Assessment and Referral of Burn Patients
Every year, nearly half a million people in the United States are treated for burn injuries. The majority of initial burn care and evaluation occurs outside of a burn center environment, at local hospitals and clinics. Many providers struggle with when to manage a burn independently and when to refer to a specialist. Below, we cover initial assessment and referral guidelines for burned patients. The University Hospital Burn Center is available as a resource to you at all times.
Determining the severity of a burn
Burns are challenging to assess, particularly when the injury is new. These wounds tend to evolve over the first 48-72 hours after the injury. Often, the full extent of the damage to skin and underlying tissues is not clear.
The depth of a burn is dependent on the temperature of the heat source, duration of contact, thickness of the epidermis and dermis, and blood supply to the area of the burn. For example, very young and elderly patients have thinner skin and are more susceptible to deeper burns.
Characteristics of superficial, partial-, and full-thickness burns
• First degree (superficial) burns appear red, erythematous, and often painful. Sunburn-like presentation.
When to make a referral
The American Burn Association recommends referral to a burn center for the following patient situations:
1. Partial thickness burns greater than 10% total body surface area (TBSA)*
*TBSA can be estimated using the palm and fingers of the patient’s hand. One palm+fingers= approximately 1% TBSA. Always use the patient’s hand, not your own, to estimate TBSA.
For more information or treatment:
The UW Health Burn Team is available to collaborate regarding patients at all times. Please contact the Access Center at (608) 263-3260 to reach us.
To schedule education or training about the evaluation and treatment of burn wounds, please contact Andrea Wipperfurth, Program Manager, at (608) 263-8024.