(Palm of hand is about 1% BSA)
Referral to burn center:
- 2nd or 3rd Degree Burns covering > 10% TBSA
- Burns to vital organs
- Circumferential burns
- Electrical Burns
- Chemical Burns
- Inhalation Injury
- Concomitant trauma (If Major Trauma, The Trauma Center , Not the Burn Center should be the initial stabilizing unit)
- When in doubt , consult with a burn center
First 24h Fluid Requirements = TBSA burned (%) x Wt (kg) x 4 mL/kg
Give 1/2 of total requirements in 1st 8 hours, then give 2nd half over next 16 hours