BurnsRefer

• Ringer lactate (adult over 15%, child over 10% TBSA), Silver sulfadiazine 1% (not face), Framycetin 1% cream (face), Paracetamol, Morphine (severe), Td

• First aid: Cool running water for 20 min (useful up to 3 h), remove rings, cover with cling film; no ice, toothpaste or ghee (NCDC-ICMR 2025; ISBI 2016, latest)
• Refer to a burns unit: Over 10% adult or 5% child, face, hands, feet, genitals, joints, electrical, chemical, smoke inhalation, or circumferential (ISBI 2016, latest)

First visit

• TBSA estimate (rule of nines / palm method) — Decides fluids and referral.
• Weight — Fluid calculation.

Only if indicated

• CBC, electrolytes, creatinine, blood glucose — Adult over 15% or child over 10% TBSA.
• Carboxyhaemoglobin, blood gas, chest X-ray — Smoke inhalation or enclosed-space fire.
• ECG and CK — Electrical burns.
• Urine output (catheter) — Major burns: target 0.5–1 mL/kg/h.