**9. Management of the burn patient at first step**

Early and appropriate treatment of burn injury is associated with better prognosis. Prehospital management and the treatment of burn patients in the emergency department fall out of the scope of this chapter and include the general rules for trauma patients. As the airway edema may start soon after burn and unexpectedly, early intubation may be indicated. Since massive edema may develop in extended burns, all jewelry and accessories should be taken off. Specific interventions may be indicated according to the mechanism of burn (electrical, chemical burns). Until the patient is referred to the medical center, wounds should just be covered with clean cloth. Cooling with compress may be done; however, unburned regions should be kept warm in order to avoid hypothermia [12, 15].

As the hypovolemic shock is associated with high morbidity and mortality, fluid resuscitation should be done early and adequately. Several criteria have been described for fluid resuscitation of burn patients [11, 17].
