Major trauma – Burns

Authors: Jonathan Matthews, Rajan Atwal / Editors: Paramjeet Deol, Shashank Patil, Jorge Leon-Villapalos, Chris Gray, Lauren Taylor / Reviewer: Chris Gray, Joshua Davison / Code: / Published: 11/02/2021 / Reviewed: 15/01/2026

This module covers burns assessment and management in the Emergency Department (ED).

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.
  • Be aware of the common pitfalls in burns injury management

References

  1. Stewart BT. Epidemiology, risk factors, and prevention of burn injuries. UpToDate, updated in 2025.
  2. NHS commissioning board: Specialised Burn Care (All Ages), Service specification D06/S/a, 2013
  3. Hettiaratchy S, Dziewulski P. Pathophysiology and types of burns. BMJ 2004; 328 :1427.
  4. Orgill DP. Assessment and classification of burn injury, UpToDate, Updated in 2024.
  5. Hettiaratchy S, Dziewulski P. ABC of burns. Introduction. BMJ. 2004 Jun 5;328(7452):1366-8.
  6. Sheridan R. Cutaneous burns Symptoms, diagnosis and treatment. In: BMJ Best Practice. 15 Apr 2025 [cited 2026 Jan 12].  
  7. BattalogluE, GreasleyL, LeonVillapalosJ, YoungA, PorterK. Management of Burns in PreHospital Trauma Care. Faculty of PreHospital Care & British Burn Association. 2019.
  8. Lee JH, et al. Airway Obstruction after Laryngeal Burn Induced by Swallowing Hot Food. Korean J Otorhinolaryngol-Head Neck Surg. 2015 Sep;58(9):634-636.
  9. London and South East Burns Network. Initial Management of Severe Burns, 2020. London(UK): London and South East Burn Network;10 Feb 2025 [cited 2026 Jan 12].
  10. Stander et al The emergency management and treatment of Severe burns Emergency medicine International 2011; 2011: 161375. 
  11. Hettiarachy et al Initial management of burns II assessment and resuscitation BMJ 2004 Jul 10; 329(7457): 101103.
  12. British Burn Association: European practice guidelines for Burn Care Based by the Copenhagen EBA meeting, September 2002.
  13. National Institute for Health and Care Excellence (NICE). Burns and scalds. Clinical Knowledge Summaries, NICE, 2023.
  14. Borrows E, Randle E, Chigaru L. Burns Management. Clinical guidelines. Childrens Acute Transport Service (CATS). NHS; 2022.
  15. National Institute for Health and Care Excellence (NICE). Mersey Burns for calculating fluid resuscitation volume when managing burns. [MIB58] NICE, 2016.
  16. Public Health England. Tetanus: the green book, chapter 30, 2013. Last updated 2025.
  17. Dollery W. Cardiac monitoring not needed in household electrical injury if the patient is asymptomatic and has a normal ECG. BestBETs, 2003.
  18. London and South EastBurn Network. Making a Burns Referral. London(UK): London and South East Burn Network;10 Feb 2025 [cited 2026 Jan 12].
  19. Health New Zealand. Escharotomy Guidelines. National Burn Service Resources. [cited 2026 Jan 12].
  20. Riphagen S, et al. Paediatric Critical Care: Early management of burns. Version 5.0. South Thames Retrieval Service (STRS) at Evelina London.14 May 2025.
  21. Dien S, et al. The evidence – based topical therapies for management of minor burns in outpatient clinic. Journal of General-Procedural Dermatology & Venereology Indonesia. 2015;1(1):9-19.

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