Dutch Burn Center Beverwijk
Brandwondencentrum Beverwijk (BWC) at the Rode Kruis Ziekenhuis (RKZ) provides high-quality clinical care in the field of burns treatment. It is extremely specialized care, which requires specialized expertise and often special facilities.
The treatment of burn injuries requires a multidisciplinary approach: specialists from different disciplines work together to provide the best possible care. The BWC treats both people with serious burn injuries and, because of their expertise of scar treatment, those with other serious wounds.
The BWC is also a research center and the birthplace of pioneering scientific research and new methods for treating burns.
What is a burn?
A burn is partial or full damage to the skin, which is caused by the action of heat, electricity or chemical substances. The seriousness of the burn depends on: the size of the wound, the depth, the location(s) of the burn, patient age, additional injuries.
Almost everyone experiences burns at some point in their lives. The scale of these usually means that a plaster or a visit to their General Practitioner is all that is needed. If the burns are too extensive, too deep, or if complications are involved, admission to a hospital or special center is necessary.
First, second and third degree burns
- First-degree: The skin is just a bit red and painful. This heals quickly and does not require hospital treatment.
- Second-degree: Only the top level of the skin is affected. These burns can heal after treatment with cream/special dressing. A second-degree burn heals within two to three weeks.
- Third-degree: The complete thickness of the skin has been entirely lost. Unless very small, a skin transplant is needed for these wounds to heal. Deep second burns and third degree burns will always leave a scar.
Box or ward?
The danger of infection demands that the burn center is organized different from other wards in the hospital. The BWC has four individual ‘boxes’ and four two-person wards. A box is a room equipped for one patient where intensive care can be supplied.
Whether a patient is admitted to a box or to a two-person ward depends on various factors:
- the depth and extent of the burns;
- the age and health of the patient;
- the location of the burns;
- breathing problems caused by inhalation of heat or smoke.
Help for Children
The after-care nurse also supports children and their parents with burns. There is the ‘Back to school project’ for example when the after-care nurse accompanies the child on the first day back to school after the accident.
The BWC daily visiting times are from 1 pm to 21.00 pm.
No more than two visitors can visit a patient at the same time. Different visiting times are, by exception, permitted and must be arranged with the nursing staff.
Visits from children are often important but children under twelve are not allowed to visit.
Procedures for visitors
There are hygiene procedure rules for visitors. Their purpose is to protect patients against infections from outside and to protect the hospital from burn wound bacteria.
- Visitors must wear gloves at all times and wash their hands when leaving the box or ward.
- When visiting a patient in a closed box, visitors must wash their hands in the airlock and then put on gloves and an apron.
- Visitors may not visit any other patients in the hospital.
- During their stay in the burn center, patients are not allowed to use any of the public areas in the hospital.
Because soil and water are breeding grounds for bacteria. Plants and flowers are therefor not permitted. Artificial flowers can be given.
Good nutrition is very important for healing burn injuries. In consultation with the nursing staff visitors can bring all sorts of things to cheer the patient up.
Books, magazines, photos, CDs/DVDs and other means of amusement are also welcome. Wifi is freely available througout the hospital.
The BWC does not only treat burns patients. There are many researchers working in the hospital who are devoted to the further development of treatment methods through scientific research.
Admission and treatment
A treatment plan is formed once the extent and depth of the burns has been established. This can be altered during treatment.
General condition – The first aim of the treatment team is to bring the patient’s general condition up to the required level for treatment. The injuries are assessed and cared for and the patient is placed under close observation.
Monitoring – Sometimes it is necessary to continuously observe the heartbeat, blood pressure, respiration, blood oxygen levels and temperature. The patient will therefor be connected monitors so the above-mentioned can be closely watched. Both at the bedside and in the teampost.
Blood pressure and heart rate – Because the burn injuries disturb the natural balance in the patient’s body, the patient might need extra fluids and medicines to support the heart and restore the balance. This recovery period can last from a few hours to a few days.
Respiration – If breathing problems (threaten to) arise due to inhaling smoke or fire, oxygen is supplied. It can also be necessary for a respirator to support breathing.
Fluids and water management – Burns damage the skin, which causes fluids to be lost. The larger the wound area, the greater the fluid loss. This fluid must be replenished via infusions (drips) and administered fluids.
Eating and drinking – Depending on the nature of the burns, the patient is not, or barely, allowed to eat or drink at first. The stomach does not function well after a burn injury.
Urine – Because it is important for a patient to maintain a good ‘fluid balance’ it is not only important to give fluids but also to check how much fluid is leaving the body. The discharge of fluid can be checked by using a urinary catheter.
Fluid balance – Burns can seriously disturb the fluid balance, which can make the patient temporarily swell. The swelling disappears in the early days after the burn injury. To avoid excessive swelling the arms and legs are sometimes raised and the patient is nursed in a half-sitting position in bed.
Taking blood – It is necessary to frequently check on substances present in the blood. Therefore blood is taken regularly.
The way burns will be treated depends on many factors:
- the depth and extent of the burns,
- the location of the burns,
- the age and condition of the patient.
Upon admittance to the hospital, first the vital functions are examined: breathing, pulse, blood pressure and blood oxygen levels. Only after this the depth and extent of the burns are examined.
Information for Professionals
Diagnosing and treating burns requires specialist knowledge. Indispensable knowledge when, as a healthcare worker, you are unexpectedly confronted with burn injuries. We have developed a Protocol for the treatment of burns especially for healthcare professionals (doctors, nurses, emergency services). This protocol describes the response to burns injuries from A to Z.
Every day wounds are cleaned, disinfected and dressed. This can be painful for the patient. Painkillers and, if necessary, tranquilizers are administered before the dressings are changed.
Patients who return home will need help to change the dressings. If family members can take care of this, a nurse will give instructions.
If this is not possible, a nurse will arrange for a district nurse to come and do this. Patients with extensive, serious burns often need to go a rehabilitation center to convalesce or sometimes be transferred to a nursing home.
Second-degree burns heal naturally, usually within two to three weeks.
The treatment for third-degree burns is always a skin graft. With seriously deep and extensive burns the burned skin can make someone very ill. Therefore in the first days after admission large parts of the deeply burned skin are removed, after which skin grafts and donor skin are placed on the wounds.
In this case the donor skin helps to completely cover the skin, so that it does not become infected. In addition the donor skin helps the skin graft to grow properly. A week after the transplant, it can be seen whether the grafted skin has become properly attached or ‘taken’.
After a graft there are generally some small remaining wounds that heal naturally after the application of ointment.
Children's Burn Centre
More than half of the children with serious burns admitted to Rode Kruis Ziekenhuis are four years or younger. The children’s burn center is part of the children’s department. However, if the burns are extremely serious, they will be admitted to the burn center for adults. The children’s burn center has twelve beds. Six for the burn victims and six for parents so they can their child day and night.
The advantage of having a children’s burn center in the children’s ward is that amenities for the children are within easy reach. For example, once children feel a bit better, they can go to the playroom. There they can play and talk to other children in the hospital about what has happened to them. This is a way of gradually starting to cope with the disturbing events that happend to them and to start moving again through play. Teaching assistants and specialist nurses work on the children’s ward. They will guide and care for the children.
Website for children (Dutch)
We have a special website about the Children’s Burn Center for children and young people. This supplies information for children of various ages.
Burn injury treatment is complex. In most cases patients suffer from a large number of medical and psychological issues. Each patient is therefore always treated by a multidisciplinary team.
- doctors: anesthetists, (plastic) surgeons, internists and the burn center’s medical coordinator
- nurses: burns-nurses specialized in several fields
- support team: psychologists, psychiatrist, social workers, after-care nurses
- rehabilitation team: physiotherapists, occupational therapists and rehabilitation doctor
- auxiliary team: bacteriologists, hospital hygienist, dietician and nutritionist
- department secretaries and housekeeping staff are also part of the team
Around the time of discharge attention is also paid to the psychosocial aspects and the return to everyday life. Help continues for the burns patient after discharge. Contact with other burn victims can help.
1942 LT Beverwijk
Coordinator +31 (0)6-46724248 (Monday-Sunday from 8 am to 8 pm)
When your relative is admitted to the Burn Center, he or she can count on extremely specialized care. It is also very important for the patient to have support close by. In 1991 the Kiwanis House was opened to make this possible. You can stay here as long as necessary during hospitalization. The Kiwanis House is a ‘home away from home’ at a five-minute walk away from the Rode Kruis Ziekenhuis and a ten minutes walk from Beverwijk Railway Station and the shopping center.
There are no mandatory fees for your stay in the Kiwanis house. A voluntary financial contribution is however highly appreciated.
Volunteers can be contacted to book an apartment. They will provide the key to your apartment and explain everything. They will also offer support while you are staying in the Kiwanis House and ensure you feel as ‘at home’ as possible.
The Kiwanis house consists of four cosy apartments for two adults and a child. They have a fully-fitted kitchen, living room, shower and toilet. It is possible to use the restaurant in the hospital. Bed linen, towels and tea towels
The communal areas provide:
- a children’s playroom with various all kinds of toys, a playpen and a cot
- large television room with computer facilities
- laundry with washing machine and tumble dryer
- garden with summer-house and outdoor toys
Bicycles and pram/pushchair to borrow. A trip to the beach or dunes will take about 20 minutes cycling).
Keep your apartment clean during your stay and leave it in good condition.
Pets are not allowed.
The daily affairs of the Kiwanishouse are taken care of by volunteers.
- Mr. E. Betzema (chairman) “The consequences for burns victims are drastic, the healing process protracted and painful. It is then very comforting to know that your family is close to you. Literally! I am happy to work on keeping this facility running.”
- Mr. A. Hienkens (secretary) Head of planning and control HDC Media “I do not have a background in burn injury care, but as a volunteer for the Children and Burns Foundation, I have seen enough indirectly of the impact it has when children and their families have to deal with burns and their consequences. Being able to offer accommodation, sometimes immediately, very close to a child hospitalized with burns in Beverwijk is unbelievably valuable. A marvelous facility for which I, as board member of the Kiwanis House Foundation, am happy to devote my efforts.”
- Ms. C. Arou-Gouya-Soeteman (treasurer) “I have worked in the financial administration department of the hospital, which also does the administration for the Kiwanis House since 2001. When the board asked me to be treasurer, I didn’t give it a second thought. In the past I have also experienced what it is to have to travel many kilometers every day to a distant hospital where a close family member was staying. Unfortunately there was no facility like the Kiwanis House then. So I am happy that now there is the possibility to be close to your family at a difficult time. And I would like to make a contribution to keep this going.”
- Prof. Dr. W. Leene Emeritus professor of histology and cell biology at the University of Amsterdam Faculty of Medicine, former Faculty Dean and former Vice Dean in the Board of Governors of the Academic Medical Center in Amsterdam (representing Kiwanis Netherlands) “As a member of Kiwanis Netherlands I have, from the very start, viewed the realization of a home for burns patients’ families at the Netherlands’ largest burn center as the most worthwhile project of our service clubs, and I still do. It deserves the continuing support of Kiwanis, since it lies at the core of our endeavors: ‘serving the children of the world’. I consider it a privilege to be given an opportunity to use my administrative experience as a physician for the Kiwanis House.”
- Ms. K. Stoker “As an after-care nurse at the children’s burn center I see the importance of a guest house for parents, brothers and sisters every day. Children with burns often spend a long time in hospital. This is a difficult time during which much is happening. The family usually does not live close to the hospital and it would be impossible for parents to visit their child for a long time every day without being able to use the Kiwanis house. Leading up to discharge the children are often allowed to visit the Kiwanis House so that parents can get used to caring for their child’s burns injuries at home. Meeting other families in the same situation is also invaluable in dealing with and accepting the accident within the family.”