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External Burn S001

Document
Last amended 
14 September 2015

In this section

Current RMA Instruments:

Reasonable Hypothesis SOP
110 of 2015
Balance of Probabilities SOP
111 of 2015
Changes from Previous Instruments:

SOP Bulletin 185

ICD coding:

Body region

ICD Code

Head

(ICD-9 941.00; ICD-10 T20)

Scalp

(ICD-9 941.06; ICD-10 T20)

Eyelid

(ICD-9 941.02; ICD-10 T20)

Nose

(ICD-9 941.05; ICD-10 T20)

Ear

(ICD-9 941.01; ICD-10 T20)

Lip

(ICD-9 941.03; ICD-10 T20)

Face

(ICD-9 941.00; ICD-10 T20)

 

 

Neck

(ICD-9 941.08; ICD-10 T20)

 

 

Trunk

(ICD-9 942.00; ICD-10 T21.01)

Upper Back

(ICD-9 942.04; ICD-10 T21.04)

Lower Back

(ICD-9 942.04; ICD-10 T21.04)

Breast

(ICD-9 942.01; ICD-10 T21.01)

Chest

(ICD-9 942.02; ICD-10 T21.02)

Abdomen

(ICD-9 942.03; ICD-10 T21.03)

Buttock

(ICD-9 942.04; ICD-10 T21.04)

Groin

(ICD-9 942.05; ICD-10 T21.05)

 

 

Shoulder, upper arm

(ICD-9 943.05; ICD-10 T22.02)

Elbow

(ICD-9 943.02; ICD-10 T22.01)

Forearm

(ICD-9 943.01; ICD-10 T22.01)

Wrist

(ICD-9 944.07; ICD-10 T23)

Hand excluding fingers

(ICD-9 944.00; ICD-10 T23)

Fingers

(ICD-9 944.01; ICD-10 T23)

 

 

Hip

(ICD-9 945.00; ICD-10 T24)

Thigh

(ICD-9 945.06; ICD-10 T24)

Knee

(ICD-9 945.05; ICD-10 T24)

Lover leg

(ICD-9 945.04; ICD-10 T24)

Ankle

(ICD-9 945.03; ICD-10 T25)

Foot excluding toes

(ICD-9 945.02; ICD-10 T25)

Toes

(ICD-9 945.01; ICD-10 T25)

Toes + nail

(ICD-9 945.01; ICD-10 T25)

Brief description:

An external burn is a traumatic injury to the exterior of the body by heat (via conduction or radiation); via ionising, electromagnetic radiation or ultrasound; by corrosive chemicals; but not via friction or conduction of electricity.

Confirming the diagnosis:

This is a clinical diagnosis provided by a doctor or nurse on the basis of observed erythema or burnt tissue after documented exposure to a burning agent.

The relevant medical specialist is an emergency physician, dermatologist or plastic surgeon.

Additional diagnoses covered by these SOPs
  • burns due to application of cold substances (excluding frostbite)

  • burns due to hot substances

  • Sunburn

  • Welding burn (to the cornea)

  • Chemical burn

  • Radiation burn

  • Diathermy or ultrasound burn

Conditions not covered by these SOPs  
  • Friction "burns"* - cut, stab, abrasion and laceration

  • Frostbite*

  • Internal burns including to the respiratory tract and gastrointestinal tract and genitourinary tract#

  • Electrical burn* - electrical injury

  • Lightning burn* - electrical injury       

  • Laser burns to the interior of the eye#

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

This is instantaneous with the application of the agent. In this SOP the RMA has added a time delay in some of the factors which represents the time to recognise the injury, but the injury occurred within minutes of the application of the burning agent.

Clinical worsening

An external burn is an injury so a clinical worsening will not occur with further burning, since each exposure is a fresh injury and requires the SOP to be invoked again.

The natural history of a burn is to heal with or without residual scarring.

If the burn is very extensive in surface area, the veteran may not survive. This is not a clinical worsening but is due to the severity of the initial burn.

If the burn becomes infected the veteran may die of septicaemia and vascular shock or the burn may have a greater degree of scarring. In this case this would be a clinical worsening and may be due to an inability to obtain appropriate clinical management.