Topic Progress:

Topic One: Initial Management

A first, rapid, primary survey with an ABC - DE trauma management approach should be undertaken before a full assessment of the burn to ensure any life-threatening problems are identified. These can arise due to complications of the burn and from any non-burn injuries.


  • Remove any obstruction
  • Check for inhalation injury
  • Signs of oedema
  • Signs of soot around the nose and mouth, sooty sputum
  • Singed nasal hairs


  • Observe chest movement on inhalation and expiration, it’s character and depth, to ensure that the patient is breathing normally.
  • Check for respiratory distress, e.g. stridor, wheeze, dyspnoea.


  • Check the pulse at the carotid artery and then the distal points to assess for shock or localised constriction.
  • For any circumferential burns, check peripheral perfusion.

Disability/level of consciousness

  • Assess before attempting to move the patient
  • Assess pain levels


  • Remove any jewellery, loose clothing, dressings or nappies. NB – do not try to remove any clothing that is adhered to the skin.
  • If no initial first aid has been given (within three hours of injury), cool the wounds for 20 minutes using running water or a wet compress.
  • The burn injury can be covered with non-adherent loose strips of cling film. NB – do not apply to the face.
  • Implement active warming measures to prevent heat loss.

(Edwards & Griffiths, 2011; SWBC, 2018; Jeschke et al., 2018)