DEPARTMENT OF PLASTIC SURGERY
CRITERIA FOR ADMISSION IN THE BURNS UNIT (WARD K-2) - 2011
ADULTS
· Acute superficial or deep 2nd degree burns (partial thickness superficial and/or deep) with Total Body Surface Area (TBSA) burned greater than 15% (rule of nines or Lund - Browder chart). · Elderly patients (> 50 years old) with acute 2nd degree burns (partial thickness superficial and/or deep) with TBSA greater than 10%. · Elderly patients were suspicion of neglect or abuse exists or poor social circumstances. · Acute 3rd degree burns (full thickness) with TBSA greater than 5%. · Any % of TBSA with suspicion of inhalational injury. · Any % of TBSA with deep involvement of the face and neck (swollen face), and/ or hands, and/ or feet, and/ or genitalia/perineum, and/ or flexion/ extension areas. Superficial burns of the face if involvement of the eyelids, lips, ears and nose that might cause any later complications (e.g., infection, contractures). · Any % of TBSA with associated other injuries (fractures, head and neck injury, chest and abdominal injuries), and associated medical conditions (epilepsy, diabetes, alcohol or drug intoxication. The departments of General Surgery, Neurosurgery, and Orthopedics should assess the patient simultaneously (or a Trauma Team). · Old 2nd and 3rd degree septic burns (if patient cannot be managed at local clinics- or Harmony Home- for dressings and later skin grafting). · Any % of TBSA with electrical burns (inclusive lightening). · Any % of TBSA with chemical burns (exception: splash burns in minor areas). |
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CRITERIA FOR ADMISSION IN THE BURNS UNIT (WARD K-2) - 2011
CHILDREN
· Acute superficial or deep 2nd degree burns (partial thickness superficial and/or deep) with Total Body Surface Area (TBSA) burned greater than 8- 10% (rule of nines or Lund - Browder chart). · Children under 1 year of age with acute superficial or deep 2nd degree burns (partial thickness superficial and/or deep)with TBSA greater than 5%. · Any % of TBSA were suspicion of neglect or abuse exists or poor social circumstances. · Acute 3rd degree burns (full thickness) with TBSA greater than 3%. · Any % of TBSA with suspicion of inhalational injury (Paeds ICU to be Contacted immediately). · Any % of TBSA with deep involvement of the face and neck (swollen face),and/ or hands, and/ or feet, and/ or genitalia/perineum, and/ or flexion/ extension areas. Superficial burns of the face if involvement of the eyelids, lips, ears and nose that might cause any later complications (e.g., infection, contractures). · Any % of TBSA with associated other injuries (fractures, head and neck injury, chest and abdominal injuries). The departments of General Surgery, Neurosurgery, and Orthopedics should assess the patient simultaneously (or a Trauma Team). · Old 2nd and 3rd degree septic burns for dressings and later skin grafting (if patient cannot be managed at local clinics for dressings and later skin grafting). · Any % of TBSA with electrical burns (inclusive lightening). · Any % of TBSA with chemical burns (exception: splash burns in minor areas). |
CRITERIA FOR ADMISSION IN THE BURNS UNIT (WARD K-2) - 2011
PATIENTS WITH BURNS WHO DO NOT QUALIFY FOR ADMISSION IN K-2 (AS PER REFERRAL FROM OTHER HOSPITALS OR TOWNS)
·Minor burns that do not fall under those described above. · Extensive burns patients who have no chance of survival*. ·Elderly (> 70 years old) patients with 30% or greater deep burns*. ·Any patient with > 70% burns where ¾ of burn areas are 3rd degree. ·Old burns for skin grafting (they must be referred to local clinics for dressings and booked for the Plastic Surgery Clinic for assessment). |
- Any patient referred from other areas that falls under those conditions above must be sent back to the referring doctor/ peripheral hospital, except if a previous arrangement was done with the ward’ doctors. The peripheral hospitals, district hospitals, health care services should communicate with the burn ward doctor before referring the patient.
- The doctor from the Burns Unit must contact and inform/ discuss with the referring doctor/ hospital. A letter must be written to explain to them the reasons for not accepting the patient.
- A careful assessment of the patient must be done in the emergency room (casualty) before sending the patient back, and any management needed should be made (I.V drip with fluid replacement, pain medication, anti-tetanus prophylaxis, and dressing).
- Patients for skin grafting will be booked for operation by arrangements made after assessment in the Plastics clinic, or by telephonic arrangement with the Medical Officer or the consultant of Plastic Surgery.
- The referring doctor is responsible for the assessment, stabilization, adequate initial resuscitation, and safe transportation of the critically ill burned patient, before he/she is accepted in the Burns Unit.