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Theatre teams should be informed whenever a major burn case is expected or has arrived. A member of the theatre team should be responsible for ensuring the availability of appropriately trained staff and facilities.⁴

All specialist burn services should participate in major incident planning with national and regional networks.⁴

Providers of emergency care outside burn services should have the knowledge and equipment needed to treat burn-injured patients should there be an extended delay in transporting the patients to a burn centre, as might be the case in a mass casualty incident.⁶⁵

Transfer of the critically ill burn-injured patient between services should follow national guidelines.^66,67,68

Burn service leaders should actively engage in local and regional surge in demand planning.

Each burn service should prepare to provide mutual aid to other burn services who may be overwhelmed.

Early communication between service leads is vital.⁶⁹

Agreed local clinical guidelines should be in use that have been produced by an appropriately constituted multiprofessional team, comprising anaesthetists, specialist nurses, surgeons, critical care clinicians, pharmacists, specialty consultants or autonomously practising anaesthetist and managers. These guidelines should cover at least the following:

• assessment and management of pain and pruritus, including the recording of pain and itch scores^13...

The anaesthetist should be part of a burns multidisciplinary team.⁴

Burn surgery operating lists should be scheduled in working hours.⁶³