1. Department of Plastic and Reconstructive
Surgery and Burns
Outreach Programme
Kimberley Hospital
Dr. Maria Giaquinto-Cilliers

2.  Management of the Burn Victim at the
Scene
 Initial Management
 Transport to Facility for Further Care

3.  Management of the Burn Victim at the
Scene
 Stop the Burning Process
 Flame: smother the fire with water or a
blanket + remove burned clothing
 Scald: cool the are with water immediately
(within 30 sec after injury) + keep patient
warm and dry
 Chemical: wash with copious amounts of
water (especially eyes)
 Electrical: make sure patient is not still in
contact with source before touching; patients
down: CPR/ shock (cardiac dysrhythmias)

4.  Initial
Management
 Airway Management
 Fluid Resuscitation
 Dressings
 Pain Management

5.  InitialManagement
 Airway Management
 Mechanism of injury: inhalation injury
findings= singed eyebrows or nasal
hairs, black nasal/oral discharge, grossly
swollen lips, hoarse voice, carbonaceous
soot in back of throat or sputum, facial
burns, abnormal oxygenation, history of
enclosure ina smoked filled location

6.  Initial
Management
 Airway Management
 Anxiety+ fear+ hypoxia in a patient victim
of house fire: rapid breathing of inhaled
smoke, with carbon monoxide + other toxic
gases in superheated temperatures +
airway tissue oedema= life-threatening
airway emergency

7.  Initial Management
 Airway Management
 If needed: intubation of the patient (patient
in arrest or unconscious without gag reflex;
 If not prepared for intubation (skills): bag-
valve-mask ventilation;
 Other cases: give oxygen by mask

8.  Initial Management
 Fluid Resuscitation
 Get venous access (even in burned tissue)
 Secure the IV line (bandage)
 Start fluid replacement with Lactated Ringer’s
 Criteria for IV placement in pre-hospital:
burns >20% with transport>60 min
hypovolaemic shock from associated injuries
potential for life-threatening airway
obstruction/cardiac arrest
 Record the fluid given

9.  Initial
Management
 Dressings
 Remove patient’s clothing
 Remove jewellery
 Keep environment warm to avoid
hypothermia
 Cover burns with dry dressings/ dry sheets
+ blanket on top; do not apply other
ointments

10.  InitialManagement
 Pain Management
 Do not give oral or IMI pain medication
 If possible, give IV morphine (5-10mg for
adults). Keep bag-valve-mask available for
respiratory depression

11.  Transport to Facility for Further Care
 Burn patient is a multiple trauma patient
 Remember the ABC
 Remember to stabilize spine (cervical
collars)
 Bring along someone to report history for
unconscious patients
 Report history to receiving facility