Authors: Jonathan Matthews, Rajan Atwal / Editors: Paramjeet Deol, Shashank Patil, Jorge Leon-Villapalos, Chris Gray, Lauren Taylor / Reviewer: Chris Gray / Code: / Published: 11/02/2021
To make an accurate assessment of the depth of a burn, skin needs to be cleaned, blisters removed (except for small non-tense blisters [<6mm]) and capillary refill time tested.
E-learning module in burns assessment and management in the Emergency Department
After completing this session you will be able to:
Guidance on which blisters to de-roof and how to do it by the London and South East of England Burn Network (LSEBN) can be found here.
- Be able to recognise the impact of burns injuries in the Emergency Department
- Be aware of the classification of burns injuries
- Be able to assess the depth and size of a burn
- Understand risk stratification in major burns patients
- Be aware of key assessment, management points and investigations in the patient with severe burns.
- lsebn.nhs.uk Burns Blister Management
- Be aware of the common pitfalls in burns injury management
- lsebn.nhs.uk Deroofing Guideline
- Peck MD: Epidemiology of burn injuries globally, uptodate.com, Topic 822 Version 13.0, 2016
- NHS commissioning board: Specialised Burn Care (All Ages), Service specification D06/S/a, 2013
- Benson A, Dickson WA, Boyce DE: Burns, BMJ 649-652, 2006
- Hettiaratchy S, Dziewulski P: Pathophysiology and types of burns, BMJ 1427-1429, 2004
- Rice PL, Orgill DP: classification of burns, uptodate.com, Topic 819 Version 12.0, 2016
- Hettiaratchy S, Dziewulski P: ABC of burns introduction, BMJ 328:1366, 2004
- British Burn Association: European practice guidelines for Burn Care Based by the Copenhagen EBA meeting, September 2002
- The depth of the burn can be classified into 1 of 4 types. The British Burn Association (BBA) accepted definition has replaced the older 1st, 2nd and 3rd degree classification.
- Clinical Knowledge Summaries: Burns and scalds, 2015
- American College of Surgeons ATLS Course Manual 9th Ed Chapter Thermal Injuries, 2012
- London and South East Burns Network Initial Management of Severe Burns, 2015
- Stander et al The emergency management and treatment of Severe burns Emergency medicine International 2011; 2011: 161375.
- Remote PHC Manuals Burns, 2014
- Hettiarachy et al Initial management of burns II assessment and resuscitation BMJ 2004 Jul 10; 329(7457): 101103.
- Mersey Burns St Helens and Knowsley teaching hospital NHS trust, 2014
- Barnes et al The Mersey Burns App: evolving a model of validation EMJ Emerg Med J doi:10.1136/emermed-2013-203416
- Hoon et al Airway Obstruction after Laryngeal Burn Induced by Swallowing Hot Food Korean J Otorhinolaryngol-Head Neck Surg. 2015 Sep;58(9):634-636. Korean.
- Gillies et al Use of cut endotracheal tubes should be avoided in the initial resuscitation of the burned patient Emerg Med J 2003;20:109 doi:10.1136/emj.20.1.109
- London and South East Burns Network Burns Referral Guidelines: criteria for referral 2015
- New Zealand National Burn Service, Escharotomy Guidelines
- British Burns Association (2016), Emergency Management of Severe Burns 16th ed.
- Public Health England. Tetanus: the green book, chapter 30, 2013. Last updated 2020.
- Dollery W., Cardiac monitoring not needed in household electrical injury if the patient is asymptomatic and has a normal ECG. BestBETs, 2000