Burn injuries are complex and they necessitate vigilance in the clinical management, due to the multitude of related problems. Establishing the early steps of the management lays the foundation of all the treatment efforts that will ensue. Moreover, the initial steps shape the outcome profile of the patients. Hence the importance of the guidelines of the early management of burn patients. This helps quality assurance, reduces risks, and optimizes the cost-benefit relationship, while remaining adaptable to patient factors and local requirements.

The guidelines address the early phase of management. This includes among others, the airway, respiratory, pain and sedation requirements, wound care and fluid management. ⁽¹⁾ Standardized management during the first 24-48 hours after burn injury is critical because these early decisions—airway protection, burn shock resuscitation, wound care, analgesia, and triage—directly influence survival and long-term outcomes. ^(1-3) Evidence-based protocols reduce variability in practice, minimize complications, and optimize resource utilization. ^(1,2)

This local guideline has been developed by adapting nationally recognized standards to our healthcare context, ensuring applicability within available resources while maintaining alignment with international best practices. ^(1-3) Credible guidelines follow transparent, multidisciplinary processes grounded in evidence-based medicine principles. The WHO Handbook for Guideline Development and the Institute of Medicine standards emphasize validity, clarity, and scheduled updates to maintain trustworthiness. These processes integrate high-quality research where available and expert consensus where evidence is limited—an inherent reality in burn care—while considering feasibility, equity, and patient values. ^(4,5)

International frameworks inform this national adaptation. The American Burn Association (ABA) provides detailed recommendations on burn shock resuscitation, electrical injuries, pain management, and infection control, complemented by the Advanced Burn Life Support (ABLS) manual for emergency implementation. ^(3,6) Similarly, the International Society for Burn Injuries (ISBI) and Japanese Society for Burn Injuries (JSBI) ⁽⁷⁾ promote globally applicable, resource-sensitive standards under the vision 'One World, One Standard of Care,' while Interburns operemarks standards guide tiered service delivery in diverse health systems. ^(1,2,8)

By adopting these principles, this guideline aims to harmonize care delivery, enhance quality assurance, and support clinicians in providing safe, effective, and timely interventions for burn patients. ^(1-8) This guideline has been developed within the framework of Egypt's National Guideline Development and Adaptation Program, jointly led by the Egyptian Health Council (EHC), the Ministry of Health and Population (MOHP), and the World Health Organization (WHO) Country Office Egypt. It follows the internationally endorsed GRADE-ADOLOPMENT methodology to ensure methodological rigor, transparency, and contextual relevance. ^(9,10)