**1. Introduction**

Burns are among the most challenging and physiologically complex injuries and can be associated with the development of early hemodynamic collapse and shock [1, 2]. Patients who have sustained significant burns are at risk of rapidly developing "burn shock" due to the simultaneous presence of local and systemic inflammatory response to injury that most closely resembles hypovolemic shock [3, 4]. While burns themselves have the potential to be the primary source of shock, the presence of large burns should not distract the vigilant provider from ruling out additional injuries during their assessment of a trauma patient [5, 6]. After addressing any immediate airway threat during the initial trauma evaluation, it is of utmost importance to promptly determine the presence of other potentially life-threatening non-burn injuries. Once other life-threatening injuries are ruled

out, the resuscitating team's focus can be directed toward managing the burn. Rapid initiation of therapy tailored to each burn patient during the initial 48 h from the time of burn injury is critical for preventing burn shock, secondary injuries, and other downstream sequelae [3]. In this chapter, we will discuss the fundamentals of burn shock, starting with pathophysiologic and mechanistic considerations and concluding with clinical management pearls.
