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Referral Guidelines

The American Burn Association and the American College of Surgeons recommend transfer to a burn center for burned patients who meet any of the following criteria.

A clinician is always available to provide direct physician-to-physician or nurse-to-nurse consultation about any concern related to burn care. Questions about specific patients should be resolved by consultation with the burn center physician. For consultation, please call the physician referral line, 800-877-7197.

  • Second- and/or third-degree burns covering more than 10 percent of the patient's total body surface area in patients of any age.
  • A third-degree burn greater than 5 percent in patients of any age.
  • Any second- or third-degree burn that could cause functional or cosmetic impairment to the face, hands, feet, genitalia, perineum, and/or major joints.
  • Electrical and lightning burns.
  • Chemical burns.
  • Burns involving inhalation injury.
  • Circumferential burns of the extremities and/or the chest.
  • Burns combined with other trauma where the burns are a greater threat of mortality or morbidity than the trauma.
  • Burns in patients with preexisting medical conditions that may make burn resuscitation and recovery more difficult or present a risk of mortality. This includes diabetes, chronic obstructive lung diseases and coronary artery disease.
  • Hospitals without qualified personnel or equipment for the care for children.
  • Burn Injury in patients who will require special social, emotional, or long-term rehabilitative support. This includes cases involving suspected child abuse, substance abuse, etc.


  1. American Burn Association. Hospital and Prehospital Resources for Optimal Care of Patients with Burn Injury: Guidelines for Development and Operation of Burn Centers. Journal of Burn Care and Rehabilitation. 1990; 11: 98-104.
American College of Surgeons. Resources for Optimal Care of the Injured Patient: 1993. American College of Surgeons. 1993; 64.

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