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SSM PRESENTATION
Ammaarah Isaacs
ISCAMM002
MBChB III
22 Aug 2022
METHODS
• Systematic review search on PubMed using the keywords 'burns', 'treatment', 'prehospital'
yielded 6 results of which 2 fit the inclusion criteria.
• Google Scholar keyword search for ‘fluid therapy in burns prehospital’ yielded 14800
results of which 1 fit the inclusion criteria
• Google Scholar free word search for ‘duration of cooling burns’ yielded 73 300 results of
which 1 fit the inclusion criteria
• Google search for 'burns algorithms prehospital’ of which 4 were utilized.
General burn assessment: Patient Extrication
1° - Superficial / Minor Ensure self and patient safety
START
Remove patient from burn source
2°- Moderate
Remove any restrictive clothing and
3° - Major jewellery
%TBSA ass. not included in superficial Cool burn with running tap water (8-15 ℃)
burns ≥ 20 min℃[1]. Hydrogel dressings alt. only if
no H2O available[1][2]
Primary Survey Secondary Survey
• Airway damaged? Management
• Inhalation injury?
Detailed Burn Assessment:
Airway Carbonaceous sputum • Early intubation 1°, 2° or 3° - assess %TBSA via
Closed space fire
YE • High flow O2 • Rule of 9’s or Palm method
Respiratory distress – hoarseness/stridor • Rule of 8’s – infants <10 kg
Cough / Dyspnoea
Singed facial / nasal hairs
S Minor: <10% adults, <5% paeds/elderly, <2% for full
NO Upper airway oedema[16] thickness
YE Shock Management:
Moderate: 10-20% adults, 5-10% paeds/elderly, 2-5% for
Breathing • Oxygenation – all burns victims full thickness
receive 100% O2 S 20 ml/kg IV bolus
Major: >20% adults, >10% paeds/elderly, >5% for full
Ringer's lactate[8] thickness[19]
• Assess for CO poisoning [16]
Fluid resuscitation:
• Insert IV
Continue with Parklands IV fluid administration
Circulation • Vitals – Glucose, BP, SATs, Temp
• Signs of hypoperfusion? Parklands Formula: Pain Management:
4 ml/kg x %TBSA x weight IV administration:
(kg) Morphine – 0.1 mg/kg[1]
• Trauma resus = total/2 Ketamine – 0.25 – 0.5 mg/kg[10][8]
• Assess altered mental
Disability status/consciousness – NO Wound care:
1/2 1/2
CO/CN poisoning Wrap wound in cling wrap