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Burns

Useful management information

  • Refer to Management of paediatric burn patient
     
  • Steps for providing adequate first aid
    • Stop
      • Stop drop and roll
      • Remove all heat source including clothes, nappies, jewellery
    • Cool
      • Running cold tap water for 20mins
      • Do NOT use ice
    • Cover
      • Use cling film to cover wound
  • Consider non-accidental injury – concerns about supervision, delay in presentation, history of burn but unexplained or inconsistent with injuries, repeated injuries, multiple burns, and burns to buttocks or genitals
  • Next of kin or person(s) who is legally responsible for patient consent, with the exception of children under guardianship orders with the Department of Communities, Child Safety and Disability services, should be present at the first outpatient appointment
  • ANZBA First Aid
  • ANZBA Referral Criteria
  • Centre for Children’s Burns & Trauma Research | Burn First Aid

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

  • No Category 1 Criteria – see ‘Emergency’ tab
Category 2
(appointment within 90 calendar days)
  • Old scar reconstructive
    • i.e. functional, growth, scar concerns or cosmetic concerns
Category 3
(appointment within 365 calendar days)
  • No category 3 criteria

If your patient does not meet the minimum referral criteria

  • Find assessment and management information at Brisbane South HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

 

Essential referral information for Burns referrals (Referral will be returned without this)

  • General information including contact details of the family
  • History and causative agent:
    • When did it happen? How did it happen? What was done? Length of cooling? Who saw it?
  • Download ITIM app that allows TBSA to be calculated by drawing area on body chart  
  • Assess the burn size using the Lund-Browder chart
  • Weight of child to be provided on any eReferrals to allow prior calculation of premed for dressings and debridement

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional referral information for Burns referrals

  • Digital clinical images may be transferred electronically for advice on the optimal initial dressings and the need for transfer for further assessment. Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Emergency Immediate transfer to the Emergency Department

If any of the following are present or suspected, please refer the patient to emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region
Burns
All major burns require emergency management and referral

The Paediatric Burns Centre (PBC), Qld Children’s Hospital offers a 24/7 referral service. For a referral coming from regional QLD, an email referral service is available. Criteria for referring to the service is based on the Australian New Zealand Burns Association transfer guidelines for Burns Service referral.

  • For those burns located in the Gold Coast region and below to Grafton NSW, please refer to Gold Coast University Hospital first. Paediatric surgical registrar or on call surgical cover 1300 744 284

If Gold Coast hospital is unable to care for the patient, then please follow the information below to refer to PBC
To refer a patient to the Paediatric Burns Centre (Qld Children’s Hospital);

  • Contact the Burns Register on call via switch (07) 3068 1111
  • Complete Category 1 Referral to Burns Outpatients (QH staff only)
  • Submit referral form by clicking ‘submit at the end of the form or by emailing through to burns-opd@health.qld.gov.au
  • Attach any photos to this email if possible
  • If advised that the patient can be treated locally, continue to contact the burns Registrar at each dressing change to update progress and send through photos to above email address

All paediatric patients should be referred to the PBC however they may not physically be required to attend the Queensland Children’s hospital. If treatment can be managed in the local area, then this is the preferred treatment
 

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 17 November 2022