The suggested minimum threshold for referral into Specialised Burn Services can be summarised as:

• All burns ≥2% total body surface area (TBSA) in children or ≥3% TBSA in adults
• All full thickness burns
• All circumferential burns
• Any burn not healed in 2 weeks
• Any burn with suspicion of non-accidental injury should be referred to a Burn Unit/Centre for expert assessment within 24 hours

In addition, the following factors should prompt a discussion with a Consultant in a Specialised Burn Service and consideration given to referral:

• All burns to hands, feet, face, perineum or genitalia
• Any chemical, electrical or friction burn
• Any cold injury
• Any unwell/febrile child with a burn
• Any concerns regarding burn injuries and co-morbidities that may affect treatment or healing of the burn

If the above criteria/threshold is not met then continue with local care and dressings as required.

If burn wound changes in appearance / shows signs of infection or there are concerns regarding healing then discuss with your nearest Specialised Burn Service.

If there is any suspicion of Toxic shock syndrome (TSS) then refer early.

It is unusual for burn injured patients to be taken directly to a Specialised Burn Service. Emergency retrieval services should follow the transfer pathway for Major Trauma patients.

National guidance on the referral pathway of burn-injured patients is also available via The National Burn Care Referral Guidance (2012) 

We recommend that you contact your nearest Specialised Burn Service for initial advice on assessment and management of a burn injury. You will then be advised to contact the most appropriate Specialised Burn Service in relation to the severity of the injury and given appropriate medical advice if required. 

If you are unable to contact a Burn Service directly, please contact the National Burns Bed Bureau (NBBB) who will be able to advise on the nearest burns bed available to you.  NBBB telephone number: 01384 679 036.