string(11) "/protocols/"

Burns 4.0

All Providers

  • Stop the burning process
    • Remove victim from the burning source, avoid electrical source
    • Remove necessary clothing
    • Do not remove stuck clothing
  • Universal Patient Assessment Protoco
  • Cardiac monitor, ETCO2 if available, pulse oximetry, consider 12 lead EKG
  • High priority given to lightning victims in cardiac arrest
  • Treatment Plan
    • Initiate high flow oxygen therapy
    • Selective Spinal Immobilization Protocol if patient is unconscious
    • Evaluate for Shock and Pain Management Protocols
    • Remove items that could constrict swelling tissue
    • Prevent hypothermia
  • Key Considerations
    • Cyanide or carbon monoxide exposure: weakness, confusion, agitation, decreased LOC
    • Care for traumatic injuries should precede burn care
    • Definitions:
      • Superficial (1st degree) – red, painful, no blisters
      • Partial Thickness (2nd degree) – red, painful, hypersensitive, swollen, blisters
      • Full Thickness (3rd degree) – dark, leathery, painless, waxy, does not blanch

ADULT (>25 kg / 55 lbs)

EMT
  • Consider advanced airway
AEMT
  • Advanced airway, vascular access per IV/IO protocol, avoid placing through burned skin if possible
  • IV Fluid: LR at 500 ml/hr
Paramedic
  • Consider early intubation in airway burns
  • High voltage or lightning strike: LR at 500 ml/hr

Pediatric (not to exceed adult doses)

EMT
  • Consider advanced airway
AEMT
  • IV Fluid: if 2nd/3rd degree is >10% BSA
    • <5 yo: 125 ml/hr
    • 5-13 yo: 250 ml/hr
    • 13 yo: 500 ml/hr
Paramedic
  • High voltage or lightning strike: LR infusion
    • <5 yo: 125 ml/hr
    • 5-13 yo: 250 ml/hr
    • 13 yo: 500 ml/hr