A burn injury requiring referral to a burn center includes:

1. A. A partial thickness or full thickness burn greater than 10 percent total body surface area (TBSA) in patients younger than 10 years old;
2. B. A partial thickness or full thickness burn greater than 20 percent TBSA in other age groups;
3. C. A partial thickness or full thickness burn that involves the face, hands, feet, genitalia, perineum, and major joints;
4. D. All full thickness burns greater than 5 percent TBSA in any age group;
5. E. An electrical/lightening injury;
6. F. A chemical injury;
7. G. An inhalation injury;
8. H. Frostbite and cold injury;

9. I. A burn injury in patients with preexisting medical disorders that could:

   1. (1) Complicate management;
   2. (2) Prolong recovery; and
   3. (3) Affect mortality;

10. J. A burn injury with concomitant trauma, such as a fracture, in which the burn injury poses the greatest risk of morbidity in accordance with the following considerations:

    1. (1) If trauma poses the greater immediate risk, the patient may be treated initially in the trauma center until stable before being transferred to a burn center; and
    2. (2) Physician judgment is necessary in these situations and shall be in concert with the regional medical control plan and triage protocols;
11. K. A burn injury in a child who has not reached their fifteenth (15th) birthday, who shall be treated in a pediatric burn center designated by MIEMSS; and
12. L. A burn injury in patients who will require special social, emotional, or long-term rehabilitative support including cases involving suspected child abuse or substance abuse.

Authority: Education Article, §13-509, Annotated Code of Maryland

Effective date: March 24, 1997 (24:6 Md. R. 488)

Regulation .04 amended effective July 1, 2002 (29:12 Md. R. 933)

Regulation .06 amended effective July 1, 2002 (29:12 Md. R. 933)

Chapter revised as an emergency provision effective June 1, 2006 (33:15 Md. R. 1277); revised permanently effective October 23. 2006 (33:21 Md. R. 1679)

Regulation .02B amended effective June 4, 2007 (34:11 Md. R. 972)

Regulations .01—.18 repealed and new Regulations .01—.21 adopted effective July 1, 2020 (47:5 Md. R. 313)

Regulation .01A amended effective July 21, 2025 (52:14 Md. R. 714)