This chapter discusses the diagnosis, evaluation and management of burns. Respiratory insufficiency or failure may result from mechanical or physiological mechanisms following a thermal injury. Thermal injuries can result in a significant impact to the cardiovascular system. The cardiovascular insufficiency observed following thermal injury may result from direct cardiac suppression via inflammatory mediators, alterations in preload, cardiac contractility, or peripheral vascular tone. The secondary assessment of a thermal injured patient should follow a systematic approach similar to that of a trauma patient. The thermal injuries should be evaluated and classified based on degree and extent of injury. A Lund and Browder chart can assist in the establishment of the extent and depth of thermal injury based on the body part affected. Partial thickness burns greater than 10% total body surface area (TBSA) is one of the criteria for patients who would benefit from transfer to a burn center.