Initial treatment guidance for suspected RF-EMF overexposure is limited and mostly comprise of symptomatic care. Treatment of service members with suspected acute RF-EMF injury should consider the following interventions (if not otherwise contraindicated):

BURNS

- Majority of RF-EMF skin burns will heal on their own without further intervention. However, medical providers may consider the following steps:
  - Cooling the burn is effective if performed within 20 minutes of the injury. For small size of superficial burns, immersion, or irrigation with running tepid water (15°C) for up to 20 minutes may reduce pain and edema. (NOTE: Iced water should not be used as intense vasoconstriction can cause burn progression. Cooling large areas of skin rapidly may lead to hypothermia.)
  - Analgesia - non-steroidal anti-inflammatory drugs such as ibuprofen.
  - Apply antibiotic ointments for mild open wound burns.
  - Hydration - encourage patients to drink plenty of water.
  - Monitor.
- 2nd- 3rd degree burns with a TBSA ≥ 20%. The patient typically requires acute fluid resuscitation for 24-48 hours and close observation for 72 hours after the incident.

For additional information, refer to JTS Burn Care CPG.

HYPERTHERMIA

- Temperature monitoring:
  - Minimum: Scheduled temperature measurement with vital sign evaluations.
  - Better: Continuous forehead dot monitoring.
  - Best: Continuous core temperature monitoring.
- Monitor for signs and symptoms of heat exhaustion – if present:

Immediately replace fluids and electrolytes via oral or intravenous (IV) routes depending on acuity and level of consciousness.

- Monitor for signs and symptoms of heat stroke – if present:

Immediately initiate cooling: place the patient under a cool environment, wetting clothing, fanning after wetting clothing, immersion in water, or apply ice packs (if available) to armpits, groin, neck, and back.

- Maintaining hydration, adding salt to food and/or electrolyte replenishing drinks, resting in shade, staying off hot surfaces (ground or vehicle).

For additional information, refer to JTS Prolonged Casualty Care Guidelines CPG.

OCULAR INJURIES

- Initial treatment guidance for suspected ocular injury from RF-EMF overexposure is limited.
- Readily identifiable injuries such as keratitis, hemorrhage, optic nerve injury should be treated using current standards in coordination with an eye care provider.

For additional information related to eye injuries, refer to JTS Eye Trauma: Initial Care CPG.

NEUROPSYCHOLOGICAL SYMPTOMS

- There is no established causal relationship between RF-EMF overexposure and TBI. For patients with “TBI-like” neuropsychological symptoms, rule out TBI from other causes and refer to JTS Traumatic Brain Injury Management in Prolonged Field Care CPG for neurological assessment and care.
- Treat any additional signs/symptoms (e.g., nausea, vomiting, headache, etc.) following standard of medical care.