title: Optimization of burn referrals.
abstract: BACKGROUND
  Correct estimation of the severity of burns is important to obtain the right treatment of the patient and to avoid over- and undertriage. In this study we aimed to assess how often the guidelines for referral of burn injured patients are met at the national burn centre (NBC), Denmark.
  
  
  METHODS
  We included burn patients referred to the NBC in a three-months period. Patient records were systematically analyzed and compared with the national guidelines for referral of burn injured patients.
  
  
  RESULTS
  A total of 97 burn injured patients were transferred for treatment at the NBC and the most common reason for referral was partial thickness burn exceeding 3% estimated area of burn (55% of the patients) while facial burns (32%) and inhalational injury (25%) were other common reasons. We found that 29 (30%) of the referrals were considered potentially unnecessary according to the guidelines. The overtriage was highest among patients suffering of burns due to scalding and these were mostly children below 2 years of age.
  
  
  CONCLUSIONS
  An overtriage of referred burn injured patient was found and 30% of the referred patients were treated as outpatients. A telemedicine solution may be useful in the evaluation of burn injured patients before transfer.
authors.affiliation: Trauma Centre, Centre of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: hannakrusek@hotmail.com.
authors.forename: Hanna K
authors.initials: HK
authors.lastname: Reiband
authors.affiliation: Department of Plastic Surgery, Breast Surgery & Burns Treatment, Centre of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Kira
authors.initials: K
authors.lastname: Lundin
authors.affiliation: Department of Plastic Surgery, Breast Surgery & Burns Treatment, Centre of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Bjarne
authors.initials: B
authors.lastname: Alsbjørn
authors.affiliation: Trauma Centre, Centre of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Sørensen
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars S
authors.initials: LS
authors.lastname: Rasmussen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002053:Burn Units; D002056:Burns / Q000473:pathology / Q000628:therapy*; D002058:Burns, Electric / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark; D005151:Facial Injuries / Q000628:therapy; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000592:standards*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015208:Smoke Inhalation Injury / Q000628:therapy; D017216:Telemedicine; D014218:Triage / Q000592:standards*; D055815:Young Adult
keywords: Burns; Image transferral; Telemedicine; Triage