Burns (Adult) - Transportation

Developed by Prof H Rhode, Dr Albie van der Merwe, Dr Stephan Fourie & Prof A Millar & released as Circular H62 of 2011 

(updated 2016 by Dr S Cox, Dr R Martinez & Prof H Rhode)

WOUND CARE PRIOR TO TRANSPORT

1. Debridement and application of topical antimicrobials are usually unnecessary.
2. Apply Burnshield or any other non-adherent dressing to the area and secure the dressing with bandages or cling wrap.
3. Transport the patient wrapped in a dry sheet and blanket, keeping the patient warm. Do not transfer in wet towels. This leads to hypothermia
4. Apply a thin layer of silver sulfadiazine to open areas if transportation will be delayed for more than 12 hours.

TRANSPORT OF BURN PATIENTS

• Contact the burn unit telephonically and discuss the patient and transfer with the unit staff. If a bed is not immediately available then an interim management regime must be initiated until the patient can be transferred.
• Discuss the mode of transfer. Road transferral is possible in almost all burn patients. Air transport may be preferable when the patient is compromised with poly-trauma or other preexisting disease.
• A history, including details of the accident and pre-existing diseases/allergies, should be recorded and sent with the patient. Associated co-morbidity and injuries may complicate any burn and the patient needs to be carefully considered and the injuries be treated according to clinical needs. Before any transfer please consult with the receiving hospital unit.
• Provide a full and complete record to the receiving service/clinician:
  • Medication given: dosage and route
  • Dressings
  • Vital signs
  • Fluids administered: type, volume and time of commencement
  • Urine output: catheterisation for accuracy
  • Procedures performed
  • Contact details of relatives
  • Name and contact details of referring person
• Prior to transfer ensure:
  • The airway is safe
  • If required, the C-Spine is stabilised
  • IVI fluid therapy is commenced and maintained with reliable lines
  • Measures to maintain body temperature have been initiated
• In the case of paediatric patients not accompanied by a parent, obtain consent in consultation with your burn centre.