3-19. ADDITIONAL CONCERNS
Be aware of the following when treating a burn patient:
a. Look for associated injuries.
b. Check the eyes and cover with moist sterile pads.
c. Check pulses of the extremities. Circumferential burns may act as a
tourniquet to block the patient's circulation.
d. For a patient with third-degree burns covering more than 10 percent of the
body (or with extensive burns of varying degrees), start an IV. Hang Plasmamate or a
similar colloid, if available.
e. DO NOT waste time picking debris off the patient's skin. Cover him with a
sterile sheet or clean dressings. Areas with equal burn depth should be covered with
cold, soaked towels.
f. Remove bracelets, rings, etc. since edema will soon follow the burn.
g. Treat associated fractures, lacerations, and other injuries.
Section IV. FLUID REPLACEMENT AND MEASUREMENT OF URINE OUTPUT
3-20. REPLACE FLUIDS
Almost immediately after a severe burn injury, many physiologic changes occur
in the body. One change involves fluid in the body. After a burn, body fluid moves
toward the burned area which is the reason for some swelling at the burn site. Some of
this fluid is then trapped in the burn area which means that fluid is not available for use
elsewhere in the body. The result is fluid loss in the body. Fluid is also lost from the
burned area in the form of water vapor and seepage. Sometimes, large amounts of
water are lost. For the body to function normally again, the lost fluids must be replaced.
3-21. CALCULATE FLUID AMOUNT
a. Calculation. To calculate the amount of fluid the casualty needs, use the
modified Brooke formula. This formula should be used when treating a casualty during
the first 24 hours after a burn. Remember, using any formula to determine a casualty's
fluid volume requirement is an estimate. Be sure to monitor the casualty's fluid intake
and output as well as his pulse, respirations, blood pressure, and general appearance.
Make appropriate changes in the amount of fluid being given the casualty as needed.
Replacing the fluids a person with a burn injury has lost is called fluid resuscitation.