Action

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)

Question

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?

Your Answer: Yes

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

Your Answer: Yes