Advanced Burn Life Support Course - Ameriburn

CARE

RESEARCH

PREVENTION

REHABILITATION

TEACHING

Advanced Burn Life

Support Course

PROVIDER MANUAL

2018 UPDATE

American Burn Association

311 South Wacker Drive, Suite 4150

Chicago, IL 60606

(312) 642-9260



2017¨C2018

ABLS Advisory Committee

Tam N. Pham, MD, FACS

Contributing Editor

UW Medicine Regional Burn Center at Harborview

Seattle, WA

Amanda P. Bettencourt RN, MSN

University of Pennsylvania School of Nursing

Philadelphia, PA

Gerarda M. Bozinko, RN, MSN, CCRN

Crozer-Chester Medical Center

Upland, PA

Philip H. Chang, MD

Shriners Hospitals for Children - Cincinnati

Cincinnati, OH

Kevin K. Chung, MD, FCCM

U.S. Army Institute of Surgical Research

Fort Sam Houston, TX

Christopher K. Craig, MMS, PA-C

Wake Forest Baptist Health

Winston-Salem, NC

Alice M. Fagin, MD, FACS

Arkansas Children¡¯s Hospital

Little Rock, AR

Kathleen A. Hollowed, RN, MSN

Contributing Editor

MedStar Washington Hospital Center

Washington, DC

2018 ABLS Provider Manual

Laura S. Johnson, MD, FACS

MedStar Washington Hospital Center

Washington, DC

Peter Kwan, BScE, MD, PhD, FRCSC

University of Alberta

Edmonton, AB

Elizabeth A. Mann-Salinas, RN, PhD

Army Burn Center

San Antonio, TX

Joseph A. Molnar, MD, FACS

Wake Forest University, School of Medicine

Winston-Salem, NC

Lisa Rae, MD, MS

Vanderbilt University Medical Center

Nashville, TN

David H. Ahrenholz, MD, FACS

Contributing Editor

Regions Hospital Burn Center

St. Paul, MN

Kathe M. Conlon, BSN, RN, MSHS

Contributing Editor

The Burn Center at Saint Barnabas

West Orange, NJ

Gretchen J. Carrougher, MN, RN

Contributing Editor

UW Medicine Regional Burn Center at Harborview

Seattle, WA

1

Acknowledgements

The American Burn Association (ABA) gratefully acknowledges the leadership, time and dedication of the

current and past members of the ABLS Advisory Committee. Also, the continued assistance of the ABA

Central Office Staff is deeply appreciated.

Copyright ? American Burn Association 2018. All Rights Reserved. No part of this publication may be

reproduced in any way, or by any means without permission in writing from the publisher.

2018 ABLS Provider Manual

2

Table of Contents

Chapter 1

Introduction

4

Chapter 2

Initial Assessment and Management

7

Chapter 3

Airway Management and Smoke Inhalation Injury

23

Chapter 4

Shock and Fluid Resuscitation

31

Chapter 5

Burn Wound Management

39

Chapter 6

Electrical Injury

46

Chapter 7

Chemical Burns

52

Chapter 8

Pediatric Burn Injuries

59

Chapter 9

Stabilization, Transfer and Transport

68

Chapter 10

Burn Disaster Management

73

Appendix 1

Glasgow Coma Scale

81

Appendix 2

Tetanus Prophylaxis

82

Appendix 3

Radiation Injury

83

Appendix 4

Cold Injuries

86

Appendix 5

Blast Injuries

90

2018 ABLS Provider Manual

3

CHAPTER 1

Introduction

Objectives

Upon completion of this chapter

the participant will be able to:

? Understand the epidemiology of

burn injuries in the United States

? Describe learning goals for

this course

I. BURN BASICS

A burn is defined as damage to the skin and underlying tissues caused by heat, chemicals, or electricity.

Each year in the United States about 450,000 people receive medical attention for burn injuries. An estimated

4,000 people die annually due to fire and burns, primarily from residential fires (3,500). Other causes include

motor vehicle and aircraft crashes, contact with electricity, chemicals or hot liquids and substances, and

other sources of burn injury. About 75% of these deaths occur at the scene of the incident or during initial

transport. The leading cause of fire death in the United States is from fires due to smoking materials, especially

cigarettes. The ABA has been a lead organization in the attempt to require all cigarettes sold in every state to

be fire-safe cigarettes.

Approximately 45,000 people are hospitalized for burn injuries each year and will benefit most from the

knowledge gained in the Advanced Burn Life Support (ABLS) Provider Course.

Below are a few interesting facts regarding burn injuries in the United States. These statistics are for patients

admitted to burn centers and based on the ABA¡¯s National Burn Repository Report for Data from 1999-2008.

? Nearly 71% of patients with burns were men.

? Children under the age of 5 accounted for 17% of cases.

? Sixty-seven percent of the reported cases sustained burns of less than 10% TBSA.

? Sixty-five percent of the reported patients were burned in the home.

? During this 10-year period, the average length of burn center stay declined from roughly 11 days to 9 days.

? Four percent of patients died from their injuries.

? Ninety-six percent of patients treated in burn centers survived

2018 ABLS Provider Manual

Chapter 1 Introduction

4

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