Auckland Regional Burn Service/ National Burn Service
The National Burn Service is part of the Department of Plastic Surgery at Middlemore Hospital and serves as the Regional Burn Unit for the same catchment area as the Department of Plastic Surgery (north of the Bombay Hills).
Incorporated on-site is the National Burn Centre (NBC) which cares for the most severe burn injured patients from both local region and around the country. The National Burns Centre is part of a larger burn care network with existing regional burn treatment facilities in Christchurch, Hutt Valley and Waikato. Staff work closely with these units to manage referrals.
Middlemore’s state-of-the art National Burn Centre opened on Friday 16 June 2006. The facility provides treatment and rehabilitation for some of New Zealand’s most severe burn patients.
What is a burn?
A burn can be caused by heat (e.g. hot water, fire or contact with hot objects), electricity, radiation or chemicals. Skin is typically damaged, although deeper burns can involve underlying fat and muscle. The three important factors in determining the seriousness of a burn are (1) the size of the burn, (2) the depth of the burn (see below) and (3) its location.
Small superficial burns typically only require pain relief and the appropriate dressing to allow spontaneous healing and can be managed at home with support. Larger or deeper burns may require admission into hospital for specialist treatment.
Burn injuries can be devastating and even life-threatening. Even a small burn, not treated well, can result in life-long scarring and/or disability. Treatment of burns, even minor ones, can involve a whole team of specialists dedicated to restoring form and function.
Modern treatment of burn injuries involves early assessment and treatment aimed at getting the wound spontaneously healed within two to three weeks to minimise scarring. At times this can be done with dressings alone. At other times surgery is required to achieve healing with minimal scarring.
Follow-up outpatient appointments with members of the burn team to achieve the goal of maximising return of function and minimising scarring and disability may take weeks or months, even years.
Immediate first aid treatment begins with appropriate first aid:
- Stop the burning process
- Remove any easily-removable affected clothing
- Cool the burn with cool running water for 20 minutes, then keep the area warm and dry. Ice should not be used on the burn wound.
- Keep the patient warm at all times
- Seek medical advice for wounds that blister or if there are any concerns.
Depending on how serious the burn is (in depth, size and location) burns may be treated as either an inpatient (admitted into hospital) or as an outpatient. In both instances, multiple health professionals (surgeons, nurses, physiotherapists and occupational therapists) will be involved. As required, a social worker or psychiatric liaison staff may be involved.
Referrals into the system can come from your family doctor or via an emergency department.
Some outpatient clinics are staffed by all members of the burn team, others by the Burn Clinical Nurse Specialists alone. Referrals to these clinics can be made by your family doctor or following discharge from hospital.
Referral Criteria for National Burn Centre
- Buns greater than 30% total body surface area (TBSA)
- Full thickness burns to face, hands, genitalia or perineum
- Burn injury with significant inhalation injury
- Electrical burns - high voltage with underlying tissue damage
- Significant chemical burns
On-call Burn Coordinator National Burn Centre Contact Details are:
- Phone: 09 258 3800
Referral Criteria for Regional Burn Unit
- Burns greater than 10% total body surface area (TBSA) for adult or 5% in a child
- Burns to special areas, e.g. face, hands, feet, perineum or over major joints
- Full thickness burns greater than 5% TBSA
- Electrical burns (including lightning injury)
- Chemical burns
- Burn injury with inhalation injury
- Circumferential burns of the limbs or chest
- Burn injury in patients at the extremes ages i.e. young children and the elderly
- Burn injury in patients with pre-existing medical disorders that could complicate management, prolong recover or affect mortality
- Any burn patient with burns and concomitant trauma (e.g. fractures) in which the burn injury poses the greater immediate risk of morbidity or mortality
- Any burn suspected with abuse
RBU Referral Form:
Regional Burn Centre Contacts
Phone the on-call plastic surgery registrars:
- Middlemore Hospital - (09) 276 0000 or 021 784 057
- Waikato Hospital - (07) 839 8899
- Hutt Hospital - (04) 570 9999
- Christchurch Hospital - (03) 634 0640
Common Conditions / Services
Epidermal Burns (First Degree)
These only affect the outer layer of skin (epidermis). The burn area is red, dry and painful but no blisters are present.… More
Superficial Dermal, Mid-Dermal and Deep-Dermal Burns (Second Degree)
Superficial Dermal burns affect the epidermis and part of the second deeper layer of skin (dermis).… More
Full Thickness Burns (Third Degree)
The skin may appear dry and may be charred black or white.… More
Patients admitted with burns are cared for in different parts of the hospital depending on how severe their burn injury is and their age.… More
Inpatient Treatments - Pain Control, Wound Care and Therapy
Three main factors necessitate inpatient care for a burn injury:… More
Some patients will be assessed as being suitable for outpatient treatment after being referred in to be assessed.… More
These are a continuation of the inpatient treatments (see above). More
Weekly multidisciplinary burn clinics are held for patients under the care of the Burn Team.… More
The palm of the individual’s hand (including the fingers) is about 1% TBSA.… More
Burn depth is critical to determining whether a burn will spontaneously heal or not.… More
There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the Eligibility Directions specified criteria set by the Ministry of Health. If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.
To check whether you meet the specified eligibility criteria, visit the Ministry of Health website www.moh.govt.nz/eligibility
For any applicable charges, please phone the Accounts Receivable Office on (09) 276 0060.
- National Burn Centre Referral Form (PDF, 104.3 KB)
- Referral Flowchart (PDF, 34.3 KB)
Patient & Family Information Booklet
(PDF, 240.4 KB)
An informative and helpful booklet designed to answer questions that patients and families might have regarding the National Burn Centre.
- Recovering from Burn Injury - Coping and Emotional Recovery (PDF, 1.6 MB)
- Recovering from Burn Injury - National Burn Centre Transfers (PDF, 1.7 MB)
Visiting times (and restrictions on visitors) for each part of the hospital differs. Please contact the appropriate part of the hospital to confirm current visiting times and possible restrictions.
In general visiting hours are between 2pm and 8pm. Visitors are restricted to two at a time. Although children are welcome, they must be supervised by an adult at all times. We welcome Partners in Care to our wards. Please introduce yourself to our staff.
There is a 'No Fresh Flowers' policy on the ward as the pollen may get into wounds and cause infections.
Restricted Visiting Policy
Whaanau who want to visit a patient need to be from the patient’s own “bubble”, and will need to request permission in advance by speaking to the Charge Nurse Manager/ Charge Midwife Manager.
Contact details for all our sites are listed on the website. The decision will be made on a case-by-case basis, by a lead clinician in conjunction with infection prevention and control experts.
We encourage whaanau and friends to first consider “virtual” visiting options – by phone, text or video/ FaceTime – to stay connected and give support to patients who are in hospital.
There are some specialised services in the hospital where visiting hours may vary, for example, the Delivery Suite, or Intensive Care Unit. In these cases, signs will be in place with the relevant information. If you are not sure, please feel free to contact us at the numbers listed below:
- For Information/Visiting Hours: phone (09) 270 4799
- For Patient Enquiries: phone (09) 276 5004
- For Tiaho Mai (Acute Mental Health Unit): phone (09) 270 4742
Counties Manukau Health provides patients and visitors with a number of convenient shopping facilities. On the ground floor, by the main entrance of the hospital, you will find ‘Paataka Place’ which includes the Haumanu Pharmacy, Middlemore Florist & Gifts Ltd and a variety of food and beverage options.
For more information, visit Counties Manukau Health website.
Parking for all other visitors is available in designated paid visitor parking spaces around the Middlemore Campus beside the new Edmund Hillary Block. Please follow the signs and to enter the visitor car park insert your ticket barcode up. Remove the ticket and the barrier will rise.
Autopay stations are located throughout the carpark and Hospital main entrance. After validating your ticket you have 15 minutes to exit the carpark otherwise extra payment is required
Daily Parking Charges:
|15 minutes to 1 hour||$4.50|
|over 4 hours||$23.00|
|Lost ticket fee||$46.00|
|No part hours|
Free parking for 30 minutes between 2pm - 8pm
Between 2pm - 8pm visitors can park for 30 minutes with no charge. The visitor must leave within the 30 minutes otherwise normal rates apply.
Hours of operation: 24 hours per day / 7 days a week
Useful resources for families, patients and health professionals:
- Burns Support Group Charitable Trust Inc. (email: firstname.lastname@example.org)
- Australian and New Zealand Burn Association
- Auckland Council - fire safety conditions and burn plan
- New Zealand First Service
- Burn Survivor Resource Community (American)
- American Burn Association
- Changing faces (national charity based in United Kingdom)
- National Health Emergency Plan: Multiple Complex Burn Action Plan
- Starship Clinical Guidelines - Burns
National Burn Centre: 09 276 0044 ext 58214 or 58664
For clinical enquiries and referrals, please contact:
Auckland Region: Counties Manukau Health
Phone: 021 784 057 or (09) 276 0000 locator 938017 (on-call plastics registrar)
Waikato Region: Waikato District Health Board
Phone: (07) 839 8899 (ask for plastics registrar on-call)
Fax: (07) 839 8725 (Plastic Surgery Booking Clerk office)
Hutt Valley Region: Hutt Valley District Health Board
Phone: (04) 566 6999 (ask for plastics registrar on-call)
Fax: (04) 570 9239
Christchurch Region: Canterbury District Health Board
Phone: (03) 364 0640 (ask for plastics registrar on-call)
Fax: (03) 364 0456
Private Bag 93311
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This page was last updated at 3:12PM on May 26, 2020. This information is reviewed and edited by Auckland Regional Burn Service/ National Burn Service.