Transfer from scene of injury to a Major Trauma Centre/Unit or Emergency Department

The optimal destination for a patient with critical burn injuries is usually a Specialised Burn Service.  However, burn services have a limited number of ITU (Level 3) beds, therefore, patients should not be taken directly to a burn service without contacting the on-call burns consultant first. 

Patients should be transferred promptly to the nearest Major Trauma Centre/Unit or Emergency Department, following the Major Trauma Pathway to avoid any delay in initial treatment.  

Any treatment carried out at the scene of injury should be as brief as possible (see pre-hospital page) and patients should be kept warm during transfer.

Transfer from a Major Trauma Centre/Unit or Emergency Department to Specialised Burns Service

Once the critically injured burn patient has been assessed and initial treatment undertaken (see SWUK Guideline_Initial Assessment and Management Burn Injury v1 (Oct 2018)), the Emergency Department Consultant should contact the nearest Specialised Burn Service for advice on the most appropriate burn service to refer the patient too.  However, if you are confident in your assessment of the burn size and depth, contact the burn service appropriate to the severity of burn injury.  Visit the Burns Services page for advice on referring a patient.  Advice is also available at any time.

When transferring a critically ill burn patient to a Specialised Burn Service, please remember:

• If in doubt, intubate. Don’t cut the tube
• Central access is preferable for drug infusions
• Arterial lines are more reliable than NIBP in oedematous patients
• Hypothermia increases mortality, keep the patient warm
• Distances involved in the transfer may be great. Make sure you have enough oxygen and fluids for the journey
• Keep a legible record of the observations, fluids and drugs given.

Transfer protocols should comply with respective Intensive Care Society and Paediatric Intensive Care Society protocols:

Intensive Care Society - Transport of Critically Ill Adults 2011

PIC Standards for the Care of Critically Ill Children 2015 (includes transportation)