The fire department responded to a building fire. A firefighter was injured. The firefighter was transported to the burn center with burns over more than 20% of their body. Which intervention is appropriate for the ACUTE phase of burn care?

A. Initiate intravenous resuscitative fluid therapy: In the acute phase of burn care, especially when burns involve more than 20% of total body surface area, massive fluid shifts occur due to increased capillary permeability. Intravenous fluid resuscitation is critical to maintain hemodynamic stability, prevent hypovolemic shock, and ensure adequate perfusion of vital organs. Early fluid replacement is a cornerstone of acute burn management. B. Insert a nasogastric tube to prevent aspiration: Nasogastric tube insertion may be indicated if the patient develops ileus, abdominal distension, or significant fluid resuscitation leading to gastric complications. However, it is not a primary intervention in the immediate acute phase of burn care and is secondary to stabilizing circulation and fluid status. C. Administer analgesics prior to dressing changes: Pain management is essential for comfort and procedural tolerance, particularly before dressing changes. While important, analgesic administration is a supportive intervention and does not address the life-threatening fluid loss and shock that occur during the acute phase of major burns. D. Insert an indwelling urinary catheter to prevent retention: Urinary catheterization can be used for accurate monitoring of urine output as part of fluid management in burn patients. However, it is not a standalone intervention for the acute phase; its primary purpose is to guide fluid resuscitation, which depends first on initiating intravenous fluids.