• Patients with severe thermal burns have a considerable risk of death and morbidity.
  • Check for evidence of respiratory distress and smoke inhalation injury, which is a common cause of death in case of acute burn injury.
  • Laryngeal edema can develop suddenly.
  • Fluid resuscitation and the need for transfer are guided by burn depth and size.
  • Vascular collapse from burn shock is a crucial factor.
  • It is important to initiate rapid, aggressive fluid resuscitation to reconstitute intravascular volume and maintain end-organ perfusion.
  • The fluid requirement during the initial 24 hours of treatment is 4 mL/kg body weight for each percent of total body surface area burned, given IV. Superficial burns are not included in this calculation. Half of the calculated fluid need is to be given in the initial 8 hours; the remaining half is given over the next 16 hours.
  • It is important to monitor urine output and to maintain hourly urine output at 0.5 mL/kg in adults.
  • Burn patients may have been exposed to carbon monoxide and require high-flow oxygen.
  • Cool and clean the burn wounds, but avoid inducing hypothermia.
  • Any jewellery and any hot or burned clothing and debris not adherent to the skin must be removed.
  • Irrigation with cool water may be used.
  • Topical antibiotics to be applied to all non-superficial burns.
  • Give opioids for pain management; provide tetanus prophylaxis.