1.   STOP THE BURNING PROCESS

Use water for smoldering clothes, chemicals, hot tar, etc. (see chemical burn section)

2. CHECK AIRWAY

If deep facial burns present and/or there is a history of smoke exposure with obtundation or stridor, or other symptoms of impaired airway - INTUBATE

If history of smoke exposure, to treat carbon monoxide toxicity

Especially lung (rib fractures, pneumo, etc.) due to other trauma suffered in the accident

5. ASSESS HEMODYNAMIC STABILITY, PERFUSION

looking for evidence of impending burn shock

6. START IV

If burn (2° or 3° ) greater than 15% of total body surface (or if there are other injuries) Infuse lactated Ringers (Estimate of Requirements):

1. 15-25% TBS = 500 ml per hour
2. 25-50% TBS = 750 ml per hour
3. > 50% TBS = 1 Liter per hour

While keeping patient warm (remove wet clothes) (see burn assessment)

8. FOR MAJOR BURNS

Cover patient with dry clean dressing to conserve heat.

For third degree burns: cold is not indicated because burn is painless

FOR MINOR BURNS: (2° burns < 15%)

Can use cool compresses to control pain

Look for cardiac abnormalities, entrance and exit sites and other injuries (see Electrical burns)

11. INFORMATION TO MEDICAL CONTROL

1. Neurologic status at scene
2. Smoke exposure and airway status
3. Hemodynamic stability
4. Approximate size depth, and areas involved in burn