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
- 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.