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• Consensus on the prehospital approach to burns patient management. February 2004
  Keith P Allison
  Published on: 29 April 2016
• Consensus on the prehospital approach to burns patient management
  Alison Walker
  Published on: 29 April 2016

• Published on: 29 April 2016

  Consensus on the prehospital approach to burns patient management. February 2004

  • Keith P Allison, plastic surgeon
  • Other Contributors:
    • Keith Porter

  Dear Editor

  We thank Allison Walker for her letter and helpful comments.[1] With respect to mention of the fire service with this patient group; care was taken to generically include all pre-hospital carers and there were two representatives from the fire service present at the consensus meeting. The fire services nationally are looking to use these guidelines as a standard of care and interface with their ambulanc...

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  Dear Editor

  We thank Allison Walker for her letter and helpful comments.[1] With respect to mention of the fire service with this patient group; care was taken to generically include all pre-hospital carers and there were two representatives from the fire service present at the consensus meeting. The fire services nationally are looking to use these guidelines as a standard of care and interface with their ambulance service colleagues.

  Whilst we acknowledge the importance of ABCs and these are included early in our 9-point list. The vast majority of patients do not have life threatening injuries and it was felt that for simplicity’s sake stop the burning process, cool and dress (first aid) would do the "most for the most" and it is these simple things which need most attention in our experience of receiving these patients in hospital. In practise, some of the nine point check list are done concurrently just as with the primary survey in the ATLS mantra.

  Burns patients will often not accept face dressings in the acute stage of their injury and clearly clingfilm is not appropriate. Waterjel products are ideal for dressing this area in the short term.

  Serial halving for burns assessment is a new concept in the burns literature and at the time this article was submitted, the serial halving technique was also being circulated. We are glad that helpful comments are being forwarded about the first edition of the burns consensus document and hope that future editions can include them, without losing sight that the guidelines should be simple and applicable to all pre-hospital carers.

  References

  (1) Walker A. Consensus on the prehospital approach to burns patient management [electronic response to Allison and Porter; Consensus on the prehospital approach to burns patient management] emermed.com 2004http://emj.bmjjournals.com/cgi/eletters/21/1/112#191

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  Conflict of Interest:
  None declared.

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• Published on: 29 April 2016

  Consensus on the prehospital approach to burns patient management

  • Alison Walker, A&E Consultant

  Dear Editor

  This consensus paper on the burns patient management in prehospital care1 is an important development in the standardised care of these patients by providers of early emergency care. However, there appear to be a few anomalies in the paper. The authors fail to mention the role of the fire service in the early management of these patients, although several services carry burns first aid equipment and me...

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  Dear Editor

  This consensus paper on the burns patient management in prehospital care1 is an important development in the standardised care of these patients by providers of early emergency care. However, there appear to be a few anomalies in the paper. The authors fail to mention the role of the fire service in the early management of these patients, although several services carry burns first aid equipment and medical gases and have undergone first aid training, sometimes in conjunction with their local ambulance service. Standard first aid, emergency department and trauma training has historically placed the “ABCs” after the SAFE approach and before treatment of non-life threatening injuries. The consensus guidelines appear to place this assessment after the treatment of the burn. Unless there is ABC compromise directly from the burn this would seem inappropriate. Although Clingfilm dressings are generally appropriate, mention of the management with significant facial burns with other dressings may have been a useful addition. Also many ED staff are unfamiliar with the use of serial halves to assess burns and a reference for this would be helpful. Overall this paper is a vital step in the integration of prehospital and emergency care for patients with burns.

  References

  1. Allison K, Porter K. Consensus on the prehospital approach to burns patient management. Emerg Med J 2004;21:112-14.

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  Conflict of Interest:
  None declared.

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