INITIAL ASSESSMENT AND MANAGEMENT OF THE BURN INJURED PATIENT

BURNSURGERY.ORG

Educating the burn care professionals around the world

Section 1

INITIAL BURN ASSESSMENT TOOL

Name:

Age: Sex:

Injury Date & Time:

Assessment Date & Time:

Pulmonary:

0-36 Hours

Is there a facial burn?
Is there an airway injury: (redness, edema)
Yes
Yes
No
No

Is smoke inhalation injury present? If present, what is the Carbon Monoxide level? CO HGB Yes No

Current pulmonary status getting better or worse? Yes No

Is there a deep chest wall burn? Yes No

Cardiovascular Status

Is the patient stable? Yes No

Is status changing? Better Worse

Is vascular access and fluid treatment adequate? Yes No

Are there any circumferential extremity burns or jewelry which can impair perfusion? Yes No

Outcome Predictors:

0-36 Hours

Type of Burn: Flames?
                         Explosion?

If yes, is there injury to eye or ear?

     Hot Liquids?

                         Chemical?

If yes, is there eye injury?
Yes
Yes

Yes

Yes

Yes

Yes
No
No

No

No

No

No

                       Electrical
Was it low or high voltage?
Yes
Low <500 volts
No
High >1500 volts

Is there evidence of muscle or nerve damage? Yes No

Are there other traumatic injuries present? If yes, specify Yes No

Skin Integrity:

What body parts are burned: head, face, neck, chest, back, arms, hands, legs, feet (circle)

What percent total body surface area is burned?

Are there high risk areas involved? If yes, specify area: face, hands, feet, perineum (circle)

Yes

No

What depth is the burn? 1^st, 2^nd, 3^rd

Criteria for Burn Center transfer present?

Yes
No