Burns that can be Treated as an Outpatient

Whenever there is a question about how serious a burn is, the person who is burned should be examined by a physician. The depth of a burn can be hard to determine, especially when the burn is caused by electricity. The factors that a doctor will consider in deciding whether to hospitalize a burn survivor include the following:

• Age of patient. Children between the ages of 5 and 20 years have the best recovery from burns. Individuals over the age of 70 almost always need to be hospitalized for burn treatment.
• Extent of burn. Older children and adults generally need to be hospitalized for second degree burns that cover more than 15% of their total body surface. Children under the age of 5 generally need to be hospitalized when burned over more than 10% of their body surface. Body surface can be estimated with the “rule of nines” – the head, right arm, and left arm contribute approximately 9% of total body surface each; each leg contributes 18% (2 x 9); the chest and back each contribute 18%; and the palms of the hands contribute another 1% each.
• Depth of burn. A small, deep burn may not need to be treated in a hospital. Similarly, a large first degree burn will typically not require hospitalization.
• Location of burn. Burns on areas such as the eyelids, hands, feet, and groin may make it difficult for the patient to live independently until the injury begins to heal.
• Pre-existing medical conditions. Some medical conditions may be greatly worsened when there is a burn injury. These include diabetes, kidney failure, congestive heart failure, and chronic obstructive pulmonary disease. Burn patients with these conditions may need to be hospitalized when a person without one of the conditions would not need to be.
• Other trauma. Accidents that cause burns often cause other injuries which may require hospitalization.
• Low voltage electrical burns. Low voltage (less than 1000 volts; household currents are 110 or 220 volts) shocks, in addition to causing burns, can cause an electrical disturbance in the heart leading to an “arrhythmia.” An arrhythmia is an abnormal heart beat and can potentially be fatal. People who have received a low voltage shock should have an EKG performed. High voltage burns ordinarily require treatment in a hospital.

See more on secondary treatment of burns.