ABCs of on-the-scene burn care

Keep your wits about you during the chaos of an emergency when checking victims. “Burn Care on the Fireground” offers good advice — remember your ABCs. Here’s a short synopsis of the article.

Airway. Looking for inhalation injuries? Then look for singed nasal and scalp hair, a burned face and soot in the mouth. Note any changes in voice. If a patient is conscious, rather than perform a difficult intubation, consider providing high-flow, humidified oxygen. Then get the patient to the ER ASAP. If the patient is unconscious and you think on-the-scene intubation is necessary, then choose the most experienced person and use a tube that is one-half to one size smaller than normal to adjust for swelling caused by inhalation damage.

Breathing. Listen to the person’s lungs and breathing and be sure to provide high flow oxygen. Remember, a pulse oximiter can’t tell the difference between oxygen and carbon monoxide, so a 100 percent reading doesn’t tell you much.

Circulatory. Hypotension may be caused by carbon monoxide or cyanide inhalation, Generally, if a person is experiencing hypotension, you need to check for additional traumatic injuries that may be causing the hypotension.

As far as determining whether to head to a hospital with a burn center or a closer hospital without a burn center, consider the American Burn Association’s criteria for choosing a burn center:

TBSA over 10 percent

  • Burns to critical areas such as major joints, the hands or feet, the face or the genitalia
  • High voltage electrical burns
  • Chemical burns
  • Concurrent traumatic injury
  • Medical history that may complicate healing
  • Inhalation injury
  • Third degree burns of any size

To read the article in its entirety — and learn more about en route care — click here.