[Emergency therapy of burns].

Burns are among the most common accidental injuries, occurring in almost any environment to victims of all ages. Most of them are minor injuries and may be treated on an out-patient basis. Superficial (first-degree and superficial second-degree) burns will heal uneventfully in about two weeks without scarring, as long as no infection complicates the healing process. Major burns, however, are life-threatening, and professional treatment is crucial for survival. The intensive care and the surgical treatment in these patients demand a major commitment in terms of personnel and material resources; in addition, emotional reactions by any person involved in the case are not uncommon. A skilled and knowledgeable on-scene emergency treatment may diminish the depth of the burn wound and will furthermore reduce the number of complications like hypovolemic shock and infection. A complete clinical assessment including the patient history gives the rationale for any therapy and will help determine the appropriate referral center. The emergency treatment primarily includes the cooling of the burn wound to stop the burning process and to reduce pain, the insertion of an intravenous line, including the infusion of 1 to 2l of an isotonic electrolyte solution per hour, and the management of pain with intravenous boluses of morphine. The patient should also receive supplemental oxygen, and the burn wound should be covered by sterile drapes. Finally, every burn victim requires tetanus prophylaxis. Major burns and burn wounds at sensitive locations such as head and hands should be treated in specialized burn centers. This provides best chances for survival and increases the probability for a good cosmetic result.