From the Guidelines
The criteria for transfer to a burn unit include total body surface area (TBSA) burned > 20%, deep burns > 5%, presence of smoke inhalation, deep burns in areas that might lead to functional sequelae, and burns from high-voltage electricity, as well as other specific criteria for adults and children. When considering transfer to a burn unit, the following key points should be taken into account:
- In adults, transfer criteria include TBSA > 20%, deep burns > 5%, smoke inhalation, deep burns in function-sensitive areas, and high-voltage electrical burns 1.
- In children, transfer criteria include TBSA > 10%, deep burns > 5%, infants under 1 year, severe comorbidities, smoke inhalation, deep burns in function-sensitive areas, and electrical or chemical burns 1.
- Early transfer to a burn unit is crucial, as it can significantly improve outcomes by providing specialized care, including fluid resuscitation, wound management, and infection control 1.
- Initial management before transfer should focus on stopping the burning process, providing pain control, establishing IV access, starting fluid resuscitation, covering wounds with clean dressings, and avoiding hypothermia.
- The decision to transfer a patient to a burn unit should be based on the severity of the burn, the presence of comorbidities, and the patient's overall condition, with the goal of minimizing morbidity, mortality, and improving quality of life.
From the Research
Criteria for Transfer to a Burn Unit
The decision to transfer a patient to a burn unit is typically based on the severity of their burn injuries and the need for specialized care. Some of the key criteria for transfer include:
- Severity of burns: patients with severe burn injuries, such as those covering a large surface area of the body or affecting critical areas like the face, hands, or feet, may require transfer to a burn unit for specialized care 2
- Hemodynamic instability: patients who are experiencing hemodynamic instability, such as those with cardiac dysfunction or requiring large volume fluid resuscitation, may benefit from transfer to a burn unit where they can receive close monitoring and optimization of cardiovascular function 2
- Need for multimodal monitoring: patients who require multimodal monitoring, such as transpulmonary thermodilution, to assess hemodynamics and optimize cardiovascular function may be transferred to a burn unit where such monitoring is available 2
- Need for echocardiography: patients who require additional evaluations of hemodynamically unstable patients to assess systolic and diastolic function may be transferred to a burn unit where echocardiography can be performed 2
- Need for specialized treatment: patients who may benefit from specialized treatments, such as the use of anabolic and anticatabolic agents, may be transferred to a burn unit where such treatments are available 2