This was a retrospective review with data collated from two burns units in Sydney, Australia. The purpose of the study was to compare total body surface area (TBSA) burn size estimation between referring centres and burn units in adult patients. Comparison was made for patients transferred between Jan 2009 and Aug 2013 which equated to 698 patients. The same TBSA burn estimation between the referring institution and the burns units was found in 30% of patients being transferred. However, overestimation of the TBSA from the referring institution was found to be three times more common than underestimation. Overestimation was more likely to happen in patients transferred early and in those that were transferred more than 48 hours after the burn injury. Underestimation was found to occur more often with increasing time after the burn and with increasing TBSA burn. In patients which had >20% TBSA burns, estimations were found to be more accurate. The authors concluded that inaccurate burn size estimations result in suboptimal treatment as well as the potential for inappropriate referrals, and therefore continuing to teach and test this skill as part of the emergency management of severe burns (EMSB) course remains essential.

Accuracy of burn size estimation in patients transferred to adult burn units in Sydney, Australia: An audit of 698 patients.
Harish V, Raymond P, Issler A, et al.
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Zeeshan Sheikh

NHS Lothian, UK

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