Burns patients form a large group of trauma patients cared for by rst-aiders, ambulance staff, nurses and doctors before reaching specialist care in hospital. Guidance for these important carers is often poor or confused and this engenders anxiety and detracts from optimal patient care. This paper outlines nine key steps in the initial management of burn patients in the prehospital environment based on current available evidence and a consensus of specialists of all disciplines caring for burns patients. The basis of care should be that simple things should always be performed well.
Childs C.1994. Temperature regulation in burned patients. J Intens Care131-134.
8.
Clayton MC, Solem LD.1995. No ice, no butter. Advice on management of burns for primarycare physicians. Postgrad Med97: 151-160, 165-165.
9.
Coats TJ, Edwards C, Newton R, Staun E.2002. The effect of gel burns dressings on skin temperature. Emerg Med J19: 224-225.
10.
Cole RP, Shakespeare PG, Chissell HG, Jones SG.1991. Thermographic assessment of burns using a nonpermeable membrane as wound covering. Burns17: 117-122.
11.
Collis N, Smith G, Fenton OM.1999. Accuracy of burn size estimation and subsequent fluid resus citation prior to arrival at the Yorkshire Regional Burns Unit. A three year retrospective study. Burns25: 345-351.
12.
Cooke MW, Morrell R, Wilson Set al.1999. Does criteria based dispatch of 999 calls adequately detect the critically ill and injured?Prehospital Immediate Care3: 191-195.
13.
Cummings G, O’Keefe G.2000. Scene disposition and mode of transport following rural trauma: a prospective cohort study comparing patient costs. J Emerg Med18: 349-354.
14.
Dalton AM.1995. Prehospital intravenous fluid replacement in trauma: an outmoded concept?J Roy Soc Med88: 213-216.
15.
Demling RH, Mazess RB, Wolberg W.1979. The effect of immediate and delayed cold immersion on burn edema formation and resorption. J Trauma19: 56-60.
16.
De Wing MD, Curry T, Stephenson E, Palmieri T, Greenhalgh DG.2000. Cost-effective use of helicopters for the transportation of patients with burn injuries. J Burn Care Rehabil21: 535-540.
17.
First aid manual. The authorised manual of St John Ambulance, St Andrew’s Ambulance Association and the British Red Cross. London: Dorling Kindersley, 1997.
18.
GreavesI, Porter K eds. 1999. Scene approach, assessment and safety. In: Prehospital medicine: the principles and practice of immediate care. London: Arnold, 273-279.
19.
Greaves I HTPK ed. 1997a. Basic life support. In: Emergency care: a textbook for paramedics. London: WB Saunders, 17-26.
20.
Greaves I HTPK ed. 1997b. Burns. In: Emergency care: a textbook for paramedics. London: WB Saunders,270-278.
21.
Hammond JS, Ward CG.1987. Transfers from emergency room to burn center: errors in burn size estimate. J Trauma27: 1161-1165.
22.
Henry S, Scalea TM.1999. Resuscitation in the new millennium. Surg Clin N Am79: 1259-1267, viii-viii.
23.
Hodgetts T, McNeil I, Cooke M.1995. The prehospital emergency management master. London: BMJ.
24.
Hodson AH.1992. Treating burns by initial cooling. J Roy Soc Med85: 121-121.
25.
IHCD. 1991. Ambulance service basic training. Bristol: IHCD.
26.
IHCD. 1994. Ambulance service paramedic training. 3. Bristol: IHCD.
27.
Jandera V, Hudson DA, de Wet PM, Innes PM, Rode H.2000.Coolingthe burn wound: evaluation of different modalites. Burns26: 265-270.
28.
Jelenko C, III, Jennings WD Jr, O’Kelley WR III, Byrd HC.1971. Threshold burning effects on distant microcirculation. I. Preliminary observations. Arch Surg102: 617-625.
29.
Jelenko C III, Jennings WD Jr, O’Kelley WR III, Byrd HC.1973. Threshold burning effects on distant microcirculation. II. The relationship of area burnt to microvascular size. Arch Surg106: 317-319.
30.
Jelenko C III, Jennings WD Jr, O’Kelley WR III, Byrd HC.1974. Threshold burning effects on distant microcirculation: presence of a passively transfer-rable, nondialyzable arteriolar constrictor substance in blood of burned patients. Am Surg40: 388-391.
31.
Judkins KC.1999.Thermal injury. In: Greaves I, Porter K eds. Prehospital medicine: the principles and practice of immediate care. London: Arnold, 375-387.
32.
Kendall JM, Reeves BC, Latter VS.2001. Multicentre randomised controlled trial of nasal diamorphine for analgesia in children and teenagers with clinical fractures. BMJ322: 261-265.
33.
King TC, Price PB.1963. Surface cooling following extensive burns. JAMA183: 677-677.
34.
Kinsella J, Booth MG.1991. Pain relief in burns: James Laing memorial essay. Burns17: 391-395.
35.
Kravitz H.1970. First-aid therapy for burns - cool it: need to instruct laymen. Clin Pediatr (Phila)9: 695-697.
36.
Kravitz H.1974. Letter: cooling as first aid for burns. Pediatrics53: 766-766.
37.
Latarjet J.1990. Immediate cooling with water: emergency treatment of burns. Pediatrie (Bucur.)45: 237-239.
38.
Lawrence JC.1987. British Burn Association recommended first aid for burns and scalds. Burns Incl Therm Inj13: 153-153.
39.
Lawrence JC.1996. First-aid measures for the treatment of burns and scalds. J Wound Care5: 319-322.
40.
Marichy J, Chahir N, Peres-Tassart C, Abeguile R.2002. Prehospital management of burns. Pathol Biol (Paris)50: 74-81.
41.
McGugan EA, Paterson B, Nichol N, Klaassen B.2000. Re: accuracy of burn size estimation and subsequent fluid resuscitation prior to arrival at the Yorkshire Regional Burns Unit. A three year retrospective study. Burns26: 415-416.
Warden GD.1992. Burn shock resuscitation. World J Surg16: 16-23.
60.
Wilson JA, Kendall JM, Cornelius P.1997. Intranasal diamorphine for paediatric analgesia: assessment of safety and efficacy. J Accid Emerg Med14: 70-72.
