When and Where to Seek Medical Treatment
Often, when a firefighter receives a small burn, especially to the knees, wrist, or ears, it is minimalized and categorized as superficial. This type of injury to a firefighter is often classified as minor and described as “not that bad”. Frequently a burn injury is viewed as a rite of passage. Seeking treatment for a perceived minor injury would be unthinkable to many in the fire service. That is why education on burn injuries is so important. Firefighters should seek immediate treatment for ALL burns, sustained in the line of duty. Burns are progressive in nature, meaning that what may seem small initially may become more involved several hours later. A seemingly minor burn, that goes untreated, may result in an extended hospitalization, additional surgeries and ultimately impact ability to perform fire service duties. ALL injuries must be seen and evaluated for treatment.
It is important to receive the proper treatment for any burn injury. A local emergency room or physician may be able to treat a minor burn injury but it is strongly recommended to seek treatment from a burn center. While verified burn units are not always geographically accessible, many fire departments across the country have adopted a burn center policy for their members, requiring treatment of any burn injury at a burn center. If you, a fellow firefighter, or family member is receiving treatment at a community hospital or trauma center that does not have a burn unit, please review the American Burn Association’s Burn Center Referral Criteria, listed below, for appropriate treatment guidelines. If the burn–injured individual meets any of the criteria, request transfer to a burn center. Remember that you have a voice in your health care decisions, make sure you receive the proper treatment for your burn injury!
Burn Center Referral Criteria
A burn center may treat adults, children, or both.
Burn injuries that should be referred to a burn center include:
- 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.
- Inhalation injury.
- Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality.
- Any patient 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 unit. Physician judgment will be necessary in such situations and should be in concert with the regional medical control plan and triage protocols.
- Burned children in hospitals without qualified personnel or equipment for the care of children.
- Burn injury in patients who will require special social, emotional, or rehabilitative intervention
First Degree (Partial Thickness) Superficial, red, sometimes painful.
Second Degree (Partial Thickness) Skin may be red, blistered, swollen. Very painful.
Third Degree (Full Thickness) Whitish, charred or translucent, no pin prick sensation in burned area.