What are the key assessment criteria for determining the severity of a burn in a primary care setting?

In a primary care setting, the key assessment criteria for determining the severity of a burn injury include the following:

• Burn depth and type: Identify whether the burn is superficial epidermal (e.g., sunburn), superficial dermal, or full-thickness, as this influences management and referral urgency ¹.
• Body surface area (BSA) affected: Estimate the percentage of BSA involved; very young children with >10% BSA burns and adults with >15–25% BSA blistering require urgent referral or hospital admission ¹.
• Location of the burn: Burns involving the face, neck, hands, feet, genitalia, or over joints are more severe due to risks of airway oedema, inhalation injury, functional impairment, or contractures, necessitating specialist input ¹.
• Presence of circumferential burns: Circumferential burns to limbs or thorax can cause vascular compromise or respiratory compromise, indicating higher severity ¹.
• Signs of systemic involvement or complications: Symptoms such as heat exhaustion, heat stroke (fatigue, dizziness, nausea, confusion, tachycardia), or suspected inhalation injury require urgent assessment and possible hospital admission ¹.
• Airway, breathing, and circulation assessment: Immediate evaluation of airway patency and breathing is critical, especially for inhalation injury risk, as respiratory failure is life-threatening and deterioration can occur up to 72 hours post-burn ¹.
• Healing progress: Burns not healing within 2–3 weeks may be deeper than initially assessed and require specialist management to prevent hypertrophic scarring and functional loss ¹.
• First aid and initial management: Removal of non-adherent clothing, immediate cooling with cool (not ice-cold) water, elevation of the injury, and covering with cling film are important to limit tissue damage and oedema, which indirectly reflect severity and prognosis ¹.

These criteria are based on UK clinical guidelines integrating expert consensus and best practice recommendations ¹. Additionally, literature emphasizes that early and accurate assessment of burn severity impacts functional outcomes and long-term rehabilitation needs, highlighting the importance of comprehensive initial evaluation (Ryan et al., 2017).