The role of a 'satellite-service' in the national organisation of burn care in the Sultanate of Oman.

Khoula hospital, one of the major tertiary care hospitals, situated in the capital city, is the national trauma centre of the Sultanate of Oman. The burns-unit at Khoula hospital has developed an unique collaborative service of active participation in the initial management of burns patients admitted to the peripheral hospitals of the country. The description 'Satellite-service' is used in this paper to describe this 'remote-control service' offered by the main burns center, for the management of burned patients admitted the various peripheral hospitals (the 'satellites') throughout the country, during the shock-period of the first 36 hour post-burn. Thereafter the patients are transferred to the main center for further management. This system was instigated with a common protocol for the initial management of burns all over the country in 1981. Central registration of burns patients from peripheral hospitals was started in 1994. Retrospective analysis of the statistics and records of 151 burns patients transferred from 19 peripheral hospitals to Khoula burns center during a 3 year period from September 1994 to August 1997, showed that the satellite service is very effective in the initial management of patients during the shock period, as there was no mortality due to hypovolemia. The advantages of this service include uniform and appropriate 'initial' management of all the burns patients admitted to any of the hospitals of the country. The major disadvantages of the system were the increased work-load of the main center and poor patient-compliance with post-discharge instructions. This paper also describes how the Satellite service works in practice.