What action should be taken for casualties with burns greater than 20% of total body surface area?

For casualties with burns greater than 20% of total body surface area, immediate fluid resuscitation is critical. This is because such extensive burn injuries can lead to significant fluid loss through damaged skin, potentially resulting in hypovolemic shock. Burn patients lose both fluid and electrolytes as a result of the injury, which can severely compromise their cardiovascular status.

Initiating fluid resuscitation helps to restore circulating blood volume, maintain perfusion to vital organs, and prevent shock. The guidelines suggest starting with isotonic fluids, such as Lactated Ringer's solution, at specific rates based on the patient's weight and the extent of their burns.

While monitoring vital signs, administering pain relief, and elevating burned limbs are all important aspects of care for burn victims, they are secondary actions compared to the urgent need for fluid resuscitation in cases involving burns of this magnitude. Fluid resuscitation directly addresses the immediate threats to life posed by such severe injuries.