TPTh 6.02 Burns in the ED: Gaps in DGH Trauma Care

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ID: 323860
2026
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Abstract
Abstract Aims Burns are a common Emergency Department (ED) presentation, yet significant variation exists in assessment and early management. Guideline-compliant care is essential to reduce morbidity. This audit evaluated burn management against RCEM and NICE standards in a District General Hospital (DGH), identifying gaps and opportunities to improve trauma care and strengthen clinical safety for patients. Methods A retrospective review included all burn presentations between July and December 2024. Data collected covered demographics, mechanism, A–E assessment, burn depth, TBSA estimation, and initial management (analgesia, cooling, cleaning, covering, tetanus prophylaxis, antibiotics, fluids). Follow-up and referral were also recorded. Audit standards followed national guidance to ensure consistent assessment criteria across services. Results One hundred patients were included (50 adults, 50 paediatrics). Thermal burns accounted for 96%. Hot liquids and hot surfaces were most common. A–E assessment was documented in 5%, burn depth in 75%, and TBSA in 66%. Analgesia was provided in 23%, cooling in 36%, cleaning in 58%, and covering in 76%. Tetanus prophylaxis was documented in 6% and antibiotics in 12%. Follow-up or referral occurred in 71%. No local burn management or referral pathway existed, and documentation varied across key domains. Conclusions Strengths included cleaning and covering, but major gaps were identified in analgesia, cooling and tetanus documentation. The absence of a structured pathway contributed to inconsistent practice. A DGH-wide burn management and referral pathway has now been introduced, supported by staff education. Re-audit is planned to evaluate its impact on ED trauma care and outcomes, promoting reliable standards.
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Authors Ganga Gurung, Olusola Folayan, Priscilla Akinlade, Catello Landolfi
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.483
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