While on deployment you are caring for four patients with burn injuries. Which of the following is at greatest risk for burn-induced hypovolemic shock ?

• A. Patient with upper and lower back and circumferential left leg burn
• B. Patient with hand burn
• C. Patient with facial burn only
• D. Patient with minor toe burn

Answer: (A)

Burn-induced hypovolemic shock arises from massive fluid loss into damaged tissues and interstitial spaces after a burn, so the risk climbs with the total body surface area burned. A burn that spans both the upper and lower back represents a very large surface area, and adding a circumferential burn around the left leg increases both overall fluid loss and the risk of compromised circulation due to edema and potential limb ischemia. Together, these factors create the highest threat of hypovolemic shock among the options. By contrast, a burn limited to the hand, the face, or a single toe involves a much smaller surface area and less fluid shift, so the risk of shock is lower.