Burns: Therapy

Depending on the severity of the injury, the emergency services should be called immediately after rescuing the patient from the danger area (emergency number 112).

Notice:

  • In the presence of a scald, in contrast to a burn, clothing should always be removed immediately.
  • In the presence of a burn, the burnt the clothing should not be removed.

Principles of prehospital care

  • Rescue from the danger zone and subsequent actions:
    1. Quickly eliminate any further exposure to heat. This means, for example, completely undressing a young child if he or she has hot tea poured over him or her. The clothing could still be soaked with hot water. Clothing stuck to the skin, however, should be left.
    2. Minor scalds / burns: affected skin area for max. 10 minutes with lukewarm running water (20 ° C) cool; alternatively cooling an extremity with wet towels (20 ° C).
    3. Fluid substitution from VKOF (burned body surface area) of 10%, or for transport time over 30 min, max. 10 ml/kgKG/h.
    4. Large scalds / burns (> 15% of VKOF) and throughout infancy: cooling therapy due torisk of hypothermia is not recommended.
    5. Infant: remove wet clothes and heat-retaining measures taken.
    6. Wound areas: Cover with metal-coated burn dressing Note: Moist dressings should not be used on extensive wounds, as well as when there is a risk of hypothermia!
  • Secure vital functions
  • Basic examination / anamnesis
  • 1-2 peripheral accesses for immediate infusion therapy.
  • Heat preservation for large burns/for small burns cooling* possible immediately after burns
  • Local sterile wound treatment, no cleaning
  • If necessary, early intubation / ventilation

* For cooling small area burns, use cool tap water, but not cold tap water (about 20 °C).

Criteria for admission to a severe burn center (modified from).

  • Second-degree burns of >15% of VKOF; children: 10% of VKOF.
  • 3rd degree burns of > 10% of VKOF; children: > 5% of VKOF.
  • Burn trauma of II or III degree, but with a risk factor:
    • Localization on the face, hand, foot, axillae or over large joints, anogenital.
    • Burn trauma caused by electric current
    • Inhalation trauma, including those associated with minor external burns (e.g., explosion accidents)
  • All thermal injuries 4th degree
  • Burns of children < 8 years / adults > 60 years.
  • Burns in persons with severe pre-existing conditions

Note: Children below the above indications for a severe burn center must be referred to a specialized burn hospital.

Medical supplies

Vaccinations

The following vaccinations are advised:

Physical therapy (including physiotherapy)

  • Early physiotherapy to maintain mobility v. a. with joint involvement.

Psychotherapy