Having discussed some of the common reasons why a burn victim might need to be transferred to a burn center, we now move on to addressing how burn centers are so effective at providing the highest quality treatment to victims of severe burns.
There are over 500,000 emergency department visits for burn injuries in the United States each year. Of these injuries, approximately 20,000 require the advanced treatment offered by burn centers. In order to qualify as a verified burn center, hospitals must comply with the Guidelines for the Operation of Burn Centers including specialized staff and programs.
Medical staff working in burn centers have experience and qualifications specific to the treatment of burn injuries. Additionally, burn centers must have additional support staff that is often not required in traditional hospital departments.
Burn center surgeons are required to maintain board certification in either general or plastic surgery. They must also maintain specific burn treatment experience by working at least two out of the last five years directly in burn care or by completing a fellowship in burn treatment. To maintain their expertise, burn center surgeons must be the primary physician for at least 50 acutely burned patients each year and participate in at least 16 hours of burn-related education annually. Surgeons are also strongly encouraged to take part in the burn center’s research projects.
Burn centers must have at least one nurse at all times who is responsible for the administration of the burn center. This managing nurse must have at least a baccalaureate degree in nursing and two or more years of experience in acute burn care. Like surgeons, managing nurses must also participate in at least 16 hours of burn-related education annually.
Other members of the burn center nursing staff must be provided a burn center orientation which explains nursing requirements specific to the care and treatment of burn patients, including critical care, wound care, and rehabilitation methods that are age appropriate. These nurses must also take a minimum of two burn-related educational courses per year to maintain their competency.
In addition to traditional staff, burn centers must also provide 24 hour access to social workers, dietitians, pharmacists, respiratory therapists and psychiatrists or clinical psychologists. Each of these specialists must also have additional training in handling burn specific injuries. For example, burn center pharmacists must have at least 6 months of experience in critical care and an understanding of how drugs will affect patients with acute burn injuries.
In addition to specialized staff, burn centers must provide programs to support burn victims, their families, and their local communities. These include programs to provide for the long term care of burn patients, research programs for the advancement of the burn treatment field and burn prevention programs.
Long Term Care
As has been previously noted, burn injuries can have long term effects, especially for children. Burn centers focus not only on the immediate medical treatment but also on creating a long term care program designed to provide burn victims and their families access to the resources necessary to make a sustained recovery. Each burn center patient must have a designed rehabilitation program that identifies specific goals for that patient’s recovery. Part of this process is the mandatory Continuity of Care Program that all burn centers must provide which includes the following eight services:
- Recreational therapy for children cared for in the unit
- Patient and family education in rehabilitation programs
- Support for family members or other significant persons
- Coordinated discharge planning
- Follow-up after hospital discharge
- Access to community resources
- Evaluation of the patient’s physical, psychological, developmental, and vocational status
- Planning for future rehabilitative and reconstructive needs
Burn centers are also required to actively participate in basic, clinical or health science research projects and the medical director of a burn center must demonstrate an ongoing involvement in burn-related research. The scope of this research can be quite broad, ranging from the Arizona Burn Center’s programs to provide educational opportunities to future doctors to the University of Chicago Burn Center’s study of pediatric post-traumatic stress disorder. Additionally, burn centers are often the location where the most cutting edge burn treatment technologies are tested.
Burn centers also participate in burn education and serve as informational resources, especially to their local communities. Medical staff working in burn centers often teach local and regional Advanced Burn Life Support courses, as well as refresher courses in the pre-hospital and hospital care of the burn patient.