Anaesthetists need time to cover the following essential points in the more immediate preoperative phase. The anaesthetic room is not usually an appropriate place for this except in an emergency.
Assessment
A small number of centres perform burn surgery. These centres should offer external training opportunities for anaesthetists, nursing staff, physiotherapists and other members of the multidisciplinary team.48
Anaesthetists who provide emergency care outside burn services should be trained in the initial management of the patient with severe burns, including timely emergency assessment, resuscitation, and transfer to a burns service, through the EMSB (Emergency Management of the Severe Burn) or an equivalent course.49
The anaesthetist should be part of a burns multidisciplinary team.11
Burn surgery operating lists should be scheduled in working hours.51
A rapid infusion device should be available for the management of major haemorrhage.
Additional burn surgery operating lists may be planned at weekends and bank holidays to prevent unnecessary delays in treatment.50
Any scheduled burn lists should be organised and staffed by appropriately trained anaesthetists and surgeons, working regularly in that area, who have no conflicting clinical commitments.50
Patients requiring planned or emergency burn surgery should be cared for by theatre staff with current experience in burn care.11 Anaesthetists who provide emergency care outside burn services should be trained to manage the initial treatment of the patient with severe burns, including timely emergency assessment, resuscitation, and transfer to a burns service.
