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Burn Protocols

 

Burn injuries range from minor burns that can be taken care of with basic first aid on the fireline to life-threatening injuries that require complex treatment and surgical teams at regional burn centers. Due to recent changes in both technology and the American Burn Association referral guidelines, NWCG has updated their burn protocol recommendations which can be found on the NWCG website and in the current Interagency Standards for Fire & Fire Aviation Operations (Red Book). Firefighters should familiarize themselves with these new protocols.

A burn injury that is beyond basic first aid treatment should be sent to the nearest emergency department for evaluation. Any life-threatening issues such as airway, pain control, and fluid resuscitation can, and should, be treated at a local emergency department. Bypassing local emergency departments to go directly to regional burn centers can put the patient at risk, delay initial treatment, and result in unnecessary travel and risk to both the patient and others. Of note, if a local EMS/aeromedical resource responds and transports the patient, they will follow their destination protocols.

In the emergency department, a licensed independent provider will determine what care should be initiated. This may include any of the below:

  • Immediate transfer to a burn center after stabilization
  • Remote (tele) consultation with a burn center
  • Treatment and referral to local primary care or wound care

The NWCG burn protocol has a flow sheet that addresses the processes in the emergency department as well as a handout that can be provided to the physician to help guide treatment for our firefighters.

When a patient does not need emergent transfer to a burn center it is common for burns to continue to evolve and develop over the course of days to weeks. This means that treatment does not end after the initial emergency department visit. It is imperative to follow the directions from the emergency department and attend all follow-up appointments. All burn patients being discharged from an emergency department should receive/request a follow-up referral.

Discussion Items:

  • What does a minor burn that could be taken care of with first aid look like?
  • What would your crew do if they had a member sustain a large burn on the hand? Consider initial treatment by your crew.
  • When would you activate EMS/IWI? Which Emergency Room would they go to?

Resources:

 

Category
Firefighter Health First Aid


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NWCG Latest Announcements

2024 Week of Remembrance

Date: June 27, 2024
Contact: 6 Minutes for Safety Subcommittee 

As we approach the 2024 Week of Remembrance (WOR), June 30 to July 6, we dedicate this time to thoughtfully reviewing and recognizing the events of the 2018 Mendocino Complex. As such, this year’s theme of “Learning From the Mendocino Complex” embodies a longstanding hallmark of WOR, honoring through learning.

Throughout the week, our energy will be directed toward fostering generative conversations in briefing rooms and at tailgates.

References:

6 Minutes for Safety - 2024 Week of Remembrance

Wildland Fire Lessons Learned Center

Updated NWCG Wildland Fire Risk and Complexity Assessment, PMS 236

Date: June 24, 2024
Contact: Incident and Position Standards Committee 

The June 2024 update of the NWCG Wildland Fire Risk and Complexity Assessment, PMS 236, is now available to meet the current needs for incident management typing.

The NWCG Wildland Fire Risk and Complexity Assessment should be used to evaluate firefighter safety issues, assess risk, and identify the appropriate incident management organization based on incident complexity. Assessing risk, determining incident complexity, and identifying an appropriate incident management organization is a subjective process based on examining a combination of indicators or factors, which can change over time.

References:

NWCG Wildland Fire Risk and Complexity Assessment, PMS 236

Operations Branch Director (OPBD) Next Gen PTB Available

Date: June 10, 2024
Contact: NWCG Feedback 

The NWCG Position Task Book for Operations Branch Director (OPBD), PMS 311-109 is now available for use within the OPBD position qualification pathway. As part of the transition to Complex Incident Management (CIM), the OPBD Next Gen PTB was developed and the position qualification pathway updated.

More information about the Next Gen PTB format can be found on the NWCG Position Task Book webpage.

References:

Operations Branch Director Position Page

Operations Branch Director Next Gen PTB

NWCG Position Task Books

Updated NWCG Standards for Interagency Incident Business Management, PMS 902

Date: June 5, 2024
Contact: NWCG Incident Business Committee 

The 2024 revision of the NWCG Standards for Interagency Incident Business Management, PMS 902 is now available. The uniform application of interagency incident business management standards is critical to interagency fire operations. PMS 902 assists NWCG agencies in constructively working together to provide effective execution of each agency's incident business management program.

References:

PMS 902