((If trainees fail to remove the bracelet from the right wrist within the first 2 minutes, advise that the patient mentions her wrist is beginning to feel tight โ prompt removal before oedema develops.))
((If cooling is not commenced within 3 minutes of scene arrival, the patient reports that the pain is worsening and the area looks more inflamed โ reinforce the 20-minute minimum cooling requirement.))
((If trainees attempt to apply a dry dressing without cooling first, the patient winces and says 'that's making it worse' โ redirect to cooling protocol.))
((If trainees do not assess for inhalation injury โ ask about cough, hoarseness, or breathing difficulty โ facilitator prompts: 'Is there anything you want to ask about how she was breathing near the stall?'))
((If trainees do not perform a distal neurovascular check before and after dressing, prompt: 'Have you checked sensation and circulation in her fingers?'))
This patient is suffering from a superficial partial thickness burn to the right volar forearm caused by a hot oil splash, estimated at approximately 2โ3% Total Body Surface Area (TBSA).
- Don appropriate PPE โ gloves at minimum.
- Perform Primary Survey โ confirm airway patent, breathing adequate, no circulatory compromise, GCS 15.
- Assess burn for inhalation injury โ ask about cough, hoarseness, black sputum, or breathing difficulty (none present in this scenario).
- Remove jewellery from the affected limb โ remove bracelet from right wrist before oedema develops.
- Commence cooling of the burn area immediately โ apply cool running water (approximately 15ยฐC) to the affected area for a minimum of 20 minutes.
- Do NOT use ice, iced water, butter, creams, or other home remedies on the burn.
- While cooling, perform Vital Sign Survey โ HR, BP, RR, SpO2, GCS, pain score.
- Perform Secondary Survey โ confirm burn is isolated to right volar forearm, estimate TBSA using Rule of Nines (approximately 2โ3% for this area).
- Document time of burn injury โ 10 minutes prior to FAP presentation.
- After cooling is complete (minimum 20 minutes), apply damp sterile dressings to the affected area.
- Assess distal neurovascular observations (colour, warmth, movement, sensation, CRT) before and after dressing application.
- Reassess pain score post-cooling and post-dressing โ expect improvement from 7/10 toward 4/10.
- Reassure patient continuously throughout treatment.
- Advise patient that transfer to hospital is recommended for assessment and wound review, as blistering burns require medical evaluation.
- Arrange transport to nearest emergency department โ this patient does not meet criteria for direct transfer to tertiary burns centre (TBSA <10%, no airway burns, no involvement of face, hands, feet, perineum, or genitalia).
- Record full observations every 10 minutes.
- Scenario ends on arrival of ambulance and IMISTAMBO handover.
- Attention to hand hygiene will be given throughout the scenario.
Clinical references: Burn Trauma ยท Primary Survey ยท Secondary & CNS Survey ยท Minor Wound Management ยท Pain Assessment