ABCDE-FLUID-BURNS... Protocol for burns

The burn protocol is to ensure survival, minimize shock, prevent infection, and begin fluid resuscitation.
Following the right protocol helps to prevent huge losses.

Primary: ABCDE

A – Airway

  • Early intubation if:
  1. Facial burns

  2. Soot in the mouth or nose

  3. Singed nasal hairs

  4. Hoarseness, stridor

B – Breathing

  • Administer 100% oxygen by non-rebreather mask
  • Look for signs of carbon monoxide poisoning

C – Circulation

  • Monitor BP, HR, capillary refill, urine output

D – Disability

  • Check neurological status (Glasgow Coma Scale)

E – Exposure & Environment

  • Fully expose the patient to assess burn extent
  • Prevent hypothermia: cover with warm, clean sheets

Burn Severity Assessment

1. Total Body Surface Area (TBSA) burned:

  • Use the Rule of Nines in adults
  • Use the Lund and Browder chart for children

2. Depth of Burn:

  • Superficial (1st degree): only epidermis
  • Partial-thickness (2nd degree): epidermis + dermis
  • Full-thickness (3rd degree): extends through dermis
  • 4th degree: extends into muscle and bone

Fluid Resuscitation: Parkland Formula

FLUID

F – Fluid resuscitation is crucial

L – Use Lactated Ringer’s solution

U – Use formula (4 mL Γ— body weight (kg) Γ— %TBSA burned)

I – Infuse: Half in the first 8 hours and remainder over the next 16 hours

D – Don’t delay fluids; time starts from burn injury, not hospital arrival

Monitor:

  • Urine output: Goal: 0.5–1 mL/kg/hr in adults and 1–2 mL/kg/hr in children
  • Vital signs and perfusion indicators

Other Immediate Measures

  1. Pain control: IV opioids (morphine/fentanyl)

  2. Tetanus prophylaxis

  3. Wound care:

  • Cover with a clean sheet dressing
  • Don’t apply ice directly

Referral to Burn Center

BURNS

B – Burns >10% TBSA

U – Unusual locations (face, hands, feet, genitalia, perineum)

R – Respiratory involvement (inhalation injury)

N – Non-accidental (suspected abuse)

S – Special types (electrical, chemical, lightning)


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What signs we get in carbon monoxide poisioning?

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Can this be applicable in acid attack burns? Or do we need to approach it through a different way? Lemme know if there are any changes.

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That’s a very good question … For acid attack the 9 rule remains the same for assessment but the approach might change … If there’s some other information , please add :blush:

These are the signs we get in CO poisoning.

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It’s really informative.

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