Page 76 - ATP-P 11th Ed

Table 19 PCC Role-Based Guidelines for Burn Management
PCC Role-based Guidelines for Nursing Care and Wound Management
SECTION 1 T T T T • Perform primary and secondary surveys for any trauma patient. Acute injuries found in
C
C
C
C
the primary and secondary survey should be addressed as per standard trauma protocols
C
C
C
C • Avoid becoming distracted by the appearance of burned tissues.
C
- C - C - C - Interventions Paradigm
A C C C Airway • Minimum: Allow casualty to maintain airway.
S L M P (Roles 1a/1b/1c) • Better: Facial burns may be associated with inhalation injury. Ag-
M S C P gressively monitor airway status and place the casualty in a recovery
position IAW TCCC Guidelines.
• Best: Given a trauma casualty who is unresponsive or has an airway
obstruction, perform a Head-Tilt Chin Lift or Jaw-thrust maneuver to
open the airway in accordance with TCCC guidelines.
Fluid • Estimate body total surface area (TBSA) burned using the Rule of
Resuscitation Nines initially (DD Form 1380).
(Roles 1a/1b/1c) • Note: Superficial (First-degree burns) are NOT used in the TBSA
calculation.
• If burns >20% TBSA, fluid resuscitation should be initiated as soon
as IV/IO access is established.
• Minimum: Oral intake of water
• Better: Oral intake of electrolyte solution
• Best: Oral intake of electrolyte solution
Hypothermia • Hypothermia prevention is extremely important for burn patients.
(Roles 1a/1b/1c) • For Burns >20%, place the casualty in the Heat-Reflective Shell or
Blizzard Survival blanket for the Hypothermia Prevention Kit to
both cover the burned areas and prevent hypothermia.
Pain Control • Analgesia in accordance with the PCC Guidelines may be adminis-
tered to treat burn pain.
Wounds • Minimum: Cover with clean sheet or dry gauze. Leave blisters in-
(Roles 1a/1b) tact. Avoid wet dressings.
• Better: Clean wounds by washing with any clean water (preferably
with antibacterial soap if available), dress wounds with any available
dressings; optimize wound and patient hygiene to the extent possible
given the environment.
• Best: Clean wounds by scrubbing gently with gauze and clean water,
followed by gauze dressing.
Wounds • Best: Clean wounds by scrubbing gently with gauze and chlorhexi-
(Role 1c) dine gluconate solution (if available) in clean water, followed by
gauze dressing. Repeat daily.
• Monitor vital signs.A
• Ensure all interventions noted above are completed by TCCC ASM and CLS personnel.
• Conduct inventory of all resources.
• Document all pertinent information on PCC Flowsheet (attached).
• Additional interventions include:
(continues)

66 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 67