# COMAR Title 30 — Maryland Institute for Emergency Medical Services Systems (MIEMSS)

## Subtitle 08 — Designation of Trauma and Specialty Referral Centers

### Chapter 06 — Adult and Pediatric Burn Center Standards

#### Regulation .17 Burn Center Referral Criteria.

*COMAR 30.08.06.17*

A burn injury requiring referral to a burn center includes:

A. A partial thickness or full thickness burn greater than 10 percent total body surface area (TBSA) in patients younger than 10 years old;

B. A partial thickness or full thickness burn greater than 20 percent TBSA in other age groups;

C. A partial thickness or full thickness burn that involves the face, hands, feet, genitalia, perineum, and major joints;

D. All full thickness burns greater than 5 percent TBSA in any age group;

E. An electrical/lightening injury;

F. A chemical injury;

G. An inhalation injury;

H. Frostbite and cold injury;

I. A burn injury in patients with preexisting medical disorders that could:

  (1) Complicate management;

  (2) Prolong recovery; and

  (3) Affect mortality;

J. A burn injury with concomitant trauma, such as a fracture, in which the burn injury poses the greatest risk of morbidity in accordance with the following considerations:

  (1) If trauma poses the greater immediate risk, the patient may be treated initially in the trauma center until stable before being transferred to a burn center; and

  (2) Physician judgment is necessary in these situations and shall be in concert with the regional medical control plan and triage protocols;

K. A burn injury in a child who has not reached their fifteenth (15th) birthday, who shall be treated in a pediatric burn center designated by MIEMSS; and

L. A burn injury in patients who will require special social, emotional, or long-term rehabilitative support including cases involving suspected child abuse or substance abuse.