Triage of minor burn wounds: Avoiding the emergency department

Many patients with minor burn wounds will initially be evaluated in an emer gency department (ED) and incur unnecessary costs that could de avoided thr ough a direct referral to a burn center. In June 1997, use of an ED burn tr iage protocol was begun at our hospital. Adults with uncomplicated burns th at covered more than 1% and less than 15% of total body surface area (TBSA) and children with burns that covered more than 1% and less than 10% of TBS A were to be triaged directly to the outpatient clinic of the burn center w ithout registering in the ED. From 1996 to 1997, 653 patients were seen in the ED for burn injuries. Approximately 500 patients fit the present criter ia for direct triage to the burn center. Since the triage protocol began, t he percentage of patients triaged to the burn center has increased from 27% in the first month of use (July 1997) to 73% in December 1997. At least 33 % of ED patients were eligible by protocol but not triaged. The average ED visit time for these patients was 103 minutes versus 44 minutes for patient s mho were sent directly to the burn clinic. An estimated $125,000 per year decrease in charges would occur Filth use Of the protocol. Implementation of an ED triage protocol leads to avoidance of emergency room visits for th e majority of patients with minor burn injuries, which results in more effi cient, less expensive, faster care.