> For the complete documentation index, see [llms.txt](https://handbook.teddwa.xyz/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://handbook.teddwa.xyz/burns/burns-on-the-chest-abdomen-back-and-joints.md).

# Burns on the chest, abdomen, back, and joints

Assess breathing, protect large burns, and prevent heat loss.

### Immediate actions

1. Complete the primary assessment (ABCs).
2. Expose the area enough to assess the burn and remove loose, hot material.
3. Cool the burn with cool running water when practical and safe.

### Monitor breathing and shock

Chest or upper back burns can restrict chest movement. Watch for pain with breathing, reduced chest rise, worsening breathing difficulty, pale or clammy skin, or confusion.

Treat these signs as urgent. Keep the patient comfortable and monitor airway, breathing, and circulation.

### Cover the burn

Cover the area loosely with sterile burn dressings. For a large burn, use a sterile burn sheet after initial cooling.

Avoid tight wrapping. Prevent heat loss by covering uninjured skin and maintaining a warm environment.

### Transport

Seek urgent medical care for large, deep, circumferential, or joint-crossing burns. Continue reassessment throughout transport.

For significant burns, establish IV or IO access. Treat severe pain with fentanyl, morphine, or ketamine when appropriate.

For major burns, begin warmed isotonic crystalloid resuscitation and reassess perfusion, mental status, pulse, blood pressure, and urine output.


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