Continue to perform your evaluation and treat other injuries.

Evacuate the casualty, if needed. Some considerations are given below.

a. Administer Oxygen, if Needed and Available.

If the casualty has signs and symptoms of inhalation injury or carbon monoxide poisoning, administer humidified oxygen at a high flow rate if it is available. Be very aggressive in monitoring the casualty for deterioration of the airway. Be prepared to administer artificial ventilations and manage the airway, if needed.

b. Adjust IV Flow, if Needed.

If an intravenous infusion has been started and you are able to measure urine output, adjust the IV fluid flow to maintain an average urine output between 30 and 60 milliliters per hour. Urine output is a reliable guide to assess circulating blood volume. As long as renal artery pressure remains above 90 mm Hg (millimeters of mercury), urinary output should remain adequate.

c. Monitor Pulse Sites in Extremities.

Check the casualty’s circulation by checking the distal pulse site in each arm and leg.

d. Allow Casualty to Drink, if Appropriate.

If the casualty is not in shock and is not nauseated, you can give him small sips of cool water to drink. Stop administering the water if the casualty feels as though he may vomit or if signs or symptoms of shock develop.

e. Evacuate the Casualty.

A casualty with inhalation injury or carbon monoxide poisoning needs to be evacuated as soon as possible. Burns of the throat can swell and impair breathing. Swelling in a burned extremity can have a tourniquet-like effect on blood circulation in the extremity.

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