Burns

Question 1

How to Assess Burns

Answer 1

Burn size and degree.

Admit to major burns unit >25% partial thickness in adults. 20 for children.

Referral still warranted in full thick burns >5% and partial >10%

A to E assess

Airway - Must remain patent. If airway burn suspected ie hoarse voice, singed hairs, soot in nasal oral cavity, then anaesthetics involvement needed.

Breathing - Exclude life threatening things such as pheumothorax, and constricting burns -> escharotomy. CO poisonings.

Circulation - Give IV fluid resuscitation. Partial thickness burn above 15% coverage warrants fluid resuscitation.

Question 2

Rule of Nines

Answer 2

Ant trunk - 18
Post trunk - 18
Upper limb - 9 x 2
Lower limb - 18
Face and neck - 9
Perineum - 1

Question 3

Burns Calculator for fluid resusc.

Answer 3

4 x weight in kg x % burn = mL in harmanns to give in 24hr.

Half given in first 8hr. This includes time of burn instead of arrival at hospital

Question 4

Other managements to consider

Answer 4

Cool the burn but warm the patient.