Treatment before transfer: the patient with burns

Objectives-To review pre-burns centre management, including assessment, res uscitation, and transfer. Methods-A retrospective analysis of the notes of all the UK patients admitt ed to the Burns Centre in 1998, who had a body surface area burn of over 15 % in adults (10% in children). Results-There were 31 patients, 21 adults and 10 children, and the average burn size was 32% (12-96%). Fourteen were overestimated (average of 9%) and 13 underestimated by 7.5%. Twenty nine received intravenous fluids, 18 spe cified a formula, but it was only applied correctly in 10. The average time to the Burns Centre from the burn was 10 hours, and the time for resuscita tion and transfer, eight hours. Documentation was generally poor. Conclusion-There has previously been considerable variation in the standard of initial burn management and there have been problems with burn percenta ge assessment and resuscitation formula application. A new proforma has bee n introduced to tackle these issues.