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Early management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Management of the major burn wound in the first few hours entails:

  • first aid - see submenu; however:
    • if first aid by water cooling has not been instituted within 3 hours it does not have any benefit
    • in the latter case, wash the burn with either:
      • saline
      • soap and water
      • 0.1% chlorhexidine solution
  • elevate the burnt part in an attempt to reduce swelling
  • do not:
    • remove adherent clothing
    • break blisters unless directed by the burns unit to assess the depth of injury
    • cover with wet dressings as the thermoregulatory functions of skin are impaired and there will be a tendency to hypothermia
  • dressings for transport:
    • cover with a sterile, warm, non-adherent dressing whilst awaiting definitive care
    • a layer of clingfilm sheeting covered by a dry sheet and blanket is often effective; this limits evaporation and heat loss. However, in hot climates with long transit times, this can encourage the growth of bacteria with risk of systemic sepsis - consult burn unit.
    • an alternative if transport time is prolonged is tulle gras soaked in dilute chlorhexidine held in place with crepe bandage or loose, elasticated netting
  • be alert to the need for escharotomy and warn the receiving unit

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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