Guideline for Transfer of Patients to Burn Centers

The American Burn Association and the American College of Surgeons recommend transfer to a burn center for all acutely burned patients who meet any of the following criteria (Questions concerning specific patients should be resolved by consultation with the burn center physician):

1. Partial thickness burns >= 20% Total Body Surface Area (TBSA) in patients aged 10 - 50 years old.



2. Partial thickness burns >=10% TBSA in children aged 10 or adults aged 50 years old.



3. Full-thickness burns >= 5% TBSA in patients of any age.



4. Patients with partial or full-thickness burns of the hands, feet, face, eyes, ears, perineum, and/or major joints.



5. Patients with high-voltage electrical injuries, including lightning injuries.



6. Patients with significant burns from caustic chemicals.



7. Patients with burns complicated by multiple trauma in which the burn injury poses the greatest risk of morbidity or mortality. In such cases, if the trauma poses the greater immediate risk, the patient may be treated initially in a trauma center until stable before being transferred to a burn center. Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan and triage protocols.



8. Patients with burns who suffer inhalation injury.



9. Patients with significant ongoing medical disorders that could complicate management, prolong recovery, or affect mortality.



10. Hospitals without qualified personnel or equipment for the care of children should transfer children with burns to a burn center with these capabilities.



11. Burn Injury in patients who will require special social/emotional and /or long-term rehabilitative support, including cases involving suspected child abuse, substance abuse, etc.

References

American Burn Association: Hospital and Prehospital Resources for Optimal Care of Patients with Burn Injury: Guidelines for Development and Operation of Burn Centers. Journal of Burn Care and Rehabilitation, 1990, 11:98-104.

American College of Surgeons:Resources for Optimal Care of the Injured Patient: 1993. 1993 by the American College of Surgeons, p. 64.

(May, 1996)

*DISCLAIMER This site is designed as an introduction to thermal injury for emergency medical technicians, medical students and physicians in training. It is not a comprehensive guide to thermal injury. As such the information may not be sufficient to address specific patient problems and these should be handled by physicians familiar with the specific clinical details pertinent to the individual patient. We invite comments from all users of this site.