FIRST AID FOR BURNS

General Overview

Large burns are uncommon in the backcountry, but even small burns can be debilitating, painful and difficult to keep clean.  Small burns are relatively common backcountry injuries, typically secondary to hot water spills.

Treatment for Burns

  1. Ensure the scene is safe.
  2. Immediately soak or flush all burns in cold water. Remove clothing and constricting objects (e.g. jewelry, watches, belts).
  3. Assess and manage Airway, Breathing and Circulation problems.
  4. Gauge the depth, extent and location of the burns.
  5. Properly dress the burns with antibiotic ointment, burn gel, Silvadene ® cream or 2nd Skin ® covered loosely with sterile dressings. In extended care situations debride dead skin around blisters that have self-drained and clean several times daily.  Do not drain intact blisters.
  6. Pain medication as needed (NSAIDs often recommended).
  7. Aggressive hydration.
  8. If snow blindness is suspected, provide cool water flushes of the eye and cool compresses.  Rest and avoid sun exposure until symptoms resolve.

Evacuation Guidelines for Burns

Evacuate Rapidly:

  • Any patient with signs and symptoms of an airway burn.
  • Any patient with partial or full thickness burns covering more than 15% TBSA.
  • Any patient with partial or full thickness circumferential burns.

Evacuate:

  • Any patient with a full thickness burn.
  • Any patient with burns to a special function area: face, neck, hands, feet, armpits, or groin.
  • Any patient with a burn that cannot be managed effectively in the backcountry.

References:

“Burns.” United States Special Operations Command.  Special Operations Forces Medical Handbook.  Jackson, Wyoming: Teton NewMedia, 2001. 3-17.

Emergency Medical Technician-Basic: National Standard Curriculum Module 5 Trauma.  22 June 1995.  National Highway Traffic Safety Administration United States Department of Transportation.  2 Dec 2004. <www.nhtsa.dot.gov/people/injury/ems/pub/emtbnsc.pd>

Forgey, William.  “Burn Management.” Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care 2nd ed. Guilford, Connecticut: The Globe Pequot Press, 2001.  Chapter 7.

Schimelpfenig, Tod and Linda Lindsey.  “Burns and Lightning Injuries.” Wilderness First Aid 3rd ed.  Mechanicsburg, Pennsylvania: Stackpole Books, 2000.  Chapter 4.

Specific Protocols for Wilderness EMS Wounds.  Version 1.2 May 19, 1994.  The Wilderness Emergency Medical Services Institute.  2 Dec. 2004.  <http://www.wemsi.org/specific.html>;

Stewart, Charles E.  “Burns.” Environmental Emergencies.  Baltimore, Maryland: Williams & Wilkins, 1990.  Chapter 2.

The Merck Manual 16th Edition.  Rathaway, New Jersey: Merck & Co., Inc., 1992.

Tilton, Buck.  “Wilderness Wound Mangament.” Wilderness First Responder 2nd ed.  Guilford, Connecticut: The Globe Pequot Press, 2004.  Chapter 15.

Wilkerson, James A.  “Burns.” Medicine for Mountaineering 5th ed.  Seattle, Washington: The Mountaineers Books, 2001. Chapter 8.

Tags: First Aid,

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