/clinical/,/clinical/references/,/clinical/references/burn/,/clinical/references/burn/comm-doc/,

/clinical/references/burn/comm-doc/

201606158

page

100

UWHC,UWMF,

Patient Care,

https://uconnect.wisc.edu/media/u-connect/clinical-hub/references/trauma-manual/burn-basics/First-Aid-Handling-an-Emergency.png
Clinical Hub,References,Burn Basics

Communication with Referring Physicians During Access Center Calls

Communication with Referring Physicians During Access Center Calls - Clinical Hub, References, Burn Basics

Focus

BURN PATIENT EXAMPLES FROM REFERRING FACILITY

  1. Small burn- physician wants to refer to our clinic
    1. This patient must have had their wound care done in the referring ED and a dressing placed. A temporary dressing such as plastic wrap is not sufficient. The patient must have adequate pain control while there and a plan made for oral pain medications until the clinic appointment. Tell the patient to arrive at 11am Monday through Friday (excluding holidays).
    2. Take down name, date of birth, and phone number where patient can be reached and call the clinic RN message line at (608) 890-7611 to tell them this patient will arrive for an appointment the next clinic day.
    3. Have access center create a MR # for the patient if they don’t already have one and write a telephone encounter note.
  2. Small burn – physician wants to refer to ED
    1. Attempt PO meds for pain control (IV if PO does not capture pain)
    2. See in ED to evaluate need for admission or observation, and wound care and then discharge home with clinic follow up. Follow the Pediatric Burn Care in ED algorithm (applicable to adults also).
  3. Estimated <20 for adults, or <10% for elderly/pediatric patients%
    1. Likely need IV for pain control
    2. LR should be at maintenance
    3. This patient does not require a foley. Do not put a foley in patients with genital burns just because they have a burn there.
    4. Does not need to debride burn, can just cover it with plastic wrap
  4. Estimated >20% TBSA burn must be sent to the ED
    1. Any history of other trauma with the burn
    2. Use IV for pain control
    3. LR calculated to follow Parkland formula
    4. DOES need a foley to monitor urine output. Start at the Parkland rate and titrate fluid administration to urine output of 0.5mL/kg/hr (or 30-50ml/hr) for adults, 1.0 mL/kg/hr for kids, 2.0 mL/kg/hr for babies. Encourage them to pass this on to the transport team.
    5. Does not need to debride burn, can just cover it with plastic wrap
  5. Estimated >20 % TBSA burn who can be directly admitted
    1. Has no trauma or burn injury not concerning for concomitant trauma
    2. Burn nurse states they have bed and staffing to direct admit
    3. Use IV for pain control
    4. DOES need a foley to monitor urine output. Start at the Parkland rate and titrate fluid administration to urine output of 0.5mL/kg/hr (or 30-50 ml/hr) for adults, 1.0 mL/kg/hr for kids, 2.0 mL/kg/hr for babies. Encourage them to pass this on to the transport team.
    5. Does not need to debride burn, can just cover it with plastic wrap

Reviewed by Burn Director, May 2016