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 II methodology for guideline development and is under the auspice of the Victorian State Trauma Committee. 1
Clinical emphasis points:
A burn is a complex trauma requiring specialist multidisciplinary care.
Patients with facial, neck and inhalation burns can have difficulty maintaining their airway and deteriorate rapidly, particularly when exposed to flame burns in an enclosed space. Any signs of oedema should prompt early intubation.
Early management of burns patients aims to restore fluid loss, maintain adequate oxygenation, prevent heat loss 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.
Severe and/or complex burns 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 Adult Retrieval Victoria (ARV: 1300 368661).
All inter-hospital transfer of paediatric major trauma patients should be referred via Paediatric Infant Perinatal Emergency Retrieval (PIPER: 1300 137650).