| Degree | Burn Depth/Penetration | Appearance |
|---|---|---|
| First | Epidermis only | Sunburn-like, no blistering |
| Second | Epidermis + partial dermis | Blistering |
| Third | Dermis + underlying tissue (full thickness) | Eschar and/or whitish gray appearance |
- TBSA (total body surface area): count only 2nd- and 3rd-degree burns.
- Age of Pt (age + TBSA = % probability of mortality).
- Pulmonary injury (smoke inhalation, toxic fumes).
- Associated injuries (airway burns and other trauma).
- Chemical/electrical burns, carbon monoxide poisoning.
- Pre-existing diseases (potential for exacerbation).
- Anticipate laryngospasm/airway complications.
- Anticipate and prepare for transfer to a burn center.
- Initiate fluid resuscitation as ordered.
Fluid Resuscitation-First 24 hr (start from time of injury)
Indications
- Adults with 2nd- or 3rd-degree burns >20% of TBSA.
- Children >1 yr with 2nd- or 3rd-degree burns
15% TBSA. - All infants with 2nd- or 3rd-degree burns of 10% TBSA.
Management (Parkland Formula)
- 4 mL × kg × %TBSA burned (2nd-degree + 3rd-degree burn injury).
- Infuse half over the first 8 hr (from time of burn).
- Infuse the remaining half over the next 16 hr.
