I think escharatomy eventually (at the time when indicated),assess airway , nasal 10L O2 ,establish 2 large bore IVs start fluids(per parkland's formula) and draw blood send for type & cross and electrolytes, connect to monitors, Antiacids for stress ulcers & brad spectrum Abx prophylaxis,Parenteral nutrition, debridement,prevent /support heat loss,intubation kit on standby, call for consult as indicated.
Dan Falke, If you read my comment carefully you'll realize i covered the basics (my comment is in order of A,B,C ,all the way to consult). Your notion of "treat the pt not a textbook" and "keep it simple " can't practically co-exist. I commented about long term measures like antacids ,debridment etc for learning purposes. I would've thought to intubate first instead of nasal 10L O2 but on this single image facial and neck burns don't look severe,i see skin sloughing off &alot of soot but no depth to the burns.
With this type of injury why would you treat with 10L nasal? Why not sedate, and intubate immediately? The injuries are obviously very critical, the airway with this percentage of body burn coverage has to have either nasal or oral compromise. Keep it simple, treat the patient not the textbook, how is debridement a life saving treatment before intubation? Antiacids? The basics: airway, breathing, circulation, shock, pain, infection. Then we can get more specific with antacids, nutrition, debridement, and a burn unit consult. Big words and lengthy treatment plans can delay patient care, and confuse the long term treatment plans! Just keep it simple ❤
First I would assess the airway, breathing, and circulation, then I would manage pain, and infection control. And of course an Escharotomy
Secure airway first, do tracheostomy imediately maybe patient has larynx edem, start with 2 iv line for circulation, then we prevent sepsis washed clearly the wound with sodium cloride and debridement
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