Appropriate use of burns referral chart in burns transfers in NSW

Sepehr S. Lajevardi1, Peter K.M. Maitz2

1 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137,
2 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137,

In 2004 New South Wales Severe Burn Injury Service published the “Burn Transfer Guidelines” which has since been updated. This includes the “Burn Patient Emergency Assessment & Management Chart” (BPEA&M chart) which should be used for all burns patients requiring transfer to a specialised burn unit. This study aims to investigate the rate of compliance with the use of the chart by rreviewing all patients transferred to Concord Hospital, New South Wales from 2009 to 2013.

Total of 334 transfers identified from which 189 (57%) had BPEA&M chart not done, 106 (32%) where the form was done and 39 (12%) where the use of the form was not applicable. Reviewing early management in the two groups where the chart was not done compared to those with the chart done respectively, first aid was given appropriately in 88.3% and 94.1% (p>0.05) of patients, respiratory care was appropriate in 95.1% and 97.6% (p>0.05), correct resuscitation fluid used in 88% and 98.5% (p<0.01), Parkland formula used appropriately in 68.5% and 87.2% (p<0.01), hypothermia prevented in 81.3% and 88.3% (p>0.05), and Tetanus given in 89.4% and 98.1% (p<0.001). Furthermore in the two groups mortality was 2.4% and 1.8% (p>0.05) respectively, mean age 43.4 and 41.1 years (p>0.05), TBSA 13.8% and 14.4% (p>0.05), and length of stay 14.4 and 16.8 days (p>0.05) respectively.

Despite the easy access to BPEA&M chart through NSW health website it is only used in 32% of burns transfers. This low rate is irrespective of patient age and TBSA burn size. Given the use of the chart may improve patient outcome further education and physical availability of the in all emergency departments is required to improve its utilization.

Key Words

Burn Transfer Guidelines


Dr Sepehr Lajevardi is a Plastics Surgical Trainee with Royal Australasian College of Surgeons. He is undertaking a PhD in early management of burns at The University of Sydney and has an interest in improving the care of burns patients before transfer to a burns unit.

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