For burns classified as less than 20% TBSA 2nd/3rd degree, what is the recommended method for vascular access?

For burns classified as less than 20% Total Body Surface Area (TBSA) second and third degree, initiating two large bore IVs or intraosseous (IO) access is recommended due to the potential for significant fluid loss and the need for rapid resuscitation. Patients with burns can experience shifts in fluid volume that lead to hypovolemia, so establishing two large bore IV lines allows for the administration of fluids at a rapid rate, which is crucial in the early management of burn patients.

Having two access points ensures that if one line fails or is inadequate for the volume needed, the second line can still be used to deliver lifesaving fluids or medications. Additionally, intraosseous access is a viable alternative when conventional IV access is not possible due to patient condition or when immediate access is critical and can be achieved more rapidly, especially in emergency situations.

Establishing a single IV line may not provide the adequate flow rate necessary for effective resuscitation in moderately severe burn cases, while the use of a central line is typically reserved for more severe burn cases that exceed 20% TBSA or where prolonged access is necessary. Skipping IV access altogether is not advisable, as the immediate provision of fluids can be crucial in preventing shock