Heat & Chemical Burns

Burn injuries—whether caused by fire, hot surfaces, or caustic chemicals—are among the most painful and complex traumas to manage. Burns don’t just damage skin—they can disrupt fluids, electrolytes, and even internal systems depending on severity and exposure.

At Scene Care

1st & 2nd Degree Burns (Red, Painful, Possibly Blistered)

  1. Set up an IV to start giving the patient fluids.
  2. Rinse the burn gently with saline to clean the area.
  3. Apply burn gel to help cool the skin and prevent further damage.
  4. Wrap the burn loosely with non-stick gauze so it doesn’t stick to the wound.

3rd Degree Burns (White, Black, or Deep Burns)

  1. Set up an IV to start fluids immediately.
  2. Gently rinse the area with saline to help cool the burn.
    Note: Don’t scrub or apply pressure.

Useful Prompts

/me Looks Over Patient and Assesses for Injuries

/me Grabs Intravenous Line and Establishes IV on Patients Arm

/me Starts IV with Saline to Restore Patients Fluid Balance and Hydrate Tissues

/me Pours Sterile Saline Over Burns to Remove Foreign Material

/me Applies Burn Gel to Cool Skin

/me Loosly Applies Non-Stick Gauze Pad to Burn Area

At Hospital Care

1st Degree (Like a Sunburn)

  1. Start or continue an IV if not already done.
  2. Gently cool the area using a cool (not cold) flush or damp cloth.
  3. Apply burn cream if the patient is still uncomfortable.
  4. Cover the burn with a clean, sterile bandage.
  5. Give over-the-counter pain relief (e.g., ibuprofen or paracetamol).
  6. Advise follow-up with a doctor if:
    • The area becomes redder, more painful, swollen, or starts to ooze.
    • The patient hasn’t had a tetanus shot in recent years.
    • Blisters form and are larger than 2 inches.
    • Pain or redness lasts longer than a few hours.

2nd Degree (Blistering, Moist Surface)

  1. Start or continue an IV if needed.
  2. Gently cool the burn with a damp cloth or saline flush.
  3. Do NOT pop any blisters.
  4. Apply burn cream and antibiotic ointment.
  5. Wrap the area with clean, soft bandages.
  6. Give over-the-counter pain relief.
  7. Advise follow-up with a doctor if:
    • Signs of infection show up.
    • The tetanus shot is outdated.
    • Blisters get very large.
    • Pain or redness doesn’t go away.

3rd Degree (Severe Skin Damage)

  1. Start or keep IV fluids going.
  2. Move the patient to surgery immediately.
  3. Put an oxygen mask on the patient.
  4. Give general anesthesia to put the patient to sleep.
  5. Rinse the wound gently with saline.
  6. Remove any dirt or debris from the burn area.
  7. Prepare a skin graft:
    • Use the patient’s own skin or a synthetic graft.
  8. Attach the graft carefully and ensure it’s in place.
  9. Give antibiotics to help prevent infection.
  10. Check and monitor vital signs.
  11. Move the patient to recovery.

Watch for Complications:

  • Irregular heartbeat (especially from electrical burns)
  • Dehydration
  • Bad scarring or tight, stiff skin
  • Swelling
  • Organ damage
  • Pneumonia
  • Low blood pressure leading to shock
  • Serious infection or sepsis

4th Degree (Burn Reaches Muscle or Bone)

⚠️ Important: Amputations are not visually possible due to current Let’s RP game mechanics.

  1. Start or continue IV fluids.
  2. Move the patient to surgery.
  3. Place an oxygen mask on the patient.
  4. Administer general anesthesia.
  5. Examine the damage and decide if amputation is needed (if allowed).
  6. Perform the amputation if necessary and permitted.
  7. Clean the wound thoroughly.
  8. Suture (stitch) the wound closed.
  9. Give antibiotics to prevent infection.
  10. Check vital signs regularly.
  11. Move the patient to ICU for monitoring and recovery.