Hypovolaemia and haemoconcentration of the blood leads to a rising haematocrit which will result in poor systemic tissue perfusion. This is 'Burns Shock'. Red blood cells are lost both directly in the burn and as a result of increased fragility. Burn Shock is defined as the inability of the circulation to meet the needs of tissues for oxygen and nutrients and the removal of the metabolites. 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.