In a patient with full-thickness burns to both legs, which prescription should be implemented first?

In a patient with full-thickness burns to both legs, which prescription should be implemented first?

• A. Administer IV morphine
• B. Insert oropharyngeal airway
• C. Apply silver sulfadiazine to burn area
• D. Start two large bore IVs

Answer: (D)

Massive fluid loss from large-area burns makes restoring circulation the immediate priority. Having two large-bore IV lines allows rapid crystalloid infusion to begin resuscitation right away, which is essential to prevent burn shock and maintain perfusion to vital organs. While airway, analgesia, and wound care are important, they do not address the urgent hemodynamic threat present with extensive burns. An oropharyngeal airway is only needed if the patient cannot protect the airway, which isn’t indicated here, and applying silver sulfadiazine is a wound-care step that comes after establishing circulation. Starting two large-bore IVs best addresses the patient’s immediate physiologic needs.