Burns

On-Scene

1st and 2nd Degree

  • Start fluids through an IV
  • Clean with Saline
  • Add burn gel to burns
  • Loosely wrap with non-adhesive gauze

3rd Degree

  • Start fluids through an IV
  • Cool down with Saline

In Hospital

1st Degree - Superficial

No surgery required

  • Start fluids through an IV if not already started
  • Cool the burn with a cool, not cold, flush or cool compress
  • Apply burn cream if needed
  • Apply clean, sterile bandages
  • Treat Pain with over the counter pain medication
  • Inform the patient to follow-up with a doctor:
    • At signs of an infection (increased pain, redness, swelling, fever, oozing)
    • Hasn’t been updated on a Tetanus shot
    • Blister becomes larger than 2 inches
    • Redness and pain lasts longer than a few hours

2nd Degree - Some Blisters

No surgery required

  • Start fluids through an IV if not already started
  • Cool the burn with a cool, not cold, flush or cool compress
    • Don’t break blisters as this can cause infection
  • Apply burn cream and antibiotic ointment
  • Apply clean, sterile bandages
  • Treat Pain with over the counter pain medication
  • Inform the patient to follow-up with a doctor:
    • At signs of an infection (increased pain, redness, swelling, fever, oozing)
    • Hasn’t been updated on a Tetanus shot
    • Blister becomes larger than 2 inches
    • Redness and pain lasts longer than a few hours

3rd Degree - Destroyed Skin

Surgery Required

  • Start fluids through an IV if not already started
  • Move the patient into the operating room
  • Apply an oxygen mask
  • Administer a general anasthetic
  • Clean out the affected area with saline
  • Remove any debris inside the wound
  • Either collect a skin graft from the patient, or grab a synthetic graft from the other room
  • Attach the skin graft
  • Ensure success
  • Administer antibiotics
  • Check vitals
  • Move patient to recovery

Complications of 3rd Degree Burns

  • Arrhythmia, or heart rhythm disturbances, caused by an electrical burn.
  • Dehydration.
  • Disfiguring scars and contractures.
  • Edema (excess fluid and swelling in tissues).
  • Organ failure.
  • Pneumonia.
  • Seriously low blood pressure (hypotension) that may lead to shock.
  • Severe infection that may lead to amputation or sepsis.

4th Degree - Past Skin, Into Muscles/Bone

NOTE: Amputations are not allowed in some servers. Refer to your server rules or check with a server admin before proceeding

  • Start fluids through an IV if not already started
  • Move the patient into the operating room
  • Apply an oxygen mask
  • Administer a general anasthetic
  • Assess the situation
    • Determine if amputation is required
  • Amputate if necessary
  • Clean and suture wound
  • Ensure success and good vitals
  • Administer antibiotics
  • Move patient to ICU for recovery