Burn Care Guidelines for Physical Therapists Treatment of “Smaller” Burns

Burn wounds can be devastating and life-threatening. They can leave a person emotionally and physically scarred. It is of paramount importance that burn wounds, no matter how minor they are considered to be, receive optimal wound care. The physical, emotional, and psychological effect on our patients are parts of a whole, and as physical therapists we can have a significant and lasting impact on our patients with good, compassionate and professional care.

Burn wounds result from thermal, chemical, electrical, and frictional injuries. This course will focus on thermal and frictional burn wounds. It is first important to be familiar with the guidelines published by the American Burn Association (ABA) which outline the criteria for which a patient with burn injuries should be transferred to a Burn Unit. Because these guidelines change periodically, it would behoove the reader to check the web site for updates at www.ameriburn.com. The current guidelines (as of 5/06) for referral to a burn unit include:

      • Partial thickness burn wounds of 10% total body surface area (TBSA) or greater
      • Any burn involving hands, feet, face, genitalia, perineum, or major joints
      • Inhalation injury
      • Any full thickness burn wound in any age group
      • Electrical burns, including lightning injury
      • Chemical burns
      • Burn injury patients with pre-existing medical disorders that could complicate management, prolong recovery, or affect mortality
      • Any patients with burns and concomitant trauma (such as fractures) in which the burn injury poses the greatest risk of morbidity or mortality. In such cases, if the trauma poses the greater risk, the patient may be initially stabilized in a trauma center before being transferred to a burn unit. Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan and triage protocols.
      • Burned children for whom care by qualified healthcare professionals, or equipment, is not available
      • Burn injury in patient who will require special social, emotional, or long-term rehabilitative intervention

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