Burns

Each year nearly 2 million Americans seek medical care for burn injuries. These injuries range from minor burns sustained in domestic cooking accidents to extensive full-thickness burns with associated traumatic injuries. Burns can result from exposure to flames, chemical contact, electrical current, or exposure to hot liquids (thermal substances). Because of the frequent presence of associated injuries, the burn patient must be evaluated in the same manner as any trauma patient. This evaluation is based on a systematic approach that identifies life-threatening injuries and initiates prompt treatment. The primary survey, which uses the mnemonic “ABC,” focuses on A—securing an airway, B—assessing breathing, and C—assessment of circulation and establishing vascular access. Establishment of IV access in the burn patient should preferably be via two large bore catheters placed in unburned skin. Once the primary survey is completed, a more focused secondary survey should be performed. The secondary survey should determine the percent of the body surface area burned, the degree of burn, the presence of inhalation injury, and the presence of other traumatic injuries.