Key Messages

The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This guideline provides evidence-based advice on the initial management and transfer of major trauma patients who present to Victorian health services with severe burn injuries.

This guideline is intended for use by frontline clinical staff that provide early care for major trauma patients outside of a major trauma service (MTS); however, access to this resource is not restricted to any one group. These severe burn management guidelines provide up-to-date information for frontline healthcare clinicians.

These guidelines align with the Victorian state burns clinical practice guidelines developed by Victoria’s two burn services. They provide the user with accessible resources to effectively and confidently provide early care for critically injured burns patients. The guideline has been assessed using the AGREE methodology for guideline development and is auspiced by the Victorian State Trauma Committee.

Clinical emphasis points

  • A burn is a complex trauma that requires multidisciplinary care and ongoing therapy.
  • Patients with facial, neck and inhalation burns can have difficulty maintaining their airway and deteriorate rapidly; any signs of oedema should prompt early intubation.
    Severe burns can have a devastating effect on quality of life
    Image used with permission from the Alfred Hospital
  • Early management of burns patients aims to restore fluid loss, maintain adequate oxygenation, prevent hypothermia and address pain management.
  • Supplemental warmed and humidified oxygen should be provided to all burns patients in the initial management.
  • Accurate early identification of the burn depth and percentage of total body surface area (TBSA) will guide treatment.
  • Burns that are extensive or complicated should be managed in a specialised unit.
  • Once identified that the patient is suffering from a major burns trauma, early activation of the retrieval process is crucial.
  • All inter-hospital transfer of adult major trauma patients should be referred via ARV (1300 36 86 61).
  • All inter-hospital transfer of paediatric major trauma patients should be referred via PIPER (1300 13 76 50).