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

This guideline is developed for clinical staff involved in the care of trauma patients throughout Victoria. It is intended for use by frontline clinical staff that provide initial care to major trauma patients; both those working directly at the Major Trauma Service (MTS) as well as those working outside of a MTS.

These guidelines provide the user with readily accessible resources to effectively and confidently provide early care for critically injured patients through the use of up to date and evidence-based guidelines. It also aligns with the Victorian state burns clinical practice guidelines that were developed by Victoria’s adult and paediatric burn services. This guideline aligns with the Victorian The guideline has followed the AGREE II methodology for guideline development and is under the auspice of the Trauma State Advisory Committee (TSAC). ⁽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 368 661).
• All inter-hospital transfer of paediatric major trauma patients should be referred via Paediatric Infant Perinatal Emergency Retrieval (PIPER: 1300 137 650).