BURN

FIRST PRIORITY!
1. AIRWAY
2. STOP THE BURNING PROCESS
3. IV

1. AIRWAY
Can cause massive edema -> upper airway risk for obstruction
Early ENDOCHARDIAL TUBE is essential.
>> risk upper airway obs = >> burn size and depth, burns head and face,
burns inside mouth, inhalation injury
Inhalation injury = because EXPOSURE to heat (even larynx protects the subglottic
airway from direct thermal injury)
Indikasi: (kalau ada indikasi tsb, langsung INTUBASI)
- Face and/or neck burns
- Singeing of the eyebrows and nasal vibrissae
- Carbon deposits in the mouth and/or nose and carbonaceous sputum
- Acute inflammatory changes in the orophar- ynx, including erythema
- Hoarseness
- History of impaired mentation and/or confine- ment in a burning environment
- Explosion with burns to head and torso
- Carboxyhemoglobin level greater than 10% in a patient who was involved in a fire
Burns head and mouth -> cause MORE localized edema
Children are at higher risk because their airways are smaller.
Kalau ada STRIDOR, segera INTUBASI
Burns di LEHER, segera INTUBASI

2. STOP THE BURNING PROCESS

LEPAS semua pakaian dan perhiasan
But do not PEEL OFF
Dry chemical powder di remove dari wound
Pokoknya, jauhkan pasien dari bahan chemical nya
Badan yang terkena, harus segera di alirkan WARM TAP WATER
Covered with WARM, CLEAN, DRY linen biar TIDAK HYPOTHERMIA

3. INTRAVENOUS ACCESS
Kalau BURN >20% of the body surface -> FLUID RESUSITASI
Large-caliber (at least 16-gauge) IV lines should be introduced
immediately in a peripheral vein.
Lebih disarankan UPPER extrimities, krn lower -> phlebitis & septic
phlebitis
ISOTONIC CRYSTALOID -> RINGER LACTATE
ASSESMENT OF THE PATIENT!