Emergency care (burn)

1. Care at the scene
-airway
initial attention must be directed to the airway. Any patient should be placed on 100% oxygen via a nonrebreather mask if there is any suspicion of smoke inhalation. If the patient is unconscious or respiratory distress, ET should be performed
-other injuries and transport
The patient is assessed for other injuries and then transported. Patients should be kept flat and warm and be given nothing by mouth.
- cold application
After several minutes have elapsed, further cooling does not alter the pathologic process. Iced water should never be used, even on the smallest of burns. If ice or cold water is used on larger burns, systemic hypothermia often follows, and the associated cutaneous vasoconstriction can extend the thermal damage.
2. Emergency room care
protocol ABC must be strictly followed.
-emergency assesment of inhalation injury
Careful inspection of the mouth and pharynx should be done early. Hoarsness and expiratory wheezes are signs of potentially serious airway edema or inhalation injury. Copious mucus production and carbonaceous sputum are positif signs.
A decreased p:f ratio, the ratio PaO2 to FIO2 is the earliest indicator of smoke inhalation. Ratio 400-500 is normal, ratio less than 300, impending pulmonary problem. Ratio 250 is a indication ET.
- fluid resuscitation
- tetanus prophylaxis
- gastric decompression
- pain control
- psychosocial care
2. Care of the burn wound
- escharotomy