While awaiting transfer assess and initiate fluid resuscitation
**Initial Fluid Rate – LR
(LR is fluid of choice, but NS can be used if LR is not available)
< 5 years : 125ml/hr.
6-12 years : 250ml/hr.
> 13 years: 500 ml/hr
Resuscitation Fluid Rate – LR
Calculate Burn Fluid Resuscitation Rate for a 24- hour period, adjusting for urine output (U/O)
-Adults & Children (≥13 yrs): 2mL x kg x TBSA% divided by 16
-(U/O 0.5 mL/kg/hr or 30-50 mL/hr)
-Infants/Children (<12 years): 3 mL x kg x TBSA % divided by 16
-plus D5LR at maintenance rate using 4/2/1 rule
-(U/O 0.5-1 mL/kg/hr or 30 mL if over 30 kg)
-Electrical injury: 4mL x kg x TBSA% divided by 16 (adults with pigment in urine: U/O 75-100 mL/hr)
Does patient have Airway involvement?
Burns to face and neck
Circumferential torso burn
Burned while in a closed space
Hoarse voice, Hypoxia, stridor
Burns > 20% TBSA can cause edema formation, regardless of area
Isolated thermal injury without trauma or impending airway obstruction?
Does patient meet American Burn Association Referral Criteria?
10% TBSA
Burns over any joint, face, perineum, hands, or feet
3rd degree injury of any size
Pre-existing medical conditions
Electrical / Chemical injuries
Inhalation injury
Burn injury along with trauma
Circumferential injury