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High-volume burn center proves value to region

The center averaged 845 cases per year in 2010-2011; it is known globally for advancing therapies through research. Care encompasses patients’ function, appearance and emotions.

On July 27, 2011, UW Medicine’s Regional Burn Center at Harborview showed why it’s a vital resource for the Pacific Northwest. The team mobilized midmorning when a Lynnwood boy, 5, arrived in critical condition with burns to 30 percent of his body. Just 90 minutes later, triage and care began for a girl, 9, airlifted from Spokane with burns to nearly half of her body.

Neither the cases nor the caseload was atypical. The Burn Center projected treating upward of 900 patients this year, mirroring 2010. They come from Alaska, Montana and points between.
A nurse dresses a patient’s burn. The burn center is recognized globally for advancing patient care with aggressive research of wound dressings and artificial skin.
The Level I program is a beacon nationally and internationally. For nearly four decades it has improved patient survival after major burns – with rapid treatment, aggressive research of artificial skin, pain management, functional recovery and rehabilitation.

The American Burn Association and American College of Surgeons have repeatedly verified that the center’s care meets the gold standard. Its nurses, physicians, rehabilitation therapists, social workers, spiritual counselors, pharmacists and nutritionist treat burn-injury patients almost exclusively. The Burn Center’s care also involves psychologists who help patients and families deal with physical and emotional issues.

Addressing function and aesthetics together
The two children identified above also had the unique benefit of a plastic surgeon co-managing their cases from the start.

“Many burn centers are run by a general surgeon who, later on, will refer a patient to a plastic surgeon. We address patients’ aesthetic and functional needs from the time they are admitted,” said Dr. Nicole Gibran, the center’s director. “Both of these children have deep hand and face burns. Our plastic surgeon is involved right away so we don’t compromise functional recovery later.”
UW professor of surgery Dr. Nicole Gibran, left, discusses patient cases with burn center staff.
Many patients arrive from other hospitals’ emergency departments. UW Medicine’s Transfer Center is a vital cog, immediately connecting referring hospitals with the burn surgeon on duty. That conversation helps determine whether the patient can be managed locally or requires the unit’s advanced capabilities.

“If you only see two or three burns a year, it can be challenging to know the protocols. It’s easy to give burn patients too much fluid or unnecessary antibiotics,” said April Delgado, the Transfer Center’s director.

As well, children’s burn care is more demanding than adult care, said Nurse Manager Carolyn Blayney, a 21-year veteran of the unit.

“Kids can get into trouble quickly. They breathe faster, they have problems with sugar levels and their bodies lose more water. There are differences in what heart rate and blood pressure are considered normal. Children aren’t small adults, they’re more than that,” she said.

The Spokane child didn’t start the school year in class. A child life counselor from UW Medicine/Harborview talked with the girl’s family and teacher about her re-integration to everyday life – what help she might need and how everyone can be respectful.

The center aims to provide care until patients recover their greatest capability. This can encompass months or years.

“There's talk about the federal government wanting healthcare facilities to assume responsibility for a patient from the time of an event through recovery,” said Gibran, elected president of the American Burn Association this year. “I like to think of the Burn Center as exactly that. We care for every need until you're as close to your pre-injury state as you can get.”

To refer a patient or learn more, call the UW Medicine Transfer Center at 888.744.4791.

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Transfer Center, U-Link, Medcon, Physician Liaison, Image Transfers, Airlift Northwest

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