Adult (≥16yo): Major Burn Referral to the Scottish National Burns Centre from Lothian, Tayside or Grampian

Adult eligibility criteria:

• Age 16 years or older
• Burn ≥25% TBSA (elderly/ infirm ≥10%)
• Patients requiring level 3 ICU and significant early excision and grafting. Isolated airway injury might be best managed locally. Please liaise with GRI ICU Consultant on-call at 81337/ 81338)
• Full thickness burns ≥10% TBSA
• Other complex injuries subject to consultant-level discussions. Examples include:
  • Airway or inhalation injury in the absence of appropriate local ICU expertise
  • High voltage (≥1,000V) electrical injury
  • Polytrauma, where the burn insult is more significant than the non-burn insult and the local trauma centre is unable to manage/ cope
  • Significant frostbite or cold injury

• Escalate to Plastic Surgery Registrar and Consultant on-call. No referrals to be accepted without Consultant agreement. During working hours, please also inform one of the Burn Consultants.
• If the patient requires ICU level care, please discuss with GRI ICU Consultant on-call before accepting transfer (Consultant 81337- Trainee 81338). Depending on local bed availability, patients might need to complete ICU course locally or diverted elsewhere.
• If the patient requires life or limb saving surgery (e.g., emergency tracheostomy or fasciotomies), these might need to be performed prior to transfer. 
• Ask referrer to complete the COBIS referral form  and email it to ggc.burnshubreferrals@ggc.scot.nhs.uk and at least one member of the on-call team. 
• See also SOP 002: Burn referrals to the Scottish National Burns Centre 

• Referral cannot be accepted, unless there are exceptional circumstances (e.g., mutual aid requests or similar). This will be agreed on a case by case basis and always at consultant level. If in doubt, please ask the referrer to initiate a consultant to consultant referral.
• Refer to COBIS referral pathway  for information on which hospital the referral should be diverted to. Please advise the referrer of this.