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In the Field: Guidelines for Treatment of Different Burns

 
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Guidelines are provided for treatment of different burns.

 

Any patient whose condition meets ABA referral criteria should be referred to the University of Wisconsin Hospital and Clinics Burn Center: (800) 472-0111

 

Thermal Burns

  • Stop the burning process
  • Cool the burn with room temperature water for a few minutes only
  • Universal precautions
  • Airway and C-spine precautions
  • Treat according to BLS/ACLS/ATLS/ ABLS protocols
  • Remove all clothing and jewelryespecially rings
  • Initiate fluid resuscitation Lactated ringers
  • Cover the burn with clean dry sheet or saran wrap
  • No prophylactic antibiotics
  • Ice or wet dressings should never be used
  • Monitor distal pulses (palpable) in circumferentially burned extremities
  • Does patient meet American Burn Association referral criteria

Electrical Burns

  • Turn off power source, scene safety
  • Do not get injured yourself in effort to rescue victim
  • Universal Precautions
  • Start CPR if indicated
  • Treat according to BLS/ACLS/ATLS/ ABLS protocols
  • Remove all clothing and jewelry, especially rings
  • Assess for occult injuries
  • Monitor for cardiac arrhythmias
  • Monitor neurological status
  • Assess and document pulse or affected extremities
  • Initiate fluid resuscitation Lactated ringers
  • Meets American Burn Association referral criteria

Chemical Burns

  • Protect yourself-full personal protective equipment
  • Remove all clothing and jewelry which can trap chemicals
  • If dry powder is present brush away before irrigating with water
  • Neutralization is contraindicated
  • Certain chemicals require special consideration (e.g. Hydrofluoric acid)
  • Flush with copious warm water on scene and en route to ER/UWHC Burn Center
  • Irrigation of chemical injury is necessary prior to patient transfer
  • Identification of agent after institution of therapy may provide additional medical considerations. DO NOT delay treatment to identify agent involved
  • Chemical injuries to eyes are an emergency. Remove contacts and irrigate continuously with normal saline. DO NOT STOP
  • Meets American Burn Association referral criteria

Eliminate Scalds in the Kitchen

  • Keep children a safe distance from food preparation areas.
  • Cook on back burners and point pot handles toward the back of the stove.
  • Beware of dangling cords. Never use deep fryers around children
  • Keep hot foods and drinks at least 10 inches away from the edge of tables and counters.
  • Avoid using tablecloths on serving areas.
  • Use vented containers to allow steam to escape while cooking. Wait one minute before removing cooking covers then lift the farthest corner away from your face, hand and arm.
  • Do not eat or drink hot foods or beverages when holding or carrying children or infants. 

Prevent Microwave Scalds

  • Never heat baby bottles in the microwave. Plastic bottle liners may burst increasing the risk of scald burns to infants and toddlers.
  • Microwaves should be placed so the faces of older children and people in wheelchairs are higher than the front door of the microwave. Microwaves should be kept out of young children’s reach.
  • Thoroughly stir all microwave foods and liquids before eating.
  • Test the temperature of heated food before eating or feeding children.
  • Establish and enforce a “No Kids Zone” in the kitchen to keep children away from the stove, sink, and food preparation areas.

For more information on burn prevention contact the UW Hospital and Clinics Burn Center at (608) 263-1490 or chandel@uwhealth.org.