Burn Center
Thermal Injury
UNM Hospital Referral Criteria
Initial Management
Stop the Burning Process
Remove smoldering clothing
Brush off dry chemicals
Irrigate liquid chemicals
The UNMH Burn Center treats both children and adults.
Burn injuries that should be referred to UNMH:
• Partial thickness burns greater than 10% total body surface area (TBSA)
• Burns that involve the face, hands, feet, genitalia, perineum, or major joints
• Third-degree burns in any age group
• Electrical burns, including lightning injury
• Chemical burns
Airway
• Inhalation injury
Intubate severe facial burns and severe smoke inhalation
Endotracheal tube 7.5mm or greater (in adults)
• Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality
• Burned children in hospitals without qualifies personnel or equipment for the care of children
• Burn injury in patients who will require special social, emotional, or long-term rehabilitative intervention
Breathing
Humidified 02 for possible carbon monoxide poisoning
Circulation
Remove constricting clothing
Secure large-bore IV access, use suture instead of tape
Start IV fluids
Place foley to monitor urine output
Disability
Examine eyes for injury – irrigate as needed for possible chemical injury or foreign body
Perform a detailed neurologic exam for electrical injuries
• 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 immediate risk, the patient may be initially stabilized in a trauma center
before being transferred to a burn center. UNMH offers an excellent trauma program and these patients are often co-managed in
our facility. Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan
and triage protocols.
Initial Burn Resuscitation Index (mL/hr)
Burn Size Score (BSS)
Head
Arm/Hand
Chest/Abd
Back
Thigh/Leg
1
1
2
2
2
1
Expose Patient/Control Environment
2
Front
Calculate burn size score
Clean, dry dressings
Tetanus prophylaxis
Keep patient warm
2
Back
1
1
2
UNM Hospital Burn Center
Dial toll free: 1-888-UNM-PALS
1- 8 8 8 - 8 6 6 - 7 2 5 7
Burn surgeons, burn nurses, intensivists, nutritionists, physical therapists, respiratory therapists and social workers are
all dedicated to caring for you or your family members when they suffer a burn injury.
Weight
(lbs) 88
110
(kg)
40
50
Total
1 100
125
132
60
154
70
176
80
198
90
220
100
242
110
264
120
286
130
308
140
330
150
150
175
200
225
250
275
300
325
350
375
2
200
250
300
350
400
450
500
550
600
650
700
750
3
300
375
450
525
600
675
750
825
900
975
1050
1125
4
400
500
600
700
800
900
1000
1100
1200
1300
1400
1500
5
500
625
750
875
1000
1125
1250
1375
1500
1625
1750
1875
6
600
750
900
1050
1200
1350
1500
1650
1800
1950
2100
2250
7
700
875
1050
1225
1400
1575
1750
1925
2100
2275
2450
2625
8
800
1000
1200
1400
1600
1800
2000
2200
2400
2600
2800
3000
9
900
1125
1350
1575
1800
2025
2250
2475
2700
2925
3150
3375
10
1000
1250
1500
1750
2000
2250
2500
2750
3000
3250
3500
3750
2
Instructions
1. Calculate Burn Size Score (BSS) as follows.
a. Determine the location of burn wounds
b. Assign full score for an area burned over 50% or greater (i.e. If
more than 50% of one are is burned assign one point. If more than
50% of one leg is burned, two points)
c. Assign one-half value for areas burned <50% (i.e. If less than
half of one arm is burned, 0.5 points. If less than half of one leg is
burned, one point)
2. Add up all points
3. Cross reference points with patient’s weight
4. Start IV Fluids at rate indicated in table with Lactated Ringers.
5. Transfer the patient to the nearest care facility.
Kahn, S., Schoemann, M, & Lentz, C. (2010). Burn resuscitation index: A simple method for
calculating fluid resuscitation in the burn patient. Journal of Burn Care, 31. doi: 10.1097/
BCR.0b013e3181e4d6ee