Burn management in the emergency department

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Target exams

Red flags

• An inhalation injury (soot in the mouth, singed nasal hairs, a hoarse voice, an enclosed-space fire) mandates an early intubation before the oedema closes the airway
• Only the partial and the full-thickness burns are counted in the TBSA — the erythema (the first-degree, the sunburn-like) is excluded
• The fluid resuscitation starts from the time of the BURN, not from the time of the arrival — the first half of the Parkland is given in the first 8 hours from the injury
• A circumferential full-thickness burn of a limb or a chest compromises the circulation or the breathing — it needs an escharotomy
• An electrical burn may have a small surface injury and a deep tissue injury — check the ECG, the creatine kinase, the myoglobinuria, and consider a fasciotomy