Acute Care 42: Burn Management Treatment Plan
Initial
Treatment of Burns
Remove all clothing, jewelry, and contact lenses.
Stop the burning process.
Immediately cool burn with water or saline if < 10% of BSA.
Cleanse
wounds with saline.
Dress wounds with loose gauze dressing.
Elevate extremities.
Cover with a clean sheet if > 10% BSA.
Keep the patient warm.
Medications
Pain control—morphine IV
Tetanus prophylaxis, 0.5 mL IM
Antibiotic IV
Cimetidine IV 300 mg
Burn Transfers
If comprehensive burn treatment is not available at your facility,
consider the following transfer guidelines:
Partial-thickness and full-thickness burns are 10% of
TBSA in
patients
(PEDS)
<10 years
and 50 years of age.
Full-thickness burns over 5% TBSA in any age group
Partial-thickness and full-thickness burns > 20% TBSA in other
age groups
Patients with burns and multiple injuries
Medical histories that might be complicated by a burn
Significant electrical injury including lightning
Partial-thickness and full-thickness burns of hands, feet, face, eyes,
ears, or perineum
Carbon monoxide > 10%
Suspicion of abuse (child or adult) requiring special social service or
long-term rehabilitation support
Evidence of pulmonary or respiratory distress
Transfer of any patient must be coordinated with the burn center physician. Document all pertinent information regarding tests, temperature, pulse, fluids administered, urinary output, and treatments. Send these with the patient.