Airway with C spine control - open the airway, remove foreign
body or debris, suction, 100% O2 by mask,
for inhalation injury, naso - or oro-tracheal intubation to protect
EtCO2 and pulse ox
2. Breathing - confirm bilateral air
sounds & CXR
3. Circulation - insert 2 large bore
IV's, insertion through unburned skin is preferred to burn skin,
site preferences are in peripheral vein, femoral vein, internal
jugular vein, then subclavian vein, weigh patient in kg, estimate
the % BSA of the burn; Burn Resuscitation formula = 2-4 ml
of LR x wt in kg x % BSA with 2nd and 3rd deg. burns, give 50% of
this volume over the first 8 hours, 25% over the second 8 hours,
and 25% over the third 8 hours.
VS, insert a catheter and maintain urine output > 0.5 cc/kg/hr.
Consider CVP monitoring.
4. Disability - assess level of consciousness
using the AVPU method (A - alert, V - responds to verbal stimulus,
P - responds to painful stimulus, U - unresponsive),
the pupils, note which extremities are moving,
AVPI & pupils
5. Exposure and Environmental Control
- remove all clothing and jewelry if not yet done, patients become
hypothermic very quickly, wrap patient in clean sheets and warm
core body temparatures and identify associated injuries.