**Question:** When do you refer burns patient to a burn center, in case of partial thickness burn

A. If the burn is too small to justify referral
B. After treating the patient for a week or two
C. When the patient experiences muscle pain or deep pain
D. When the burn is less than 10% TBSA (Total Body Surface Area)

**Core Concept:** Partial thickness burns involve partial damage to the dermis, which results in blister formation and epidermal sloughing. These burns are typically classified according to their size (TBSA, or Total Body Surface Area).

**Why the Correct Answer is Right:**
Correct Answer: D. When the burn is less than 10% TBSA

Partial thickness burns are typically managed locally at the site of injury, but in some cases, they may require referral to a burn center. The criteria for referral depend on the size of the burn, as burn centers are equipped to handle larger burns and more complex cases.

**Why Each Wrong Option is Incorrect:**
A. Referring the patient based on the size of the burn is irrelevant when considering partial thickness burns, as it only applies to full-thickness burns.
B. The duration of treatment does not influence referral decisions; the focus should be on the burn size and complexity.
C. Burn pain levels and depth do not determine referral criteria for partial thickness burns; referral is based on burn size and complexity.

**Why the Correct Answer is Right:**
Partial thickness burns are generally smaller than full-thickness burns, which have more complex referral criteria. Partial thickness burns typically involve the dermis, leading to blister formation and epidermal sloughing. Since burn centers specialize in larger burn management and more complex cases, referral to a burn center is recommended when the burn exceeds 10% TBSA.

**Why Each Wrong Option is Incorrect:**
A. Referring patients based on pain severity or burn depth is not relevant for partial thickness burns; referral decisions are determined by burn size and complexity.
B. The duration of treatment does not impact referral decisions for partial thickness burns; referral is based on burn size and complexity.
C. Burn pain and depth do not determine referral criteria for partial thickness burns; referral is based on burn size and complexity.

**Clinical Pearl:**
In cases of partial thickness burns, referral to a burn center should be considered when the burn exceeds 10% TBSA. Burn centers provide advanced care and expertise for larger burns or those with complexities that may not be achievable at smaller healthcare facilities. Timing of referral or pain severity is not the deciding factor; referral criteria are based on burn size and complexity.