Emergency Briefcase · Trauma & Burns

Burn Evaluation & Treatment

A structured workflow for depth, total body surface area, airway risk, perfusion, pain, and early burn-center coordination.

Stop the burning processTBSA drives fluidsUrine output guides

Progressive case

Commit before you reveal

A 76-kg adult has partial-thickness burns to the anterior trunk and a circumferential right arm after a garage fire.

Pattern recognition

Superficial, partial thickness, full thickness; reassess because burns evolve.

Rule of Nines or Lund–Browder; exclude superficial erythema.

Face, hands, feet, genitalia, perineum and major joints.

Electrical, chemical, inhalation, circumferential and associated trauma.

Circumferential injury can threaten limb perfusion or ventilation even when TBSA is modest.

Critical sequence

ABCDE and associated-trauma assessment.
Remove hot or wet items and jewelry; prevent hypothermia.
Estimate depth/TBSA and repeat distal neurovascular exams.
Analgesia, tetanus, clean covering and early burn consultation.
Use formula-guided warmed crystalloid as a starting point; titrate to endpoints.

Interactive tool

Weight (kg)% TBSA partial + full thickness

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4 mL × kg × %TBSA; half from time of burn in first 8 hours. Follow local protocol and titrate.

Cognitive traps

Formula fixation

The equation is an estimate, not an endpoint.

Overcounting TBSA

Do not include superficial erythema.

Cold resuscitation

Ice and prolonged cooling can worsen injury and hypothermia.

Static exam

Burns and perfusion evolve; reassess.

Knowledge check

1. Which burns count for resuscitation TBSA?

2. Formula fluids are best viewed as:

3. Lost Doppler signals with circumferential burn?

Stabilize first, size accurately, prevent hypothermia, and titrate to physiology—not the equation.

Education only. American Burn Association referral and ABLS resources.