Tactical Combat Casualty Care (TCCC) Practice Test

When burns exceed 20% of total body surface area, the immediate action to take is to start fluid resuscitation. This is critical because extensive burns can lead to significant fluid loss due to capillary permeability and dermal damage, resulting in shock and potentially life-threatening complications.

In cases of substantial burns, adequate fluid resuscitation is vital to maintain hemodynamic stability and organ perfusion. The Parkland formula is often used in the initial management of burn patients to determine the amount of fluid required in the first 24 hours after the injury. Starting fluid resuscitation promptly helps prevent hypovolemic shock, which can occur as a result of the body's inability to maintain adequate blood volume due to fluid loss through the damaged skin.

While pain relief and wound care are also important components of burn management, they typically come after ensuring that the patient is stable and receiving sufficient fluids. CPR is only necessary if the patient exhibits signs of cardiac arrest or is unresponsive, which is not inherently implied by the percentage of burn injury alone. Thus, fluid resuscitation is the primary immediate concern when burns extend beyond 20% of total body surface area.