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 NICE CKS.
• 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 NICE CKS.
• 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 NICE CKS.
• Presence of circumferential burns: Circumferential burns to limbs or thorax can cause vascular compromise or respiratory compromise, indicating higher severity NICE CKS.
• 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 NICE CKS.
• 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 NICE CKS.
• 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 NICE CKS.
• 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 NICE CKS.

These criteria are based on UK clinical guidelines integrating expert consensus and best practice recommendations NICE CKS. 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.