Understanding Burn Injury Management: A Cross-Sectional Survey of Physicians Working in Northern Ontario Emergency Departments

Purpose In Northern Ontario, emergency physicians provide initial burn management, often without specialist support. This study evaluated the experience, practices, and resource limitations among Northern Ontario emergency physicians to identify gaps affecting burn care and specialist consultation. Methods An anonymous, cross-sectional REDCap survey was distributed by email to physicians providing emergency care across academic, community, and rural hospitals in Northern Ontario from May to August 2025. Physicians were recruited using convenience sampling through Northern Ontario School of Medicine (NOSM) University and hospital network contact lists. The survey assessed burn management knowledge and experience, clinical and referral practices, and perceived training and resource gaps. Responses were summarized using descriptive statistics, with categorical variables reported as frequencies and percentages. Results Fifty physicians responded; nearly half (48%, 24/50) practiced in rural settings, and most were family medicine-trained. Although 78% (39/50) reported moderate confidence in burn management, variability in knowledge and practice was evident. Twenty percent (10/50) incorrectly included superficial burns in total body surface area (TBSA) calculations, and only 66% (33/50) felt confident assessing burn depth. Initial management was consistent for analgesia, dressings, and tetanus prophylaxis but varied for debridement and fluid resuscitation; debridement of partial-thickness burns occurred only 42% (21/50) of the time. Most physicians (80%, 40/50) reported never having on-site plastic surgery coverage, and specialist consultations were sought primarily for transfer decisions and follow-up. Only 16% (8/50) reported consistent access to wound care. Most respondents were either unaware whether a burn directive existed at their site (52%, 26/50) or reported that no directive was in place (32%, 16/50). Nearly all participants (84%, 42/50) expressed interest in additional burn education. Conclusions Burn management in Northern Ontario emergency departments is highly variable, with knowledge gaps and limited specialist access potentially affecting outcomes. Regional standardization through a shared burn directive, combined with targeted physician education and expanded specialist access via teleburn or virtual consultation, may improve consistency of care across the region and in other settings facing similar constraints.