a. Facial burns, especially those that occur in closed spaces, may be associated with inhalation injury. Aggressively monitor airway status and oxygen saturation in such patients and consider early intubation or surgical airway for respiratory distress or oxygen desaturation.

b. Estimate total body surface area (TBSA) burned to the nearest 10% using the Rule of Nines.

c. Cover the burn area with dry, sterile dressings. For extensive burns (>20%), consider placing the casualty in the Heat-Reflective Shell or Blizzard Survival Blanket from the Hypothermia Prevention Kit in order to both cover the burned areas and prevent hypothermia.

d. Fluid resuscitation (extrapolated from the USAISR Rule of Ten)

- If burns are greater than 20% of TBSA, fluid resuscitation should be initiated as soon as IV/IO access is established. Initiate resuscitation with (order of preference) Lactated Ringer’s, Plasma-Lyte A/Normosol-R, Normal Saline, or Hextend; if Hextend is used, no more than 20 mL/kg (500-800 mL) should be given, followed by Lactated Ringer’s or normal saline as needed.
  - Initial IV/IO fluid rate is calculated as %TBSA x 10 ml/hr.
  - If hemorrhagic shock is also present, resuscitation for hemorrhagic shock takes precedence over resuscitation for burn shock. Administer IV/IO fluids per the K9TCCC Guidelines in Section (6).

e. Analgesia in accordance with the K9TCCC Guidelines in Section (10) may be administered to treat burn pain.

f. Prehospital antibiotic therapy is not indicated solely for burns, but antibiotics should be given per the K9TCCC guidelines in Section (11) if indicated to prevent infection in penetrating wounds.

g. All K9TCCC interventions can be performed on or through burned skin in a burn casualty.

h. Burn patients are particularly susceptible to hypothermia. Extra emphasis should be placed on barrier heat loss prevention methods.