Kathmandu, October 7
The government has prepared the “National Burn Treatment Service Standards” to bring uniformity to the treatment of burn patients across the country.
Prepared by the Curative Service Division under the Department of Health Services, the standards cover everything from initial burn treatment to specialist care, referral, rehabilitation and training of health workers.
The standards classify burn treatment services in Nepal into four levels. Level 1 is basic burn care, Level 2 is general burn care, Level 3 is specialist burn centres and Level 4 is super-specialist burn centres.
The standards also treat training of health workers as an important part of the treatment system. Health workers at the local level and in communities must be trained in initial burn treatment, patient classification, fluid management, pain control, wound dressing, monitoring, record-keeping and referral where necessary.
Under the standards, where a higher-level treatment centre is more than two hours away, the local hospital must develop the capacity to provide resuscitation care to burn patients for the first 24 hours. Level 3 and Level 4 centres have also been made responsible for further specialist and advanced treatment and training related to burns.
For first aid, the standards recommend cooling the burnt area under cool running water for 30 minutes where possible, and then covering it with a clean cloth or dressing. They also state clearly that toothpaste, soil, ghee, oil, butter, herbal pastes, and ice or ice water should not be applied to burns.
The standards also provide that systemic antibiotics should not be given routinely to all burn patients, and should be used only on the basis of medical evaluation when there is clear evidence of infection.
The standards link burn treatment with initial care, stabilisation, specialist treatment, surgery, infection control, nutrition, rehabilitation, psychosocial support and the referral system.
The Ministry of Health said the standards will ensure timely treatment and referral of burn patients at appropriate health institutions according to their condition, maintaining the quality and uniformity of burn care across the country.
