NOTE:
Pulse oximeters are not effective on carbon monoxide poisoning patients.
They will falsely read 100 percent due to the carbon monoxide binding to the
hemoglobin.
6-8.
EXPOSE THE BURNED AREA
Remove all smoldering clothing and objects that retain heat. Cut and gently lift
away any clothing covering the burned area. Do not pull clothing over the burned
area.
CAUTION:
Do not cool the burned area with water on any burn greater than 10
percent body surface area. Over cooling of any burn can cause the
patient to become rapidly hypothermic.
CAUTION:
Do not immerse a third degree burn.
a. Stuck Clothing. If clothing is stuck to the burned area, cut around the
clothing and do not disturb the stuck clothing.
b. Jewelry. If the casualty is wearing jewelry on a burned arm or hand,
remove the jewelry and put it in his pocket. Burns often cause swelling and the jewelry
may have to be cut off later if it is not removed now. Tell the casualty what you are
doing and why.
c. Chemical Environment. If you are in a chemical environment, do not
expose the wound. Apply the dressing over the protective garments.
6-9.
ESTIMATE THE PERCENT OF BODY SURFACE AREA BURNED
An estimate of the percent of body surface burned is used to determine if fluid
replacement (intravenous infusion) is needed to prevent or help control shock and, if
so, the amount of fluid to be administered. The amount of body surface burned can be
estimated using the "rule of nines." The approximate skin surface of each section of
an adult body is shown in figure 6-3.
a. When estimating the amount of skin surface burned to determine the
amount of intravenous fluids to be administered, only count the areas covered by
second-degree and/or third-degree burns.
b. If the casualty is a small child, the percentages change slightly. Figure 6-4
gives the approximate body surface area (BSA) percentages for a small child.
MD0554
6-6