Initial care of the burn patient is similar to that of critically ill patients with other diseases or multiple trauma. Postburn anemia occurs in patient with thermal injuries over 10” of their body surface area. Respiratory pathophysiology in a burn patient results directly from thermal injury to the upper airway, inhalation of smoke and the by-products of combustion, and indirectly from the pulmonary response to the inflammatory mediators. Pulmonary dysfunction is a major cause of death in burn victims. Temperature regulation of the hypothalamus is reset after a major burn injury. Major burn injuries cause a dramatic alteration in metabolism, leading to hypermetabolism and hypercatabolism. In addition, covering burn wounds with autograft, allograft, or synthetic substitutes shortens the duration of hypermetabolism. A major goal of wound management is to protect the viability of the zone of stasis to promote wound healing with desirable cosmetic and functional outcomes.