Burns : journal of the International Society for Burn Injuries
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Self-inflicted burns are a rare cause of injury, accounting for only 1.0% of burns in the United States. While rare, the physical and psychosocial ramifications of these injuries are lasting. The goal of this study was to examine the etiologies, risk factors and outcomes of self-inflected burns in an urban setting. ⋯ Patients with self-inflected burn have a higher rate of previous self-harm behavior, psychiatric comorbidities and substance abuse. These patients are more likely to require surgical excision and grafting and expanded institutional resources compared to those with non-intentional burn with similar degree and size of burn. Increased counseling of at-risk populations may help to decrease this potentially preventable method of injury.
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Acute management of a severely burned patient is an infrequent and stressful situation that requires medical knowledge as well as immediate coordinated action. Many adverse events in health care result from issues related to the application of 'non-technical' skills such as communication, teamwork, leadership and decision making rather than lack of medical knowledge. Training in these skills is known as Crisis Resource Management (CRM) training. ⋯ Participants felt that the course developed their ability to interact with other team members, further improved their understanding of how to appropriately use resources, emphasized the importance of role clarity and developed their communication skills. Additional quantitative and qualitative analyses obtained from participants were also reviewed after each course. The SIMBurns course aims to contribute to the education of those in healthcare in order to improve patient safety and to continue advancing the education of our emergency burn care teams.
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Review Retraction Of Publication
Management of calciphylaxis in a burn center: A case series and review of the literature.
Calciphylaxis is a rare, necrotizing skin disorder usually associated with kidney disease, but also caused by many other systemic illnesses. This disease is associated with mortality rates as high as 80% at 1year. ⋯ We propose that these patients be treated similar to patients with thermal burn injury; meaning intensive wound care, surgical management, critical care and physical therapy. Burn centers are uniquely capable of caring for these incredibly complex patients due to their experience in managing patients with extensive skin and soft tissue defects, wounds and diseases.
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Severe burns can induce a hypercoagulable state which is not depicted in conventional coagulation assays. The thrombin generation assay allows global assessment of coagulation and can identify hypercoagulability. We report changes in thrombin generation in patients after severe burn injury. ⋯ In the first two weeks following burn, both the thrombin generation assay and rotational thrombelastometry show a hypercoagulable state, while conventional coagulation tests remain normal.
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Randomized Controlled Trial
The effect of hospital clown nurse on children's compliance to burn dressing change.
Pediatric burn injury is a traumatic experience which affects the child both physically and psychologically. Following the burn injury, repetitive dressing changes are one of the main problems, and to manage the level of distress caused this procedure, various distraction strategies are being used. However, the effect of hospital clown during burn dressing change among children has not been studied before. Therefore, the present study aimed to investigate the effect of hospital clown-nurse on children's compliance to burn dressing change. ⋯ Children in the intervention group had better compliance to burn dressing change, in other words, they cried and/or yelled less, they were more active, had better mood, better communication and interaction with the accompanying parent and the nurse. In addition, older children in the experimental group had better compliance to the burn dressing change.