Burn Treatment

Initial treatment of burn casualties will be resuscitative.

When such casualties are first seen, a simple plan of treatment must include: maintenance of airway with ventilating support as needed, adequate fluid therapy, and careful records of input and output.

A. Maintenance of Airway

This is of particular importance in head and neck burns or in unconscious casualties. If large numbers of casualties are seen requiring transportation over long distances early in the post-burn period, tracheotomies may have to be done on a routine basis.

Tracheotomies done prior to the onset of edema are much easier to perform than when they are done after edema has resulted in respiratory obstruction. When only small numbers of casualties require treatment, tracheotomies are rarely required.

B. Fluid Therapy

The shock that is associated with an extensive burn will be severe, and survival of these casualties depends upon adequate, balanced fluid replacement therapy.

The military uses a standardized formula for determining the fluid requirements of burn casualties. The basic principle in these formulae is that the amount of fluid required is proportional to the percent of body surface burned and body weight.

The type of fluid used includes colloidal materials to replace the plasma constituents lost as well as electrolytes.

C. Fluid Requirements for First 24 Hours

(1) Colloid solutions: 0.5 ml x body weight in kilos x percent of body surface burned. (2) Electrolyte solutions: 1.5 x body weight in kilos x percent of body surface burned. (3) Additional fluids: 2000 ml 5-10% glucose in water.

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