🚑 EmergencyTrauma / SurgicalStudentInternResident

Burns

Also known as: burn injury · thermal injury · scald

Thermal, chemical or electrical injury to the skin (and sometimes the airway). Assess the airway, estimate the burned area, and resuscitate with fluids — early structured care saves lives.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

All ages; scalds are common in children and flame burns in adults; risk in epilepsy and in occupational/household settings.

Red flags — escalate / refer

Inhalation injury (facial burns, soot, hoarse voice, stridor) → secure the airway EARLY.
Large/deep, circumferential, chemical/electrical/high-voltage burns, or burns with trauma → major burn: refer to a burns unit.

Work-up / diagnosis

1ABCDE with a trauma lens; assess the airway for inhalation injury.
2Estimate burn size (% TBSA — rule of nines; the patient's palm ≈ 1%) and depth; weigh the patient (drives fluids).
3Look for associated injuries and carbon-monoxide/cyanide exposure.

Management — overview

Airway first: intubate early for inhalation injury; give high-flow oxygen.
Fluid resuscitation for significant burns using a formula (e.g. Parkland), titrated to urine output.
Analgesia; cool the burn (avoid hypothermia), remove constrictions; clean and dress wounds; give tetanus prophylaxis.
Circumferential/deep burns compromising perfusion or breathing → escharotomy. Refer major burns.

In-depthFull dosing & advanced protocol

Drug dosing

IV Ringer's lactate (Parkland formula)

Fluid resuscitation for significant burns

Adult dose: 4 mL × weight(kg) × %TBSA over 24 h from injury (half in the first 8 h); titrate to urine output
Route: Intravenous

Caution: Use %TBSA of second-degree+ burns; the formula is a starting estimate — titrate to urine output.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Analgesia (opioid) + tetanus prophylaxis

Pain control & prophylaxis

Adult dose: IV opioid titrated; tetanus per status
Route: IV

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Airway, escharotomy & referral

Inhalation injury: a low threshold for early intubation before airway oedema develops; consider CO/cyanide toxicity.
Circumferential full-thickness burns: escharotomy to restore perfusion/ventilation.
Refer to a burns unit by size/depth/site (face, hands, perineum), age, and mechanism (electrical/chemical).

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

IV Ringer's lactate (Parkland formula)

Analgesia (opioid) + tetanus prophylaxis

📈 Airway, escharotomy & referral

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

IV Ringer's lactate (Parkland formula)

Analgesia (opioid) + tetanus prophylaxis

📈 Airway, escharotomy & referral

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Airway, escharotomy & referral

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Airway, escharotomy & referral

References