Referral to burn unit
Authors: Rami Mossad Ibrahim, MD, Elisabeth Lauritzen, MD, Frederik Gulmark Hansen med.stud., Magnus Balslev Avnstorp, MD and Rikke Holmgaard, Consultant, Burns Specialist, MD, PhD
After completing the primary patient examination and burn assessment of size and depth, you must decide whether the patient may be treated at a local hospital or should be transferred to a Burn unit.
Minor burn injuries, which need to be bandaged, may be treated in the ER at the local hospital.
Transfer to a Burn unit is indicated when the patient has suffered larger burns or when there is a need for fluid resuscitation. The transfer should be coordinated with the Burn unit.
Referrals may be considered when
- The injury exceeds 5 % of TBSA in children (<15 years) and exceeds 10% of TBSA in adults
- Subdermal burns exceeding 5% of TBSA
- If escharotomies are needed
- Electrical or chemical injuries
- If inhalation injury is suspected/diagnosed
- If there is any doubt regarding treatment
- Pregnant, elderly or infants may also be referred as well as large burns on hands, feet, face and genital should be considered hospitalized
Can often wait until the patient is seen by a burn specialist!
Escharotomy is ONLY indicated in deep circumferential burns with clinical symptoms of compromised perfusion.