Burn Severity Assessment in a Survival Situation — How to Determine?

Assessing Burn Depth

Burns can be categorized into four main types: first-degree (superficial), second-degree (partial-thickness), third-degree (full-thickness), and fourth-degree (escharotic). The most critical factor in determining burn severity is the depth of tissue damage. To assess burn depth, gently press the burned area with a gloved finger; if blanching occurs, it’s a second-degree burn. For third-degree burns, the skin will feel leathery and may be charred.

Evaluating Total Body Surface Area Affected

The Rule of Nines is a widely accepted method for estimating total body surface area (TBSA) affected by a burn. This involves dividing the body into sections, each representing approximately 9% of TBSA. The head and neck count as one section, the front and back of each arm count as one section each, the chest and abdomen count as one section, and the legs count as three sections each. For burns on children, use the Lund and Browder chart, which adjusts for age-dependent body proportions.

Applying the Burn Severity Assessment

Based on the assessment, provide immediate care for burns of all depths, including cooling, debridement, and dressing. For second- and third-degree burns, consider the extent of the injury and the patient’s overall condition when planning for transportation or evacuation. In severe cases, prioritize preventing shock and maintaining a stable airway, breathing, and circulation (ABCs). This may involve establishing an intravenous line, administering fluids, and providing oxygen therapy as needed.