cS (CHECK LISTSPRIMARY SURVEY OF SEVERE BURNS Check Do ‘Airway Patent or not patent airway eon OF airway TD Speak to the patient Clear the airway of foreign material chin lift, jaw thrust de 1 Never hyperflex or hyper- extend the head and neck 1 Control cervical spine, best with rigid collar | control Check capilary refill (normal return <= 2 seconds) Check the circumferential burn on the limb (need for escharotomy?) Breathing and | Sign of hypoxia and 1 Expose the chest, ensure the ventilation | hyperventilation or —- is adequate and hypoventilation equal Beware of carbon 1 Away provide monooxide intoxication. suplementation oxygen 100%, Cherry pink and nok 4151 /min via non rebreathing breathing patient mask f Beware circumferential chest | (required ventilate via bag burn (is an escharotomy and mask or intubate if * required?) necessary Girculation | Sign of shock TD Apply pressure to point of seh ge | Cec the contrat pus hemgragy revent PR ee ores 1 insert 2 large bore IV line, prefereably through unburned ste" a 1 ifthe patient is shock, give bollus of ringer lactate to attain radial pulse Take blood sample (Full Blood Count, Arterial Blood Gas Analysis) and treat thé other linical signof shock due to another cause Level of Unconsciousness A: Alert \V: Response to verbal stimuli P : Response to pain stimuli C1 check the level of consciousness C1 Check the pupil responsto light (brisk and equal) 1 Beware that hypoxemia and shock can cause restlessness and decrease level of consciousnessExposure with environmental control Remove all clothing and jewelry Layton o 1D Keep the patient warm C1 Estimate TBSA with Rule-of- nine or palmar surface area T adequate fluid resuscitation and monitoring C1 Parkland Formula : 3-4 mlx weight{kg) x %burn TBSA (+ maintenance for children) O_ Use Hartmann solution (Ringer Lactat) Half of calculated fluid is given in the first 8 hours, the rest is given on the next 16 hours 1 Measure urine output hourly Check ECG, Pulse, Blood pressure, respiratory rate, pulse oxymetry, arterial blood gas analysis o 1 Adjust resuscitation fluid as indicated | Analgesia Pain Management 1D Give intravenous IV Morphine 0,05 - 0,1mg/kg O Titrate to effect Exclude other trauma O X-Ray: © Lateral cervical o Chest © Pelvis o Other Tubes ‘Avoid gastroparesis Decompress stomach 1 insert nasogastric tube ( >10% children ,>20% adults)