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Provides instructions for wound exposure and environmental control, estimation of burn size using Rule of Nines and Lund & Browder, and thresholds for initiating fluid resuscitation with pediatric and adult dosing. Includes burn depth classifications, special management for flame, scald, contact, chemical, and electrical burns, smoke inhalation care, referral criteria to a burn center, and overview of burn center services.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/burn-assessment-and-management-initial-assessment-and-management-guidelines-to-assist-emergency-personnel/565863/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/burn-assessment-and-management-initial-assessment-and-management-guidelines-to-assist-emergency-personnel/565863.png","ImageObject",442,249,{"name":88,"@type":89},"Miles","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-21","2026-10-13",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the primary survey approach for burn patients in the initial stage?","Question",{"text":108,"@type":109},"Use ABCDEF to check airway and C-spine immobilization, breathing and ventilation, circulation, disability/neurologic deficit, expose and environmental control, and fluid (F).","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When should fluid resuscitation be initiated for burn patients?",{"text":113,"@type":109},"Initiate fluid resuscitation when burn size exceeds 10% for pediatric patients or 15% for adult patients. Patients with more than 30% TBSA burns require two large-bore IVs and pre-hospital caution applies for cardiac/pulmonary disease or age over 70.",{"name":115,"@type":106,"acceptedAnswer":116},"What criteria trigger referral to a certified burn center?",{"text":117,"@type":109},"Referral is recommended for >10% TBSA partial thickness burns, any full-thickness burns in any age, burns to face/feet/hands/genitalia/perineum/major joints, electrical or chemical burns, inhalation injury, patients with pre-existing medical disorders or concomitant trauma, pediatric burns without qualified resources, and cases needing special social/emotional/rehabilitative intervention.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},565863,1792109707,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Burn Assessment and Management  \nGuidelines to assist emergency personnel in the initial management of burn patients  \nInitial Assessment and Management  \nConduct initial assessment  \nPrimary Survey: Use ABCDEF to check the patient’s status:  \nA Airway/C spine immobilization B Breathing and ventilation C Circulation  \nD Disability, neurologic deficit E Expose (remove all clothing and jewelry)  \nEnvironmental control (keep warm) F Fluid  \nSecondary Survey: Use head-to-toe approach  \n• Remove all clothing and jewelry  \n• Quickly assess percentage of skin involved and depth of burn  \n• Cover patient with clean, dry sheet  \n• Keep warm (hypothermia occurs rapidly)  \n• Avoid use of ice or ointments  \n• If material is stuck to the skin, do not attempt to remove  \n• For circumferential burns, elevate burn extremity above the level of the heart  \n• May consider clear plastic wrap to reduce heat loss  \n\n| Calculate the percent of total burn surface area (exclude erythema)\u003Cbr>• Use the “Rule of Nines” to estimate burn size for adult and pediatric patients\u003Cbr>• Use Lund & Browder chart below to estimate percentages by age\u003Cbr>• Include only partial (second degree) and full thickness (third degree) burns |  |  |\n| --- | --- | --- |\n| “Rule of 9s” Burn-Size\u003Cbr>Assessment (Include partial and full thickness burns only)\u003Cbr>\u003Cbr>Pediatric\u003Cbr>| |  |\n|  | | To estimate scattered burns: The size of the patient’s hand (palm with fingers closed) represents 1% of his or her total burn surface area. |\n\n\n| Begin fluid resuscitation\u003Cbr>If burn size is greater than 10% pediatric or greater than 15% adult, initiate fluid resuscitation.\u003Cbr>Patients with > 30% TBSA burns require 2 large bore IVs (may be inserted through burned skin if necessary) .\u003Cbr>Pre-hospital fluid management |  |\n| --- | --- |\n| \u003C 5 yrs. 6-13 yrs.> 14 yrs. | 125 ml LR/hour 250 ml LR/hour 500 ml LR/hour |\n| Caution: Start IV fluid at 250 ml LR/hour for patients with pre-existing cardiac disease, pulmonary disease or age > 70.\u003Cbr>Avoid fluid challenge unless patient is hypotensive due to trauma. |  |\n\nBurn Injury Depth Classifications  \nFirst degree burn/superficial  \nThese burns are not included in the percentage of total body surface.  \n• Only epidermis is involved  \n• Skin is pink and dry with no blistering  \n• Heals in 3-5 days, usually does not scar  \n• Minimal risk of infection  \n• Capillary refill present  \n| Burn management\u003Cbr>Flame/Scald/Contact Burns\u003Cbr>• Remove all clothing and items such as jewelry\u003Cbr>• Cover the burned area loosely with a dry dressing or clean sheets/blankets\u003Cbr>• Do not apply ice or ointments\u003Cbr>• May need to initiate fluid resuscitation\u003Cbr>• Manage pain as indicated\u003Cbr>Additional Management of Special Types of Burn Injuries\u003Cbr>Chemical Burns\u003Cbr>• Remove contaminated clothing\u003Cbr>• Brush off powder and solid chemicals from clothing\u003Cbr>• Irrigate involved skin with water or saline for at least\u003Cbr>20 minutes or until the burning sensation is relieved Caution: Do not delay transporting patient; may need to continue irrigation en route.\u003Cbr>Electrical Burns\u003Cbr>The danger from an electrical shock depends on voltage, current, pathway and co-morbidities.\u003Cbr>• Initiate fluid resuscitation regardless of burn size\u003Cbr>• Assess for associated injuries: |  |\n| --- | --- |\n| - Cardiac arrest\u003Cbr>- Dysrhythmias – treat per ACLS protocol\u003Cbr>- Respiratory failure | - Unconsciousness\u003Cbr>- Muscle pain and contractions\u003Cbr>- Seizures\u003Cbr>- Numbness and tingling |\n| • Special circumstances: High-voltage electrical injuries require trauma immobilization and evaluation\u003Cbr>Smoke Inhalation\u003Cbr>• Administer 100% oxygen\u003Cbr>• Monitor patency of airway closely\u003Cbr>Contact the burn center for definitive management.\u003Cbr>FL157100817 |  |\n\nSecond degree burn/partial thickness  \n• Epidermis and dermis involved  \n• Skin is bright red or pearl-pink, painful and moist  \n• May have small to large blisters  \n• Rapid fluid loss may occur with large burns  \n• Heals in 10 days-2 weeks  \n• Capillary refill","cbCaitghFl9yZjFg","https://ap.wps.com/l/cbCaitghFl9yZjFg","pdf",913421,"English","# Initial Assessment and Management\n## Primary Survey (ABCDEF)\n## Secondary Survey (Head-to-Toe)\n## Percent Total Burn Surface Area and Burn-Size Estimation\n## Fluid Resuscitation and Pre-hospital Fluid Management\n## Burn Injury Depth Classifications\n## Burn Management for Common and Special Types\n## When to Refer to the Burn Center\n## Third Degree Burn/Full Thickness\n## Burn Center Overview","[{\"question\":\"What is the primary survey approach for burn patients in the initial stage?\",\"answer\":\"Use ABCDEF to check airway and C-spine immobilization, breathing and ventilation, circulation, disability/neurologic deficit, expose and environmental control, and fluid (F).\"},{\"question\":\"When should fluid resuscitation be initiated for burn patients?\",\"answer\":\"Initiate fluid resuscitation when burn size exceeds 10% for pediatric patients or 15% for adult patients. Patients with more than 30% TBSA burns require two large-bore IVs and pre-hospital caution applies for cardiac/pulmonary disease or age over 70.\"},{\"question\":\"What criteria trigger referral to a certified burn center?\",\"answer\":\"Referral is recommended for \\u003e10% TBSA partial thickness burns, any full-thickness burns in any age, burns to face/feet/hands/genitalia/perineum/major joints, electrical or chemical burns, inhalation injury, patients with pre-existing medical disorders or concomitant trauma, pediatric burns without qualified resources, and cases needing special social/emotional/rehabilitative intervention.\"}]","Burn Assessment and Management - Initial Assessment and Management - Guidelines to assist emergency personnel | PDF",1791859668]