👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Patient Treatment & Transport🔖 Free to read, print, and share
Also known as: burns · rule of nines · tourniquet · evisceration · amputation · splinting
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Use this quick-reference guide to recognise, treat and hand over Burns, Wounds & Bleeding on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Rule Of Nines
Adult: head 9, arm 9, leg 18, front 18, back 18
Infant: head 18, leg ~14
Palm ≈ 1%
📌 Wounds
Chest → occlusive
Organs → moist + occlusive
Object → stabilize in place
📌 Bleeding
Tourniquet 2–3 in above, not a joint
Note the time · never loosen
📚 Burns, Wounds & Bleeding — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Special wounds each have one rule the exam checks: what to cover, what never to remove and how to stop bleeding in the right order. Burns add the rule of nines and the depth of injury.
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Key points
Understand these first
Rule of nines (adult): head 9, each arm 9, each leg 18, front 18, back 18, genitals 1.
Infant: head about 18 and each leg about 14. The patient's palm is about 1 percent.
Stop the burning, cool briefly with water, then dry sterile dressings and keep the patient warm.
Tourniquet 2–3 inches above the wound, not over a joint; note the time; never loosen it.
Splint the joints above and below a long-bone fracture and check pulse, motor and sensation.
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Treatment priorities
What to do, in order
Sucking chest wound: occlusive dressing; lift a corner if the patient worsens.
Evisceration: moist sterile then occlusive dressing — never push organs back.
Impaled object: stabilize in place unless it blocks the airway or CPR.
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Red flags — report now
Escalate immediately
Small electrical burns hiding deep injury
Bleeding that continues after a tourniquet
Signs of a pelvic fracture with shock
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Patient teaching
What patients must know
Amputated part: gauze, sealed bag, kept cool — never directly on ice.
❓ Burns, Wounds & Bleeding: NREMT FAQs
What are the priority actions for Burns, Wounds & Bleeding in the field?
Sucking chest wound: occlusive dressing; lift a corner if the patient worsens. Evisceration: moist sterile then occlusive dressing — never push organs back. Impaled object: stabilize in place unless it blocks the airway or CPR.
What findings in Burns, Wounds & Bleeding change your plan or your transport decision?
Small electrical burns hiding deep injury. Bleeding that continues after a tourniquet. Signs of a pelvic fracture with shock.
What do I need to know about Burns, Wounds & Bleeding for the NREMT?
Rule of nines (adult): head 9, each arm 9, each leg 18, front 18, back 18, genitals 1. Infant: head about 18 and each leg about 14. The patient's palm is about 1 percent. Stop the burning, cool briefly with water, then dry sterile dressings and keep the patient warm. Tourniquet 2–3 inches above the wound, not over a joint; note the time; never loosen it.
What should the crew communicate or document for Burns, Wounds & Bleeding?
Amputated part: gauze, sealed bag, kept cool — never directly on ice.
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Quick Tip
Rule of nines (adult): head 9, each arm 9, each leg 18, front 18, back 18, genitals 1.