Burn Centers & Telemedicine
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Fire Fighters and Burn Centers
When to Go to a Burn Center
Guide to Burn Center Treatment Standards
Burn injuries require specialized care that is only available at a Burn Center.
It is important to understand that of all the different types of traumatic injuries, burns are among the most complex and difficult to treat. As a unique type of trauma, and because of the complex nature of burn injuries, which frequently require lengthy treatment and rehabilitation, specialized medical personnel and facilities are required.
A burn center is a hospital-based health care facility with specially trained professionals and resources to treat patients from the earliest stages of burn injury through rehabilitation.
Burn injuries are suffered by people of all ages and occupations, ranging from infants scalded by hot liquids to fire fighters battling a house fire. The hospital Emergency Department is typically the first point of contact whenever medical treatment is sought after a burn injury occurs; however, many burn centers also take calls directly from the local community. Ideally, continued care for serious burn injuries should occur at a burn center.
Maximizing the patient's long-term function and cosmetic appearance are two of the many outcomes that an experienced burn treatment team can provide at a verified burn center.
There are approximately 120 burn care facilities across the U.S. Of those, 64 are verified burn centers – meaning they have met stringent national requirements set by the American Burn Association (ABA) and American College of Surgeons (ACS).
The American Burn Association (ABA) Verified Burn Centers are accredited to ensure optimal care, recovery, rehabilitation, reintegration and support for the burn injury survivor and families of the survivor.
Verified burn centers also track a wide variety of burn injury data in support of advancing medical research to improve outcomes and to promote burn injury prevention measures. Additional information on verified burn centers and burn care treatment hospitals can be found at www.ameriburn.org.
Expertise of Burn Centers:
Fire Fighters and Burn Centers
Fire fighters carry the unique risk of repeated burn injuries and heat exposure because of the work they do. All fire fighters who have suffered any type or size of burn injury should be referred to or consult with a burn specialist. If there is not a burn center in geographical close proximity, this can be done remotely or through telemedicine to ensure proper treatment.
The skin is the body’s first line of defense. It protects against infection, helps regulate body temperature and its elastic nature supports movement. When skin is burned, these and other life-saving properties are greatly impacted. Treating burns involves more than just getting a wound to heal. Once the burn site closes over, newly healed areas remain delicate and extremely heat-sensitive for many weeks thereafter. A fire fighter's work environment consists of repeated exposure to heat sources. Returning to work too soon increases the risk of further damage to the burn injury site.
Fire fighters require specialized medical intervention available only at burn centers (preferably a verified center). It is important for fire fighters to remember they will not be able to continue in their careers unless they take the time to care for themselves.
Guidelines to Follow Before Returning to Work:
When to Go to a
Some burn centers only accept patients through referral. It is important for fire department administrators, government administrators and affiliate leaders to know what burn treatment resources are available in, around, or near their jurisdictions so that appropriate care can be received.
Transportation destinations should be based on hospital capabilities, timely access and need for stabilization before transferring to another facility.
Initially, a burn patient may have to gain access to care through an emergency department. Access to burn center facilities may be limited as a result of geography, and the patient may need emergency stabilization beyond the scope and capability of pre-hospital care. Through the availability of Telemedicine (health care professionals evaluate, diagnose and treat patients in remote locations using telecommunications technology), medical professionals can access guidance from burn specialists, in providing the early necessary care of the patient with burn injuries.
There are national standards and referral criteria that guide when a burn-injured patient is best managed by being transferred to a burn center:
If there is no burn center in your local area, here are short- and long-term options:
Verifying Burn Centers
The verification for burn centers is a joint program of the ABA and the American College of Surgeons (ACS). It is a rigorous review program designed to verify a burn center's resources that are required for the provision of optimal care to burn patients from the time of injury through rehabilitation. This requires a multi-disciplinary “Burn Team” of trained professionals, including physicians, nurses, occupational and physical therapists, social workers, psychologists, dietitians, researchers and those involved in support services such as fire fighters and burn survivors. Not all hospital care facilities have the training, personnel and resources necessary to deal with the physical, psychological, emotional, functional and dietary needs of post-burn patients and their families. The many challenges faced by burn patients and their families are oftentimes long-term, requiring ongoing care and support for optimal outcome.
Not all burn centers have been verified, but the ABA has a step by step verification process which burn care facilities can follow. Some burn care facilities offer treatment to adults, children or both. In some instances, emergent care and stabilization of the patient may take place in a hospital emergency room before transferring the patient to a burn center.
In addition to standardized burn care, there are other considerations that are also a priority. Adhere to standard principles of trauma management in accordance with local protocols, before EMS or healthcare providers address the burn injury. Primary stabilization takes place at the scene, and/or at a local Emergency Department or Trauma Center. Transfer to a verified burn center or burn center should be arranged after a patient has been stabilized initially. Consult the American Burn Association website at www.ameriburn.org for a list of verified and non-verified burn centers, details about transfer guidelines or how to consult with a burn physician on patient care.
Step-by-Step Guide to Basic Burn Center Treatment Standards
Review the Practice Guidelines for Burn Care or the additional resources listed below for more details on specific burn treatment guidelines and protocols.
*The above are all steps to stabilize a burn patient, but not all of these steps are done on-scene.
Telemedicine is an efficient clinical delivery tool that assists in offering solutions to issues surrounding access to specialty services and coordination of patient care. As a result, many providers and hospital systems worldwide have successfully embedded telemedicine into their care delivery systems.
Two Types of Telemedicine
Live Video Conferencing
Store and Forward
This delivery mode typically uses two-way, secure audio-visual technologies to link providers and patients together in real-time for the purposes of providing clinical consultations and/or direct patient care. These clinical encounters are generally accomplished using high-speed Internet connectivity via a variety of off-the-shelf video conferencing platforms and patient exam cameras.
This delivery mode utilizes the secure transmission of patient information through an electronic communication system. For instance, a remote hospital site would use cameras/mobile devices to secure still digital images of a patient’s burn(s), complete some demographic and clinical information (e.g., history, type of burn) and send that information to a burn specialist. The specialist then uses the information to evaluate the case and render a recommendation/assessment of the burn to the provider at the originating site. After reviewing the images and information, the telephone is then typically used to connect the sending provider with the burn specialist. The visual nature of burn and soft tissue injuries are excellent for this method of telemedicine as images of wounds can easily be assessed and treatment options discussed via distance.
Burn Center Telemedicine Programs
Burn centers represent a small but vital component of the healthcare community, and as such have an inherent obligation to provide critical education and specialty services to the population served. Burn Telemedicine allows top-of-the-line care and consultation for burn and soft tissue injuries, such as frostbite, to be made available to those who may be hundreds of miles away from a burn center. Through video conferencing equipment or the sending of images, burn experts can see patients remotely – allowing them to evaluate wounds and make clinical recommendations. Wound treatment and follow-up may often continue long term through the rehabilitation phase, allowing burn specialty centers to collaborate with local healthcare facilities in order to provide the most appropriate care for patients and their loved ones.
Potential Benefits of Burn Telemedicine:
For information regarding individual telemedicine programs, please contact the burn center in closest proximity to you.