The patient is placed at your feet. You can see significant burns over the chest, arms, and neck. There is a high-pitched stridor sound coming from their throat, and they don’t seem to be responding fully to everyone around them. You see no evidence of catastrophic haemorrhage and set to work on Airway and Breathing while your colleague gets further kit. Where airway burns are suspected, what advanced airway option (where available) can be utilised early 

You investigate the airway and see significant swelling and burns. You attempt to place an endotracheal tube, but this is impossible due to the damage done by the burns. As you have attempted to intubate, the patients’ stridor and breathing has become worse, to the point that no air is moving in or out. What actions do you need to complete next

You identify the need for front of neck access. Advanced clinicians are on route but are still 10 minutes away. Which landmarks are you aiming for with a front of neck airway 

Using your Trust’s front of neck access equipment, you gain airway access and support ventilations. You review there is a significant area of partial and full thickness burns to the patient, and your colleague asks if cooling should be applied and for how long. What is the correct answer

You realise the need for rapid transportation, and quickly get the patient into the Ambulance. Your colleague places burns gels on the affected areas where possible. An RRV Paramedic has arrived and starts driving you to A&E. Your colleague has attempted cannulation multiple times but is unable to gain access due to the area of burns. Are you able to look at Intra Osseous access in this situation 

You quickly discuss with your colleague the desperate need for access although the patient is semi-conscious, and they gain IO access. Looking at the patient, they have partial to full thickness burns across their chest, both arms, neck, and legs. As an estimate, what level of total burn surface area has the patient suffered

Looking at your fluid guidelines, over what percentage of total burn surface area dose a patient need to be for Sodium Chloride administration

The patient is well over 25% burns and you look to start sodium chloride administration. What is the initial dose volume

A 1 litre Sodium Chloride bolus has started, and you have a 15-minute run time to hospital. The patient is continuing to groan at times. Can appropriate analgesia be given to a burn’s patient with such significant burns

You continue to manage Airway and Breathing while your colleague deals with other deficits. Arriving at the hospital, you give a handover to the awaiting resus team. What do you include