The emergency nursing care of patients with major burns presents one of nursing's greatest challenges. Priority is given to lifesaving measures. After a quick overall assessment, a careful estimate of fluid and electrolyte loss is made. An issue in burn care is whether colloids should be given in the immediate postburn period. Large amounts of fluid are always given, and balanced salt solutions are being used increasingly without colloid. The patient's response to fluid therapy can be monitored by central venous pressure readings, vital signs, and hourly measurements of urinary output. Psychologic and physiologic stress intensify the problems and should be kept to a minimum. Only after other aspects of care have been attended is attention directed to care of the burn wound.