BASIC BURNS LIFE

SUPPORT
-Dr Annitha Annathurai
Department of Emergency Medicine
Singapore General Hospital

BBLSupport--Definition
Providence of appropriate , emergent definitive treatment
within 1st 24hours of injury
Understand the mechanism of injury: Explosion,Fire
( thermal), Chemical Burn, Electrical Burn,Lightning injury.
Recognizing type of burns: Airway Burns
( Inhalational)Injuries
Looking for associated injuries : multitrauma esp if
explosion Blast injuries
Recognizing which types of burns need to transfer to a
Burns Centre for specialised care
This is a standard Protocol driven Management which
should be agreed upon by medical personnel across the
region to ensure standardised care

BBLSImportant considerations
Airway : Ensure patency
Breathing: High flow oxygen
Circulation: Good Intravenous access,
give fluids
Removal of soiled clothes
Cooling of burn sites
Immediate evacuation from site of incident

Carbon monoxide poisoning

Inhalation injury above the glottis
Inhalation below the glottis
Any victim, burned in a closed area,
like a house fire, should be presumed
to have an inhalation injury until
proven otherwise

Give HIGH FLOW OXYGEN

Scene
Survey

Cause of burns may still be active eg explosive, live

wires, chemical agents
Fires in enclosed spaces increases risk of inhalational
injury, smoke may contain toxic gases CO, cyanide
Stop ongoing burning process, remove clothes if
possible, rinse copiously with water

Patient
Assessmt

Primary survey as for trauma patient, ABCs

Signs of A/w burns
Note %BSA and depth quickly
Assess RR, chest wall, auscultation, neurological

Critical
Interventn

Oxygen
Cooling
Stop Bleeding
Ventolin nebulization if pt is wheezing

Identify
LOAD &
GO

Inhalational injury
>= 20% BSA second degree burns
Send to burns centre

NOTIFY

Inform the receiving hospital

early so that they are prepared to
receive patient

Secondary
Survey

Signs of inhalational injury

Signs of shock
Extent and depth of burns
Arrhythmia
Cause of burns if not elicited earlier

IV Fluids
Wound care

Start fluid management

Cover burns sites with dry sterila nonstick
dressing
Cooling body sites with water ( 10mins at least)

Analgesia

Entonox contraindicated in
inhalational injury
Cooling and evacuate ASAP

Indications:
SUSPECT
Chemical
Contaminatn

An incident when 1 or more persons is exposed to

known release of chemical
Suspicion of possible chemical contamination
Multiple persons suffering fits or loss of
consciousness or breahtlessness simultanously in
an enclosed area

Scene
Survey

Look for obvious fumes, chemical spill

Dont touch spilled chemicals
Look for number of casualties
If mass casualty then look for First Aid Post

DON PPE

Ambulance Crew not expected to work in

contaminated area
Wear gloves, aprons, mask
Then examine patient

Patient
Assessment

If whole body exposed or contaminated with

chemical agent, then for decontamination first
Then re-evaluation for injuries.

For chemical burns, you must wash with copius water,

very often,
U can get reaction if small amt is used.
Esp to eye alkali or acid wash copiously.

Complicated with cardiac arrest, VF

Ensure scene safe and no more current
Before touching the casualty

Lightning injuries

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THANK
YOU