The clinical picture of severe shock consists of pale cold skin and a rapid yet thready pulse. Urine output falls and the patient becomes increasingly restless and disorientated. Often consciousness is lost only as a preterminal event. Management Principles First aid Remove the casualty from further injury. Extinguish flames, remove clothing, turn off the electrical source, or douse the chemically burnt patient with water.
Flames ascend so lie the patient down.
Cover the burn with a clean dressing, avoid the patient getting cold and transfer to a hospital as soon as possible. Additional oxygen should be given during transfer. Primary management Airway - check the airway is clear. Endotracheal intubation is necessary if there are deep burns to the face and neck, soot in the nostrils, burns of the tongue and pharynx, stridor or hoarseness. Weigh the patient.