Stop the burning process, assess depth and BSA, protect the airway, fluid resuscitate by Parkland formula.
Steps by Cert Level
ALL: Stop the burning: remove clothing/jewelry. Cool with room-temp water (NOT ice) for 10–20 min. Cover with dry sterile dressing. Assess: depth (superficial/partial/full), BSA (rule of nines), and inhalation injury.
EMT: O2 high flow — inhalation injury is the #1 cause of burn death. Monitor airway aggressively. Do NOT pop blisters.
AEMT: Large-bore IV x2. Parkland formula: 4mL x kg x %BSA in first 24h — give half in first 8h. Room-temp NS (not cold).
PARAMEDIC: Inhalation injury: early intubation before edema closes airway — delay = surgical airway or death. Cyanide consider if enclosed space fire: Hydroxocobalamin 5g IV. Morphine for pain 0.1mg/kg IV titrated.