Burn Management
Standardize resuscitation and transfer of adult and pediatric burn patients.
Updated: 02/05/2025
BurnsParklandTransferCOCyanideOn this page3 sectionsHide sections
⚠️ Confirm burn center transfer contacts are current before use.
🏥Transfer Criteria
▼- Full thickness burns
- >10% TBSA partial thickness
- Deep burns: face, hands, genitalia, feet, perineum, joints
- Burns + trauma or complex comorbidities
- Inhalational injury suspected
- Pediatric burns
- All chemical, high-voltage (>1000V), lightning injuries
📞
Confirm contacts before use: ICU/polytrauma/pregnant → Santa Clara Medical Center. Non-ICU, stable → St. Francis Medical Center.
💧Adult Resuscitation (>20% TBSA)
▼- Use Lactated Ringer's
- Total 24h = 4 × weight(kg) × TBSA% → see Parkland calculator
- First ½ over first 8h from injury; second ½ over next 16h
- Foley — UOP goal 30–50 mL/hr, check hourly
🌬️CO & Cyanide
▼1
CO: COHb venous co-oximetry
If >3% in nonsmoker → 100% NRB O₂
2
Cyanide: elevated lactate + metabolic acidosis
Get ALL labs BEFORE hydroxocobalamin — affects all results including UA and ABG.
3
Hydroxocobalamin 70 mg/kg IV
Low threshold with inhalation injury or respiratory failure.
- Status
- AHS Official Protocol
- Source
- highland_burn_managment-CPG.docx
- Last reviewed / updated
- 02/05/2025