OSCE — major burns assessment and Parkland calculation · MBBS OSCE

Brief (to candidate)

A 70 kg adult has burns to the entire anterior trunk and right arm from a house fire 1 hour ago. He is hoarse. Estimate TBSA, calculate fluids, and manage the airway risk.^[1]

Candidate instructions

First aid: cool running water 20 minutes within 3 hours (Griffin); remove clothing; avoid ice/hypothermia.^[3]
Rule of Nines: 18% + 9% = 27%; exclude erythema-only.
Parkland (4 mL end of ABA 2–4 mL): 4 × 70 × 27 = 7560 mL/24 h; half in first 8 h from burn time (Bodnar/StatPearls).^[1]^[2]
Airway: 100% O2, early intubation consideration, COHb — no unsourced COHb percentage recipes.
Analgesia, tetanus, dressing, ABA-guided referral.

Examiner checklist

Domain	Expected
TBSA	Correct segments; exclude erythema
Maths	Half in 8 h from injury time; ABA 2–4 mL range named ^[1]^[2]
Airway	Inhalational recognition; 100% oxygen
Monitoring	Least fluid for organ perfusion — not an unsourced 0.5 mL/kg/h clock ^[1]
Disposition	ABA referral criteria; EMS severe adult band is 20% or more

^[1] ^[2]

Common errors

Counting from arrival time not burn time.
Including simple erythema.
Delaying airway until obstruction complete.^[1]

References3Show

[1]Bodnar D, Parker L, Rashford S, et al. The Pre-Hospital Initial Fluid Therapy Estimate in Early Nasty Burns (PHIFTEEN B, 15-B) Guideline applied to a retrospective cohort of Intensive Care Unit patients with major burns Burns, 2020.PMID 33183830
[2]Mehta M, Tudor GJ Parkland Formula StatPearls, 2026.PMID 30725875
[3]Griffin BR, Frear CC, Babl F, et al. Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns Ann Emerg Med, 2020.PMID 31474480

Brief (to candidate)

A 70 kg adult has burns to the entire anterior trunk and right arm from a house fire 1 hour ago. He is hoarse. Estimate TBSA, calculate fluids, and manage the airway risk.^[1]

Candidate instructions

First aid: cool running water 20 minutes within 3 hours (Griffin); remove clothing; avoid ice/hypothermia.^[3]
Rule of Nines: 18% + 9% = 27%; exclude erythema-only.
Parkland (4 mL end of ABA 2–4 mL): 4 × 70 × 27 = 7560 mL/24 h; half in first 8 h from burn time (Bodnar/StatPearls).^[1]^[2]
Airway: 100% O2, early intubation consideration, COHb — no unsourced COHb percentage recipes.
Analgesia, tetanus, dressing, ABA-guided referral.

Examiner checklist

Domain	Expected
TBSA	Correct segments; exclude erythema
Maths	Half in 8 h from injury time; ABA 2–4 mL range named ^[1]^[2]
Airway	Inhalational recognition; 100% oxygen
Monitoring	Least fluid for organ perfusion — not an unsourced 0.5 mL/kg/h clock ^[1]
Disposition	ABA referral criteria; EMS severe adult band is 20% or more

^[1] ^[2]

Common errors

Counting from arrival time not burn time.
Including simple erythema.
Delaying airway until obstruction complete.^[1]

References3Show

[1]Bodnar D, Parker L, Rashford S, et al. The Pre-Hospital Initial Fluid Therapy Estimate in Early Nasty Burns (PHIFTEEN B, 15-B) Guideline applied to a retrospective cohort of Intensive Care Unit patients with major burns Burns, 2020.PMID 33183830
[2]Mehta M, Tudor GJ Parkland Formula StatPearls, 2026.PMID 30725875
[3]Griffin BR, Frear CC, Babl F, et al. Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns Ann Emerg Med, 2020.PMID 31474480