Journal of burn care & research : official publication of the American Burn Association
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More than 1 million burn injuries occur in the United States each year and as many as half of these injuries require medical treatment. Most data used to describe burns are from national databases derived from random or purposive samples of injuries. Few studies describe burn rates within a state. ⋯ Scald burns were the most common etiology. The mortality rate was 0.4%. The results of this study and future studies using this methodology may be used to identify populations at increased risk for burns and to target burn prevention and outreach medical education more appropriately.
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Case Reports
Rehabilitation of speech and swallowing after burns reconstructive surgery of the lips and nose.
Rehabilitation of speech and swallowing postburns reconstructive surgery has not been previously described in detail in the literature. Severe facial burn injury requiring subsequent reconstructive surgery may result in complications including circumoral contracture and aesthetic and functional irregularities. These complications may manifest as facial and labial sensation deficits, poor oral access for intubation and oral/dental hygiene, and inadequate oral competence causing chronic drooling and poor articulation. ⋯ Speech pathology intervention aimed to 1) facilitate safe transition from nonoral to oral intake, 2) improve articulation and speech intelligibility, and 3) minimize oral contracture development. At 6 months postinjury, the patient can safely tolerate a soft diet, demonstrate speech clarity at preinjury level, and has recovered functional oral range of movement. Rehabilitation of speech and swallowing is an essential factor to consider when planning postburn reconstructive procedures.
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Acute respiratory distress syndrome (ARDS) remains a challenging disease leading to increased mortality in burn patients, and inhalation injury may contribute to the development of severe ARDS. Extracorporeal life support (ECLS) provides a method of gas exchange while allowing time for lung recovery in the setting of early, severe ARDS. Recent study suggests that a selected population of patients with severe ARDS may benefit from ECLS, especially if initiated early. ⋯ The patient was discharged home on hospital day 50 on room air. ECLS aids innate lung recovery by allowing time for the diminution of high peak inspiratory pressures, prevention of barotrauma, and ultimately mitigating ventilator-induced lung injury. ECLS should be considered early as a viable supportive modality after inhalational injury in patients failing advanced ARDS management strategies.
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This study describes the first aid used and clinical outcomes of all patients who presented to the Royal Children's Hospital, Brisbane, Australia in 2005 with an acute burn injury. A retrospective audit was performed with the charts of 459 patients and information concerning burn injury, first-aid treatment, and clinical outcomes was collected. First aid was used on 86.1% of patients, with 8.7% receiving no first aid and unknown treatment in 5.2% of cases. ⋯ This report is one of the few publications to relate first-aid treatment to clinical outcomes. Some positive clinical outcomes were associated with recommended first-aid use; however, wound outcomes were more strongly associated with burn depth and mechanism of injury. There is also a need for more public awareness of recommended first-aid treatment.