Page 4 - Emergency medicine for students ebook

Burns
Symptoms:
Ø Blisters, pain (degree not related to severity of the burn- most serious burns can be painless), peeling skin, red skin, shock (pale and clammy skin, weak, blue lips, decreased alertness), swelling, white or charred skin.
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Pre-hospital aid:
1. Stop the burning process (water on fire/fire extinguisher/remove person from area/switch off power supply/use of non-conductive implements)
2. Remove clothes/jewellery near burnt area of skin BUT not anything that has stuck to the skin (care to be taken in chemical burning)
3. Cool burn with cool/luke warm water for 10-30 mins
4. Try and keep patient warm to prevent hypothermia
5. Cover burn with cling film. Place layers of it on the area. DO NOT
wrap it all the way around (this will create a tourniquet effect)
6. If possible provide high flow O2
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When to go to hospital:
• Call 999 or go straight to hospital if a baby or child has been burned
• All chemical and electrical burns
• Large or deep burns – any burn bigger than your hand
• Burns that cause white or charred skin – any size
• Burns on the face, hands, arms, feet, legs or genitals that cause blisters ------------------------------------------------------------------------------------------------------- Major burn treatment in hospital:
1. Airway- Assess for and treat any obstruction (eg stridor, swelling), give O2, apply cervical collar if possible spinal injury
2. Analgesia- 2xlarge bore cannula, IV morphine, IV 50mg cyclizine
3. Fluids- 0.9% saline, at 2-4mL of crystalloid per kg body weight per %
body surface area burned over first 24hrs. Give half of this volume in first 8hrs.
o Urinary catheter
o Check pulse, BP and RR every 10-15 min initially
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