You are on page 1of 23

BASIC BURNS LIFE

SUPPORT
-Dr Annitha Annathurai
Department of Emergency Medicine
Singapore General Hospital

BBLSupport--Definition
• Providence of appropriate , emergent definitive treatment
within 1st 24hours of injury
• Understand the mechanism of injury: Explosion,Fire
( thermal), Chemical Burn, Electrical Burn,Lightning injury.
• Recognizing type of burns: Airway Burns
( Inhalational)Injuries
• Looking for associated injuries : multitrauma esp if
explosion Blast injuries
• Recognizing which types of burns need to transfer to a
Burns Centre for specialised care
• This is a standard Protocol driven Management which
should be agreed upon by medical personnel across the
region to ensure standardised care

BBLS—Important considerations
• Airway : Ensure patency
• Breathing: High flow oxygen
• Circulation: Good Intravenous access,
give fluids
• Removal of soiled clothes
• Cooling of burn sites
• Immediate evacuation from site of incident

Carbon monoxide poisoning
Inhalation injury above the glottis
Inhalation below the glottis
Any victim, burned in a closed area,
like a house fire, should be presumed
to have an inhalation injury until
proven otherwise

Give HIGH FLOW OXYGEN

Scene
Survey

•Cause of burns may still be active eg explosive, live
wires, chemical agents
•Fires in enclosed spaces increases risk of inhalational
injury, smoke may contain toxic gases CO, cyanide
•Stop ongoing burning process, remove clothes if
possible, rinse copiously with water

Patient
Assessmt

•Primary survey as for trauma patient, ABCs
•Signs of A/w burns
•Note %BSA and depth quickly
•Assess RR, chest wall, auscultation, neurological

Critical
Interventn

•Oxygen
•Cooling
•Stop Bleeding
•Ventolin nebulization if pt is wheezing

Identify
LOAD &
GO

•Inhalational injury
•>= 20% BSA second degree burns
•Send to burns centre

NOTIFY

• Inform the receiving hospital
early so that they are prepared to
receive patient

Secondary
Survey

•Signs of inhalational injury
•Signs of shock
•Extent and depth of burns
•Arrhythmia
•Cause of burns if not elicited earlier

IV Fluids
Wound care

•Start fluid management
•Cover burns sites with dry sterila nonstick
dressing
•Cooling body sites with water ( 10mins at least)

Analgesia

Entonox contraindicated in
inhalational injury
Cooling and evacuate ASAP

Indications:
SUSPECT
Chemical
Contaminatn

•An incident when 1 or more persons is exposed to
known release of chemical
•Suspicion of possible chemical contamination
•Multiple persons suffering fits or loss of
consciousness or breahtlessness simultanously in
an enclosed area

Scene
Survey

•Look for obvious fumes, chemical spill
•Don’t touch spilled chemicals
•Look for number of casualties
•If mass casualty then look for First Aid Post

DON PPE

•Ambulance Crew not expected to work in
contaminated area
•Wear gloves, aprons, mask
•Then examine patient

Patient
Assessment

•If whole body exposed or contaminated with
chemical agent, then for decontamination first
•Then re-evaluation for injuries.

For chemical burns, you must wash with copius water,
very often,
U can get reaction if small amt is used.
Esp to eye alkali or acid wash copiously.

Complicated with cardiac arrest, VF
Ensure scene safe and no more current
Before touching the casualty

Lightning injuries

2

1
1.

2.

3.

THANK
YOU