Burn Injury Assessment: An Interactive Lesson Plan

Greg Friese is a featured speaker at EMS World Expo 2012, scheduled for October 29–November 2 in New Orleans, LA. For more information, visit EMSWorldExpo.com.      

The Virtual Training Director is a column for training officers that utilizes the content of feature articles in EMS Magazine to help facilitate training sessions. Use or adapt this lesson plan for your organization, its personnel and its local protocols.

Essential Information

   Burns are associated with dramatic mechanisms and often present visual damage that can range from the curious to the horrific. In the Burning Issues article, you will find an excellent primer on burn injury types, assessment and prehospital care. The authors remind us of the importance of burns relative to trauma, as well as the need to manage ABC life threats before specifically caring for burns. EMS providers need to use mechanism of injury details and patient assessment findings to identify the burn cause, severity and type. Use that information to prepare a treatment plan and implement transport to the most appropriate receiving facility.

   Rather than simply presenting a lecture on burns based on the information in the article, I have outlined an interactive training session for participants to create simulated burn injuries that other participants will assess. Before your training session, ask members to read the article so they have the necessary burn knowledge needed for the interactive small group work. (Remember: You can make and distribute copies of any of our articles for education purposes.)

   Time needed: 1 to 2 hours.

Instructor Preparation

   Prepare a moulage kit with enough supplies, appliances and applicators for groups to simultaneously moulage multiple burn patients. You may also wish to prepare patient profiles that each team may use if time is too limited for them to prepare their own patient profile.

Training Objectives

• Understand causes of burns
• Explain different levels of burn severity
• Differentiate types of burns
• Practice burn assessment in small group scenarios
• Review local burn injury treatment protocols

Group Training Outline

1. Introduce the training topic of burn injury assessment by describing the team activity to prepare a patient and then assess all of the other patients.

2. Review the following concepts from the article. Add additional content as needed based on your group's knowledge and experience.

• Burn severity: superficial, partial-thickness and full-thickness
• Systemic inflammatory response syndrome
• Zones of injury: hyperemia, stasis and coagulation
• Burn types: thermal, electrical and chemical

TEACHING TIP: Ask participants to define these terms in their own words with concrete examples.

3. Preparation of interactive activity. Divide participants into three- or four-person teams. Make one person in each team a patient. Each team will plan and deliver a patient assessment scenario that includes:

• Selecting a specific burn MOI--chemical, thermal or electrical
• Using moulage to apply a simulated burn injury to their patient
• Preparing other vital sign and injury findings appropriate to the patient's burn injury and MOI

TEACHING TIP: Each team will probably need 15 to 30 minutes to plan their scenario and apply moulage to their patient. Give a check sheet to each team so they plan all needed components. Assist participants in applying moulage that is realistic for the burn injury type and severity.

4. Assessment rodeo

In a large classroom or outdoor space, arrange patients in a circle, about 15 feet apart. The remaining members of each team will have five to seven minutes with each patient to:

• Determine mechanism of injury
• Expose injuries
• Identify ABC life threats
• Check vital signs
• Gather patient history
• Perform a physical exam to identify traumatic injuries, if present; assess the burn type and depth; calculate burn total body surface area.
• Outline a treatment and transport plan