check for associated injuriesB Estimate extent and depth of burn -Rule of Nines- Childs head is disportionately larger than adult headC Estimate weight of the patient
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Maintain ventilationA Administer humidified 100 oxygen by mask to treat possible carbon monoxide poisoning B Examine airway for signs inhalation injury 1 Singed nasal hairs2 Carbonacious material in upper airway 3 Edema or inflammatory changes in the upper airway
EMS Assessment and Initial Care of Burn Patients
C Maintain AirwayD Consider Airway thermal injury if these signs and symptoms are displayed ndash Difficulty breathingndash Sooty expectorated sputumndash Striderndash Coughndash Nasal hair or oral mucosa burnsndash Hoarsenessndash Decreased PaO2 FiO2
EMS Assessment and Initial Care of Burn Patients
Maintenance of peripheral circulation in patients with circumferential burns
A Remove rings and braclets-give to familyB Clinical Signs of impaired circulation1 Cyanosis2 Impaireddelayed capillary filling3 Progressive neurologic signs paresthesias and paresis ie numbness and weakness4 Doppler extremity pulses
EMS Assessment and Initial Care of Burn Patients
Physical Examination
A Check for associated injuriesB Estimate extent and depth of burn -Rule of Nines- Childs head is disportionately larger than adult headC Estimate weight of the patient
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
C Maintain AirwayD Consider Airway thermal injury if these signs and symptoms are displayed ndash Difficulty breathingndash Sooty expectorated sputumndash Striderndash Coughndash Nasal hair or oral mucosa burnsndash Hoarsenessndash Decreased PaO2 FiO2
EMS Assessment and Initial Care of Burn Patients
Maintenance of peripheral circulation in patients with circumferential burns
A Remove rings and braclets-give to familyB Clinical Signs of impaired circulation1 Cyanosis2 Impaireddelayed capillary filling3 Progressive neurologic signs paresthesias and paresis ie numbness and weakness4 Doppler extremity pulses
EMS Assessment and Initial Care of Burn Patients
Physical Examination
A Check for associated injuriesB Estimate extent and depth of burn -Rule of Nines- Childs head is disportionately larger than adult headC Estimate weight of the patient
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Maintenance of peripheral circulation in patients with circumferential burns
A Remove rings and braclets-give to familyB Clinical Signs of impaired circulation1 Cyanosis2 Impaireddelayed capillary filling3 Progressive neurologic signs paresthesias and paresis ie numbness and weakness4 Doppler extremity pulses
EMS Assessment and Initial Care of Burn Patients
Physical Examination
A Check for associated injuriesB Estimate extent and depth of burn -Rule of Nines- Childs head is disportionately larger than adult headC Estimate weight of the patient
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Physical Examination
A Check for associated injuriesB Estimate extent and depth of burn -Rule of Nines- Childs head is disportionately larger than adult headC Estimate weight of the patient
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Initial Burn Wound Care
A Clean and debride loose tissueB For small burns lt15 BSA use moist steriledressings C For serious or large BSA burns use dry dressing to avoid hypothermiaD Commercial burn dressing are great but astandard hospital sheet works as wellE Cover burns with dry sterile dressing or cover with a clean sheet
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
History
A Circumstances of injuryB Pre-existing illnessC MedicationsD AllergiesE History of enclosed space fireF History of alcohol or drug use
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Adult Rule of Nines
1048698 Head and neck 91048698 Front torso 181048698 Back torso 181048698 Upper extremities 9 Each1048698 Lower extremities 18 Each1048698 Genitalia 1
1048698 Total 100
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Rule of Nines
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Pediatric Rule of Nines
1048698 Head and Neck 181048698 Front torso 181048698 Back torso 181048698 Upper Extremities 91048698 Lower Extremities135 each1048698 Genitalia 1
1048698 Total 100
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Severity of Burn Injury 1 Superficial or First Degreendash Epidermisndash No Blisters1048698 2 Partial Thickness or Second Degreendash Deeper dermal layersndash Blisters1048698 3 Full Thickness or Third Degreendash Full skin thicknessndash Charring
4 Full Thicknessndash Full thickness involving bones and muscles
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Superficial Partial Thickness
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Deep Partial Thickness
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Deep Full Thickness
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Determining Criticality of Burns
Minor - Superficial burns and small partialthickness burns lt15 BSA
Moderate - Partial thickness of gt15-30 BSAsmall full thickness burns
Severe Partial thickness of gt30 BSA + FullThickness gt15 BSA
Burns to hands feet face genital or withcircumferential patterns are critical
Inhalation injuries are always critical
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
Carbonacious Sputum
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Intravenous Fluid TherapyA Required by patients with burns greater then 20 of total body surfaceB Secure large bore IV in good veinC Estimate fluid needs for 1st 24 hours postburnD Administer 12 of calculated volume in 1st 8hrs Calculations Adults 2-4ml LR x weight in kilogram x percent burn = 24 hour requirement Children less then 4 mlkg plus maintenance fluids
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Analgesics per local protocol currently none at Schofield but you could wait for City and County
and after they treat pain you could transport if they agree
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow
EMS Assessment and Initial Care of Burn Patients
Burn Center Criterion
Burn Size gt 20 BSA in Patient lt10 and gt 50Third degree Burn gt 5 BSAAirway or Inhalational InjuryCarbon Monoxide gt 15Electrical or Lightening InjuryDeep Burns face hands feet perineum or major joints- hip knee elbow