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BURN ASSESSMENT
CRASH CARDCC-BRN-01 · ACUTE CARE 06
%TBSA — RULE OF NINES 2°/3° only · peds deltas amber
REGIONADULTPEDS
Head / neck918
Arm (each)99
Leg (each)1814
Trunk — anterior1818
Trunk — posterior1818
Perineum1
PALM RULE  patient's palm including fingers1% TBSA — scattered / irregular burns
DEPTH exam findings
SUPERFICIALepidermis · red, dry, blanches · painful · no blisters · not counted in TBSA
SUPERF. PARTIALpapillary dermis · wet, blisters, brisk blanch · very painful
DEEP PARTIALreticular dermis · mottled, sluggish / no blanch · ↓ pinprick sensation
FULLall layers · leathery, waxy, charred · no blanch · painless to touch
FLUID RESUSCITATION LR · count 2°/3° only
Parkland4 mL × kg × %TBSA · LR · total / 24 h
Modern start≈2 mL/kg/%TBSA · initial rate, then titrate
Peds+ D5 maintenance gtt · alongside resus fluid
⚠ HALF IN FIRST 8 h — FROM TIME OF BURN
0–8 h first half 8–24 h second half — clock starts at the burn, not arrival
Subtract prehospital fluid already given from the first-half volume.
EXAMPLE 70 kg × 40%11.2 L / 24 h · ≈700 mL/h × 8 h · then titrate to UOP
FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY
FRONT
INHALATION INJURY airway closes fast
⚠ RED FLAGS INTUBATE EARLY
enclosed-space fire · carbonaceous sputum · singed nares / facial burns · stridor · hoarseness
Edema peaks over hours — secure the airway before it does.
CO · CYANIDE same fire, both possible
CARBON MONOXIDE
  • SpO₂ unreliable reads normal
  • 100% O₂ NRB · co-oximetry
  • 4–5 h air → ~1 h on O₂
  • HBO: AMS · pregnancy · COHb >25%
CYANIDE
  • enclosed space + AMS + ↑lactate
  • soot + hypotension / arrest → treat
  • hydroxocobalamin 5 g IV
  • peds 70 mg/kg · don't wait on labs
ELECTRICAL surface underestimates depth
Dysrhythmiacontinuous ECG + 12-lead · monitor ≥12–24 h if abnormal
Rhabdodark / tea urine → UOP 75–100 mL/h until clear
Deep injuryserial compartment checks · entry/exit wounds mislead
Labstrend CK · K⁺ — treat hyperkalemia early
BURN CENTER TRANSFER any one criterion
  • 01 partial >10% TBSA
  • 02 any full thickness
  • 03 face · hands · feet · genitalia · joints
  • 04 electrical or chemical
  • 05 suspected inhalation injury
  • 06 extremes of age
ESCHAROTOMY burn-team call
Indicationcircumferential full thickness — limb, chest, neck
Withpoor distal perfusion · restricted chest excursion / ↑PIP
TITRATE TO UOP — NOT THE FORMULA
adult 0.5 mL/kg/h · child 1 mL/kg/h · electrical 75–100 mL/h — reassess hourly
VERIFY AGAINST LOCAL PROTOCOL
BACK

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CC-BRN-01 · ACUTE CARE 06

Burn Assessment Reference Badge

Rule of Nines with peds deltas, palm rule, depth tiers, Parkland fluids, toxic and electrical flags.

$14First run — ships July 25
1
  • Free US shipping
  • Rigid PVC · water-resistant
  • 2.25 × 3.5 in · badge-reel slot
SKUCC-BRN-01
SeriesACUTE CARE 06
Size2.25 × 3.5 in (CR80)
MaterialRigid PVC, water-resistant
FinishDark ink on field-kit tan
ForER and burn-unit nurses, paramedics, flight crews.

Field reference — not a protocol. Verify against local protocol.

On this card

Burn calls don't wait for you to look things up. This dense field-kit card carries the entire burn workup — %TBSA, depth, fluids, and the toxic/electrical complications — with the places people actually get it wrong flagged in amber. Built for ER and burn-unit nurses, paramedics, flight crews, and tactical medics — anyone who assesses burns under pressure and needs textbook-standard numbers without pulling out a phone.

Front

a Rule of Nines table with adult and pediatric columns side by side (the peds deltas set in amber); the palm rule — including fingers ≈ 1% TBSA; a four-tier DEPTH table with exam findings per tier; a FLUID RESUSCITATION section — Parkland 4 mL × kg × %TBSA, the modern ≈2 mL/kg starting rate, and the peds D5 maintenance line; an amber timing strip — HALF IN FIRST 8 H, FROM TIME OF BURN, subtract prehospital fluid already given; and a worked 70 kg × 40% example.

Back

an amber INHALATION INJURY panel — red flags, intubate early, edema timing; paired CARBON MONOXIDE and CYANIDE panels (SpO₂ unreliability, 100% O₂ and co-oximetry, CO half-life, empiric hydroxocobalamin dosing); an ELECTRICAL section — dysrhythmia monitoring, rhabdo and urine-output target, deep injury, CK/K⁺ trending; the six field-actionable burn-center transfer criteria; escharotomy indication and triggers; and the boxed rule: TITRATE TO UOP — NOT THE FORMULA, with adult, child, and electrical targets. Rigid PVC, water-resistant, standard CR80 badge size in the tan field-kit colorway with dark olive-and-amber print. Punched badge-reel slot at the top — rides behind your ID on any reel or lanyard and survives the shift. Content is clinician-reviewed and drawn from standard published references. Field reference only, not a protocol — always verify against your institution's protocols.

Pairs with

VENT TRANSFER
CRASH CARD
GAS EXCHANGE problem → correction
O2SpO2 / PaO2 low↑ FiO2 then ↑ PEEP
CO2EtCO2 / pCO2 high↑ RR then ↑ volume
CO2EtCO2 / pCO2 low↓ RR
DOPES
  • Displaced tube
  • Obstructed / plugged
  • Pneumothorax
  • Equipment failure
  • Stacked breaths
DOTTS
  • Disconnect vent
  • O2 100% · bag by hand
  • Tube: suction + EtCO2
  • Tweak settings
  • Sounds equal
HIGH PRESSURE  kink · plug · biting · bronchospasm · PTX
LOW PRESSURE  disconnect · cuff leak · extubated
TIDAL VOLUME 6 mL/kg PBW · by height & gender
HTF mLM mL
5'0"275300
5'2"300330
5'4"330355
5'6"355385
5'8"385410
5'10"410440
6'0"440465
6'2"465495
6'4"495520
ARDSNET (ARMA)
  • TV 6 mL/kg PBW · range 4–8
  • Plat ≤30 · if >30: ↓TV 1 mL/kg → min 4
  • RR ≤35 · titrate to pH
  • pH 7.30–7.45 · ≥7.15 tolerated
  • PaO2 55–80 · SpO2 88–95
  • ΔP ≤15 (Amato, post-hoc)
PBW derives from height + gender, not weight. 8 mL/kg = table × 1.33.
⚠ STILL HYPOXIC — ESCALATE IN ORDER
1 sedate deeper 2 paralyze 3 ↑PEEP (Plat ≤30, ΔP ≤15) 4 prone if able 5 accept SpO2 88 / pH ≥7.15 6 ECMO call (P/F <80)
High PEEP derecruits in seconds — clamp the tube before ANY circuit break.
FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY
Vent TransferCC-VT-01
LAB VALUES
CRASH CARDCC-LV-01 · ACUTE CARE 01
BASIC METABOLIC PANEL adult reference
Na135–145
K3.5–5.0
Cl / CO₂98–106 / 23–29
BUN / Cr7–20 / 0.6–1.2
Glucose70–100 (fasting)
Calcium8.5–10.5
Mg / Phos1.7–2.2 / 2.5–4.5
EXTENDED CHEMISTRY
Anion gap8–12
Osmolality275–295 mOsm/kg
Ammonia lab-specific15–45 µg/dL
Lipase lab-specific10–140 U/L
ABG arterial · PaCO₂ / PaO₂ mm Hg
pH7.35–7.45
PaCO₂35–45
PaO₂80–100
HCO₃⁻22–26 mEq/L
SaO₂95–100 %
Lactate0.5–2.0 · >4 critical mmol/L
amber = high-alert analyte — recap on back
FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY
Lab ValuesCC-LV-01
ETT SIZING
CRASH CARDCC-ETT-01 · ACUTE CARE 02
PEDIATRIC ETT uncuffed-led · cuffed = −0.5 · depth at lip
AGElbkgUNCUFFCUFFDEPTH cm
Preterm2–51–2.52.5–3.06–8
Newborn7–113–53.0–3.59–10
6 mo1573.5–4.03.0–3.510.5–12
1 yr22104.0–4.53.5–4.012–13.5
2 yr26124.54.013.5
4 yr35165.04.515
6 yr44205.55.016.5
8 yr55256.05.518
10 yr70326.56.019.5
12 yr88407.06.521
14 yr110507.0–7.56.5–7.021
FORMULAS · 1–10 YR
  • Uncuffed (age÷4)+4
  • Cuffed (age÷4)+3.5
  • Depth 3 × tube ID cm
  • Neonate kg + 6 cm at lip
BLADE
  • Preterm Miller 0
  • NB–2 yr Miller 1
  • 2–8 yr Miller / Mac 2
  • 8 yr+ Mac 3 · Mac 4 lg
SUCTION CATH 2 × ETT ID in Fr · 4.0 tube → 8 Fr
GASTRIC / OG 2 × ETT ID in Fr · decompress after BVM
STYLET straight-to-cuff ~35° · tip never past Murphy eye
⚠ FAILED AIRWAY — MOVE, DON'T REPEAT
1 reposition + bougie 2 size down 0.5 3 SGA / LMA 4 2-person BVM + OPA/NPA 5 surgical airway — mark cricothyroid early if predicted difficult
Max 2 attempts per operator — SpO2 recovery between every attempt.
FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY
ETT SizingCC-ETT-01