Because of their specialization, burn centers are best equipped to handle the most severe types of burn injuries. The American Burn Association recommends the following burns be handled by a burn center medical team:
- Second Degree Burns greater than 10% TBSA
As seen in the graphic to the right, second-degree burns are burns that penetrate the skin’s outer layers (the epidermis) but don’t penetrate all the way to the fatty layer beneath the skin (hypodermis). Second-degree burns are easily identified by the blisters that form on the skin. When second-degree burns cover 10% or more of the body’s surface area, damage to the skin compromises its ability to fight infection and makes complications of the burn injury more likely.
Once a burn has penetrated to or through the hypodermis, it is likely that skin grafting will be a necessary part of treatment. Burns this severe also cause nerve damage and may lead to amputation or loss of function of the affected area. Burn center surgical teams have more experience with these specific types of injuries and give burn patients the greatest chance at limiting long term damage.
- Burns to the Face, Feet, Hands, or Major Joints
Burns to the face have the potential of causing problems with a patient’s sense of hearing and sight. They can further create cosmetic problems that are difficult to deal with after the injury has healed. Burns to the feet, hand, or joints can cause long term mobility issues if not properly treated.
- Electrical Burns
Electrical burns have the potential to interfere with the body’s natural electrical signals, making them especially dangerous. The full extent of electrical burns can also be difficult to diagnose because the energy from an electrical burn can run throughout the body while the physical signs of the burn may appear localized on the skin.
- Chemical Burns
Like electrical burns, the full extent of the damage from chemical burns is not always apparent by visual inspection. Chemicals that cause burns can also interfere with the body’s natural chemistry. At the extremes, chemicals which have been absorbed through the skin can start to dissolve internal organs or bones.
- Inhalation Injuries
Burns, either chemical or thermal, to the sensitive tissue of the throat can be dangerous in isolation. But especially when coupled with other burn injuries, inhalation injuries drastically increase the likelihood of death.
- Patients with Preexisting Medical Conditions
Burn injuries often cause damage that can aggravate or intensify pre-existing medical conditions. Conditions that are commonly complicated by burn injuries include heart conditions, kidney disease and diabetes.
- Burns Along with Physical Injury
Serious burns are oftentimes accompanied by other traumatic injuries, such as fractures. If the burn is the more serious injury (more likely to cause death), the patient will be taken to a burn center first. However, if the traumatic injury is more severe than the burn, the patient will be treated for the more serious injury first before being taken to a burn center.
- Children when Hospital Doesn’t Have Necessary Equipment
Because burn centers are required to have specialized equipment in order to remain classified as a burn center, they are often the only department with the medical equipment necessary to treat children. The extra experience of the burn center staff also makes them better suited to handle the unique factors that accompany treating a child.
- Burn Patients Who Require Special Social, Emotional, or Rehabilitative Intervention
Burn centers are also required to staff physical, occupational and burn therapists; psychiatric or clinical psychologists; and social workers 24 hours a day. Having the staff already on hand makes burn centers the best location to deal with patients who have additional needs that an ordinary medical department would not be able to meet.