Figure 13-16.Rules of nine.
The head and neck
The front of each leg
The back of each leg
The upper back
The lower back and buttocks
As a general rule, all third-degree burns should be
regarded as serious, as should first-degree and
second-degree burns that cover more than 15 percent
of a casualtys body. All facial burns should also be
regarded as serious.
A casualty with a serious burn will usually be
experiencing shock, and the patients life may be in
danger. The casualty must receive emergency
treatment immediately. You should then get medical
assistance or transport the casualty to an aid station as
soon as possible.
Thermal Burns.If a casualty is suffering from a
serious thermal burn, you should take the following
1. Ensure there is an open airway.
2. Treat to prevent infection.
3. Treat for shock.
Ensure there is an open airway. Hot gases or smoke
may have caused the casualtys airway to swell shut.
Tilt the casualtys head to the chin-up position. If the
casualty is not breathing, apply artificial ventilation. If
the casualty is breathing but has facial burns, place the
casualty in a sitting position if this makes breathing
TREAT TO PREVENT INFECTION.Cover
the entire burned area with a sterile dressing. Do not
put ointments, antiseptics, or other medications on
a burn. These will interfere with later treatment. To
prevent infection of the burn, you must observe the
Never allow any unsterile objects or material to
come into contact with the burn. (However, in an
emergency situation when no sterile dressing is
available, you may cover the burn with a clean sheet or
an unused plastic bag.)
Never use rough textured materials like blankets
to cover the burn.
Never attempt to break blisters.
Never attempt to remove shreds of tissue or
charred clothing from the burn.
For thermal burns of the eye, make sure that the
casualty does not rub the eyes. Cover each eye with a
small, moist, thick compress. Fasten the compress in
place with a bandage. Treat the casualty for shock.
To treat for shock, maintain the casualtys body
heat, but do not allow the casualty to become
overheated. If the casualty is in severe pain, you may
administer morphine, but only under the mass casualty
conditions discussed earlier. A seriously burned
casualty has an overwhelming need for liquids. If the
casualty is conscious, has no internal injuries, and is
not vomiting, prepare a weak solution of salt (1
teaspoon) and baking soda (1/2 teaspoon) in a quart of
warm water. Allow the casualty to sip slowly.
Chemical Burns.Corrosive chemicals that
come in contact with body tissues may cause chemical
burns. To treat acasualty with a serious chemical burn,
take the following steps:
1. Immediately flush the burned area with large
amounts of water. Pour water over the area; use a hose
or shower if one is available. Do not apply water too
forcefully, because this could further damage the
burned tissue. While the area is being flushed, remove
the casualtys clothing, including the shoes and socks.
Keep flushing the area until all traces of the chemical
have been removed.
2. Gently pat the burned area with sterile gauze.
Do not rub the area with the gauze. Be careful not to
break the skin or open any blisters.
3. Prevent infection by covering the entire burned
area with a sterile dressing, just as you would for a