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Burns (minor) Nurse Management Guidelines

Red Flag Exclusion Criteria

  • Child at risk of significant harm

  • Suspected non-accidental injury

  • Unplanned repeat ED presentation

  • Infant ≤ 12 months

  • High risk mechanism of injury

    • Confined space

    • Electrical injury

    • Chemical burn

    • Flash burn

    • Lightning strike

    • Airway and / or facial burns

    • Concomitant trauma

  • Stridor, sore throat, hoarse voice, sooty sputum

  • Burns to hands, feet, perineum, genitalia, over major joints or circumferential

  • Singed facial hair, eyebrows, eyelashes or nasal hair

  • Partial or full thickness burns in an adult ≥ 10% body surface area

  • Partial or full thickness burns in a paediatric ≥ 5% body surface area

  • Pregnancy with cutaneous burns

  • Significant co-morbidity

  • Immune suppression

  • History of workplace injury

  • Yellow or Red Zones observations or additional criteria outlined in the NSW Health Standard Observation charts

Additional observations

Additional history

  1. Establish mechanism of injury
    • How was the burn sustained
    • Date and time of burn

  2. First-aid treatment initiated prior to ED presentation
    • What was done

    • How long was it done for

    • Was clothing and / or jewellery removed

  3. Tetanus immunisation status

Management principles

  1. Jewellery (rings / watches etc.) must be removed from affected limb (cut jewellery if required)

  2. Limb should be elevated

  3. Continue or commence first-aid measures: cool burn with cool running water (not cold / ice) for at least 20 minutes. Cooling can be effective up to 3 hours after injury


  1. Provide analgesia as required according to pain scale. Refer to Pain (any cause) NMG

  2. For an epidermal burn only (e.g. minor sun burn), a suitable skin moisturiser (e.g. sorbolene cream) will usually suffice for treatment

  3. For mid-dermal, deep dermal or full thickness burns, consult with a medical officer and NSW Specialist Burns Unit prior to applying any cream or ointment

  4. Consider photographing burn injury after obtaining appropriate patient consent (see ACI State-wide Burn Injury Service Burn Patient Management 2014 p. 22)

  5. Cover burn with appropriate dressing as guided by ACI State-wide Burn Injury Service Minor Burn Management p. 9

  6. Consider consultation with a NSW Specialist Burns Unit for advice

  7. Document assessment finding, interventions and outcomes

References / further resources

  1. ACI Minor Burn Management: ACI State-wide Burn Injury Service Agency for Clinical Innovation, Sydney

  2. ACI (2014) Clinical Practice Guidelines: Burn Patient Management: ACI Statewide Burn Injury Service Agency for Clinical Innovation, Sydney

Contact Details for NSW Specialist Burns Units

Children’s Hospital Westmead (paediatric patients):

  • +61 2 9845 1850 (business hours)

  • +61 2 9845 1114 (after hours)

Concord Repatriation General Hospital (adult patients):

  • +61 2 9767 7775 (business hours)

  • +61 2 9767 7776 (after hours)

Royal North Shore Hospital (adult patients):

  • +61 2 9463 2111 (business hours)

  • +61 2 9926 7111 (after hours)

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