Important considerations and FAQs

Be aware of hypothermia - it is easy to forget to keep the patient warm

Hypothermia is invisible to the naked eye, unlike a burn injury.

At least 30% of patients with severe burn injuries arrive at the Victorian Adult Burn Service with a temperature less than 35C. This has negative consequences for clotting, contributes to the trauma triad of death, limits early surgical opportunities, and is associated with a significantly higher mortality, than patients who arrive to the ED normothermic. 

Clinicians make great efforts to minimise heat loss and actively keep the patient warm, but this practice is variable.  

Frequently asked Questions

What is a severe burn?

In the Victorian State Trauma System, severe burns are injuries >20%TBSA, high voltage electrical injuries (>1000volts) and inhalation injury 

I’m not sure that this case is a severe burn, what should i do?

You should still contact Adult Retrieval Victoria on 1800 368 661. Use ISBAR to ensure a comprehensive assessment of the current situation and ARV will be able to assist. 

What sort of wound care should be performed?

Wound care should be rapid. Wound care for severe burns should be rapid and transfer should not be delayed by performing dressings which will be removed on arrival at the Trauma Centre. Ideal wound preparation for transfer should: 

  • Perform First aid
  • Wrap wounds in clingfilm, not circumferentially 
  • Patient should be kept warm  
  • Blisters can be managed at the Burn Service if transfer time is < 6 hours.  
  • If the transfer is to be delayed >6 hours, discuss preferred dressings with the Burns service 

For circumferential burns, elevate the affected area/s if clinically appropriate. This will help to reduce swelling and its deleterious effects on distal circulation and/or breathing.