Burn Units in Canada

[mariomike]

In case of a burn related MCI in Ontario, Canada’s largest burn centre is at Sunnybrook Hospital. It has 14 beds.

Thirty percent of patients come from the Greater Toronto Area (GTA), while 70% are referred from across Ontario.

The Hospital for Sick Children "Sick Kids" is Canada's busiest pediatric burn centre with 14 beds.

When one considers a nightclub fire in Boston killed 492 , and injured 130 , that's not a lot of beds .

 

[Staff Weenie]

Compound that with the fact that these are not typically short-stay patients. I suspect some of those beds are occupied for months at a time.

 

[Haggis]

Compound that with the fact that these are not typically short-stay patients. I suspect some of those beds are occupied for months at a time.

I have an older cousin who suffered second and third degree burns over, I think, 60% of his body while 3 years old. He spent two years in a burn unit.

 

[Blackadder1916]

For context to the discussion, some info about guidelines used for burn patient referrals. The Canadian Burn Association endorses the ABA guidelines and protocols.

Burn Patient Referral Guidelines | American Burn Association

Guide clinical teams and burn centers with ABA’s burn patient referral guidelines. Includes best practices in assessment, fluid resuscitation, pediatric care, and second-degree burns.

www.ameriburn.org

Guidelines for Burn Patient Referral​

Developed to support clinical teams, these guidelines are intended to aid in referral decisions and should not be used as a substitute for professional judgment. If referencing or sharing these guidelines, please cite the American Burn Association as the original source.

If you have sustained a burn injury, please seek medical advice from a medical professional.

And a couple of referral guidelines/algorithms from Ontario.

https://kwemamd.ca/documents/CCSO_Burn-Centre-Consultation-Guidelines_EN_20240131.pdf

https://tbrhsctraumaprogram.ca/wp-content/uploads/2022/03/Trauma-Burn-Guidelines.pdf

And for those who like to get down into the weeds, this 2023 Master's of Nursing thesis "Burn Mass Casualty Incident Planning in Alberta: A Case Study".

https://ucalgary.scholaris.ca/server/api/core/bitstreams/c9394125-4b4e-40ff-a8ad-3a582e94eec7/content

 

[mariomike]

When the Cocoanut Grove went up in flames , the 171 victims who made it alive to Boston City and Mass General hospitals became subjects in the most comprehensive clinical trial in the annals of burn treatment,” writes Barbara Ravage in her book Burn Unit: Saving Lives After the Flames.

 

[Blackadder1916]

While there a small number of designated burn beds in Canada, the utilization pattern also has to be taken into account.

This from the Edmonton unit.

https://www.ualberta.ca/en/surgery/news/2025news/4april/burntreatment.html

The Edmonton Firefighter’s Burn Treatment Unit is an eight-bed comprehensive burn unit, with four designated critical care beds and four high intensity beds, located at the University of Alberta Hospital. It is a shared management critical care unit specializing in the care of the burned adults (in collaboration with the Critical Care doctors) and children (in collaboration with the Pediatricians).

Our burn unit is the only one in Canada verified by the American Burn Association to treat both adults and kids. Our inpatients are cared for by critical care-trained nurses, as well as a dedicated team of occupational therapists, physiotherapists, respiratory therapists, dietitians, social workers, Child Life specialists, a psychologist, and numerous support staff. As patients’ care is de-escalated and they are transferred out of the burn unit to the Plastics 3D3 or Pediatrics 4D wards, they continue to be followed by the Burn team, both during their hospitalization and after discharge.

My ex used to be the nurse manager of a 6 bed burn unit in the San Francisco Bay area.

AI ASSISTED Brookside Hospital in San Pablo, California (later renamed Doctors Medical Center) operated a well-known local care unit in the 1990s that treated regional industrial and home-fire burn victims, serving nearby heavy industry like the Chevron refinery and local plant accidents. [1, 2, 3]
Hospital Overview & Context

• Original Name: Brookside Hospital (opened in 1954 in San Pablo, CA). [1, 2]
• Later Name: Doctors Medical Center (managed by Tenet Healthcare starting in 1997, later returned to the West Contra Costa Healthcare District). [1]
• End of Operations: The hospital permanently closed its doors on April 21, 2015, and the site was later sold and demolished. [1, 2]

Burn Care in the 1990s

• Local Need: Due to surrounding oil refineries and heavy industrial corridors in Contra Costa County, Brookside routinely received emergency burn patients from local industrial accidents, refinery incidents, and residential fires. [1, 2, 3]
• Regional Network: While Northern California's primary specialized tertiary burn institutes included facilities like the Bothin Burn Center at Saint Francis Memorial Hospital in San Francisco and the Santa Clara Valley Medical Center, Brookside served as a vital community emergency and acute-response hub for West Contra Costa County. [1, 2, 3]

Like the description of the UofA center, they used a step-down approach to long term hospitalization, though they had the added complication of "insurance". Beside the usual supporting rehabilitation services there was also a unique (for the time) in-house asset of a hyperbaric medicine department with a dozen single chambers.

https://academic.oup.com/jbcr/article-abstract/11/2/140/4786494?redirectedFrom=fulltext

Adjunctive Hyperbaric Oxygen in the Treatment of Thermal Burns: An Economic Analysis
Abstract
Current reimbursement for burn care underscores the importance of cost containment in the treatment of burn injuries. We evaluate the economic impact of adjunctive hyperbaric oxygen in burns of 19% to 50% total body surface area in patients admitted to our burn center from January 1982 to July 1987. Length of hospitalization, number of surgical procedures, and total cost of care, exclusive of surgical fees, were examined. Eleven patients did not receive adjunctive hyperbaric oxygen therapy, whereas 10 did. The hyperbaric oxygen—treated group had an average decrease in length of stay of 14.8 days, a reduction of surgical procedures of 39%, and an average saving per case of $31,600.