CIRCULATION with haemorrhage control

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Early assessment of circulation is mandatory to identify any life threatening concerns such as haemorrhage which must be managed promptly.

 

Assess heart rate, blood pressure & neck veins

Assess heart rate, blood pressure & neck veins
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KEY STEPS

 

  1. Inspect for any obvious bleeding – stop with direct pressure.
  1. Check heart rate, blood pressure and neck veins.
  1. Insert two large-bore peripheral intravenous (IV) cannulas,
  1. Commence fluid resuscitation as indicated.
  1. Check capillary refill and temperature of unburnt skin.

 





 

Inspect for any obvious bleeding – stop with direct pressure.

Inspect for any signs of haemorrhage and apply direct pressure to any external wounds. Haemorrhage is rare in isolated burn injuries, but in multitrauma burn injuries, consider the potential for internal bleeding, which may lead to shock.

 

Check heart rate, blood pressure and neck veins.

This will provide an assessment of the current state of the circulatory system

 

Insert two large-bore peripheral intravenous (IV) cannulas.

Insert two large-bore peripheral intravenous (IV) cannulas, preferably through non-burnt tissue. Use central or intraosseous insertion access if the equipment/skills are available and peripheral access is difficult.

  

Commence fluid resuscitation as indicated.

Commence fluid resuscitation as indicated for burns greater than 20% TBSA in adults and 10% in children.

 

Check capillary refill and temperature of unburnt skin.

Assess the circulation of the peripheries and trunk, especially distal to the burn wound if circumferential burns are present. Elevate affected limb to help minimise swelling and improve blood flow. Poor perfusion may indicate the need to perform an escharotomy.

 

 

 

 

 

 

The Alfred Hospital gratefully acknowledges the ongoing support and contribution of Skilled Medical in funding this project.  For more information on Skilled Medical, please visit www.skilledmedical.com
Supported by:

Ambulance Victoria The Alfred Victorian Adult Burn Services at The Alfred The Royal Children's Hospital Melbourne