Superficial burn injury from cooking oil splash

Patient Information

Dispatch: A 44YO female presenting to the FAP with a burn to her right forearm sustained approximately 10 minutes ago. (Sarah Nguyen)
Patient: Sarah Nguyen — 44yr (65kg)
Incident History: Pt was working at a food stall at the Perth Royal Show when hot cooking oil splashed onto her right forearm. She self-applied a cold drink bottle briefly before walking to the FAP.
Emergency Contact: Michael Nguyen (Husband) — 0412 553 891

Initial Rapid Assessment

Response: Alert
Airway: Patent. Nil airway obstructions. Nil swelling or stridor. No soot or hoarseness noted.
Breathing: Breathing comfortably. No respiratory distress. Rate and effort within normal limits.
Circulation: Radial pulse strong and regular. Skin warm and dry. Reddened, blistered area approximately 6 x 8 cm to right volar forearm. Nil active bleeding.
Disability: GCS 15 (E4V5M6). Fully oriented to time, place and person. Complaining of significant pain to affected area.
Exposure: Isolated burn to right volar forearm — reddened, moist blistering skin with no charring or leathery appearance. No other injuries identified. Jewellery (bracelet) present on right wrist.

Vitals

Time	SpO2	Resp Dist	RR	Pulse	BP	CRT	GCS	PERL	Temp	BGL	Pain
Initial	98% (RA)	Nil	16	96	122/78	<2s	15	4 4 ++	36.9	–	7
10 mins	99% (RA)	Nil	14	88	118/76	<2s	15	4 4 ++	36.9	–	4

History Taking

Treatment Response

Diagnosis

This patient is suffering from a superficial partial thickness burn to the right volar forearm caused by a hot oil splash, estimated at approximately 2–3% Total Body Surface Area (TBSA).

Facilitator Triggers — if trainees miss a critical step

! (If trainees fail to remove the bracelet from the right wrist within the first 2 minutes, advise that the patient mentions her wrist is beginning to feel tight — prompt removal before oedema develops.)
! (If cooling is not commenced within 3 minutes of scene arrival, the patient reports that the pain is worsening and the area looks more inflamed — reinforce the 20-minute minimum cooling requirement.)
! (If trainees attempt to apply a dry dressing without cooling first, the patient winces and says 'that's making it worse' — redirect to cooling protocol.)
! (If trainees do not assess for inhalation injury — ask about cough, hoarseness, or breathing difficulty — facilitator prompts: 'Is there anything you want to ask about how she was breathing near the stall?')
! (If trainees do not perform a distal neurovascular check before and after dressing, prompt: 'Have you checked sensation and circulation in her fingers?')

Treatment Objectives

1 Don appropriate PPE — gloves at minimum.
2 Perform Primary Survey — confirm airway patent, breathing adequate, no circulatory compromise, GCS 15.
3 Assess burn for inhalation injury — ask about cough, hoarseness, black sputum, or breathing difficulty (none present in this scenario).
4 Remove jewellery from the affected limb — remove bracelet from right wrist before oedema develops.
5 Commence cooling of the burn area immediately — apply cool running water (approximately 15°C) to the affected area for a minimum of 20 minutes.
6 Do NOT use ice, iced water, butter, creams, or other home remedies on the burn.
7 While cooling, perform Vital Sign Survey — HR, BP, RR, SpO2, GCS, pain score.
8 Perform Secondary Survey — confirm burn is isolated to right volar forearm, estimate TBSA using Rule of Nines (approximately 2–3% for this area).
9 Document time of burn injury — 10 minutes prior to FAP presentation.
10 After cooling is complete (minimum 20 minutes), apply damp sterile dressings to the affected area.
11 Assess distal neurovascular observations (colour, warmth, movement, sensation, CRT) before and after dressing application.
12 Reassess pain score post-cooling and post-dressing — expect improvement from 7/10 toward 4/10.
13 Reassure patient continuously throughout treatment.
14 Advise patient that transfer to hospital is recommended for assessment and wound review, as blistering burns require medical evaluation.
15 Arrange transport to nearest emergency department — this patient does not meet criteria for direct transfer to tertiary burns centre (TBSA <10%, no airway burns, no involvement of face, hands, feet, perineum, or genitalia).
16 Record full observations every 10 minutes.
17 Scenario ends on arrival of ambulance and IMISTAMBO handover.
18 Attention to hand hygiene will be given throughout the scenario.

Clinical references: Burn Trauma · Primary Survey · Secondary & CNS Survey · Minor Wound Management · Pain Assessment

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