Introduction Severe burn injuries require timely medical attention at an appropriate level of care. Correct referral of patients with burns depends on accurate estimation of injury severity. This study aims to determine how often patients at a trauma unit in a large referral hospital in South Africa are referred to the Burn Unit according the guidelines for burn referrals.

Methods Patients presenting with a burn injury to the trauma unit at the Red Cross War Memorial Children’s Hospital (RXH) during a 7-months period were included in the study. Patient medical records were studied and compared to the Western Cape Guidelines for referral of patients with burns to determine the number of patients that met the criteria, as well as the number who did not meet the criteria.

Result In total, 702 patients were included in the study. The most common reasons for referral were patients “under two years of age”, and “burns to special areas”. Out of the 702 patients that were seen at the trauma unit, 499 were transferred to the burns unit. Out of the 499 patients who were referred, 94% met the criteria for referral. Out of the patients who were not referred to the burns unit, 80% also met the criteria for referral. This group of patients differed in that they had significantly smaller burns compared to those who were referred.

Conclusion The data suggests that most patients were referred according to the guidelines, with a potential over-triage in very few cases. However, a large numbers of patients met the criteria for referral but were not transferred to the burns unit. These burns were mostly minor burns that likely did not require specialist care. In conclusion, while referral guidelines do catch the patients that need referral, they also catch many that do not need referral.