Burns 101 Triage Video Lecture | Introduction to Burn Care: Medical Treatment - Health & Fitness

deciding which patients need to be
admitted
or to the ICU is the most important
decision you'll make in the emergency
room at our institution we generally
admit patients to the ICU when they have
an inhalation injury or when they have a
total body surface area burned of
greater than 20% or greater than 15% in
children and in adults over 60 of course
these are general guidelines the
following segment we're going to talk
about the exact vocabulary used to
describe burns and prescribe a
systematic approach to the questions
that every patient has to be asked first
let's review a basic checklist that you
should follow in the first 30 minutes of
meeting a new burn patient in the
emergency department particularly with
serious burns requiring admission to the
ICU
there should be an emphasis on prompt
transfer out of the emergency room first
the ABCs assess and secure the airway if
necessary place the patient on 100%
oxygen and establish adequate IV access
ensure that the patient is being kept
warm with warm blankets or a Bair hugger
expose the patient completely and
examine the patient for circumferential
burns of the trunk or extremities and
elevate burn limbs above the level of
the heart rule out traumatic injuries or
other major medical problems as
necessary next start your assessment get
a chest x-ray if there's any question of
inhalation injury or in medically
unstable patients get a blood gas and a
carboxyhemoglobin level if you suspect
inhalation injury calculate the
percentage of body surface area burned
using the burn chart do a Woods lamp
exam of the corneas next begin treatment
use a burn chart to calculate the burn
area and use that number to calculate
your resuscitation fluids if the burn is
large enough to require formal
resuscitation place it Foley to measure
urine output give a tetanus shot
don't forget analgesia but be mindful of
overdoses of narcotic medications
remember ABC's first finally decide on
disposition should the patient be
admitted or discharged if the patient
will need admission should he or she
come into the ICU or go to the floor the
American burn Association has
established that the following injury
circumstances are indications for early
consultation and referral to a
specialized Bernsen
her partial thickness burns greater than
10% any full thickness burns burns to
hands face feet genitals or major joints
electrical burns including lightning
injuries chemical burns inhalation
injuries burns in patients with
pre-existing medical disorders that can
complicate management prolong recovery
or affect mortality burns with
concomitant trauma where the burn poses
the greatest risk of morbidity or
mortality and burn children in hospitals
without personnel or equipment to care
for children also burn injuries
requiring special social emotional or
rehabilitative interventions patients
are admitted because we can provide
something that they cannot provide for
themselves these are wound care pain
control therapy and psychosocial support