**Core Concept**
Immediate causes of death in burns refer to acute, life-threatening complications that occur within minutes to hours post-injury. These are typically related to respiratory, circulatory, or metabolic collapse rather than systemic infection or delayed toxicity.

**Why the Correct Answer is Right**
Toxemia refers to the presence of toxins in the blood, often resulting from infection or sepsis, which develops over hours to days. In burn patients, sepsis is a late complication, not an immediate cause of death. Immediate causes such as suffocation (due to airway edema), shock (from massive fluid loss and hypovolemia), and direct injury (e.g., inhalation injury or cardiac arrest) occur rapidly. Toxemia, being a delayed consequence of infection, does not manifest immediately.

**Why Each Wrong Option is Incorrect**
Option A: Injury is a broad term, but in burn pathology, inhalation injury or direct trauma can cause rapid death—thus it qualifies as an immediate cause.
Option B: Suffocation due to airway edema or inhalation injury is a classic immediate cause of death in burns.
Option D: Hypovolemic shock from fluid loss is the most common immediate cause of death in severe burns.

**Clinical Pearl / High-Yield Fact**
In burn patients, early death is usually due to shock or suffocation; toxemia (toxic blood levels) is a late complication of sepsis and is not an immediate cause. Always remember: "Shock and suffocation kill first; infection kills later."

✓ Correct Answer: C. Toxemia