Table 1.

Operational standards agreed at the consensus meeting in Nepal.

1.	Burn patients should be assessed and treated by health care workers who had had training appropriate to the level of service their facility provides (Basic, Intermediate or Advanced).
2.	Where a facility is unable to provide the required skill level, burn patients should be transferred to a facility able to offer the appropriate treatment. Burn patients should receive immediate treatment that is safe and effective before they are transferred.
3.	Burn patients with other significant co-existing trauma should be managed according to WHO trauma guidelines [18].
4.	Burn patients with deep burns should be treated in a healthcare facility that can offer skin grafting.
5.	Where appropriate, early excision and grafting is strongly encouraged.
6.	All burn patients should receive adequate pain control from the first contact with the healthcare professional.
7.	Burn patients should receive holistic treatment, which addresses all their needs in including surgical, nursing, physiotherapy, occupational therapy, dietary, psychological and medico-legal support. This is best provided by a multi-disciplinary team.
8.	The provision of advanced care includes access to reconstructive surgery, advanced diagnostic facilities, blood bank, critical care, anaesthetists, hospital specialists and other services.
9.	All burn care providers should ensure burn patients are mobilised, positioned and splinted as appropriate as soon as possible to minimise disability.
10.	All burn care providers should ensure that burn patients receive optimal nutrition to maximise early wound healing.
11.	Paediatric care and therapy should be appropriate to the unique needs of the child.
12.	Burn care should be delivered according to the agreed Consensus Burn Care Clinical Guidelines [13].
13.	There should be a lead person with overall responsibility for burn care in each facility who is responsible for ensuring that the Guidelines are adhered to.
14.	Facilities providing advanced care should have a designated area that is allocated only for burn patients.
15.	Burn patients should be followed up by burn professionals to ensure holistic scar management, rehabilitation (physical and psychosocial) and access to reconstructive surgery following discharge from the health care facility.
16.	Facilities treating burn patients should be adequately resourced, equipped and staffed to provide such care.
17.	Specialist burn units should offer training and on-going support to health care professionals managing burns in other facilities within their region/district
18.	Specialist burn units should participate in research programmes where appropriate.
19.	Burn patient data should be recorded at all levels of health care and a national Burn Register is recommended.
20.	There should be a system for on-going inspection, quality control and quality improvement for burn care facilities.
21.	Health care professional involved in burn care at all levels should be engaged in burn injury prevention activities. Community involvement should be encouraged.
22.	Specialist burn units and health care professionals should be engaging in policy-makers and health planners at all levels to ensure appropriate provision and delivery of burn care and burn prevention programmes.
23.	The Ministry of Health should be responsible for ensuring that every burn patient in their country has access to the appropriate level of burn care to ensure equitable burn care provision.
24.	The international burn care community has a critical role to play in recognising and supporting the implementation of these essential standards for burn care.
25.	Burn injury disproportionately affects the poor. Fund-raising and advocacy for burn patients is essential to ensure access to appropriate care for all burn patients. Appropriate and timely burn care had been shown to significantly reduce the massive social and financial impact of burn injury.