Burns : journal of the International Society for Burn Injuries
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Appropriate first aid can reduce the morbidity of burns, however, there are considerable variations between international first aid recommendations. We aim to identify, and compare first aid practices in children who present to Emergency Departments (ED) with a burn. ⋯ A low number of children received optimal burns first aid, with potentially harmful methods applied in a considerable proportion of cases. There is an urgent need for internationally agreed, evidence-based burn first aid recommendations.
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Randomized Controlled Trial
New fluid therapy protocol in acute burn from a tertiary burn care centre.
Ringer lactate is the main fluid for resuscitation of acute burns. However it is not a complete fluid alone, as it does not take care of sugar and electrolyte balance adequately. This study has been carried out to compare the use of Ringer lactate (RL) alone and combination of RL with Dextrose Normal Saline (DNS) as fluid replacement therapy in acute burn. ⋯ RL is not an ideal fluid for maintenance as it is low in sodium (130mEq/L) as well as potassium (4mEq/L) in view of daily electrolyte requirement. There is no glucose content in it to provide calories. Therefore, DNS should be added as daily maintenance fluid with RL as replacement for evaporative losses following burns.
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Acute respiratory distress syndrome (ARDS) is a complication that affects approximately 40% of burn patients and is associated with high mortality rates. Extracorporeal membrane oxygenation (ECMO) therapy is a management option for severe refractory hypoxemic respiratory failure; however, there is little literature reporting the effectiveness of this therapy in burns. Our study objective was to review patient outcomes in burns following severe ARDS treated with ECMO. ⋯ Mortality in burn patients with ARDS who are managed with ECMO is extremely low. Careful selection and timely intervention with ECMO contributed to good clinical outcomes.
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Native Americans (NAs) have worse healthcare outcomes over some measures than non-Native Americans (non-NAs) (i.e., lower life expectancy, higher heart disease and psychiatric disease rates). Little data exists to show if there are differences in the hospital course of burned NAs versus non-NA patients. The purpose of this study is to analyze the epidemiology, clinical course, and outcomes of NA burn injury in Arizona. ⋯ Our data demonstrate that NAs have a different experience with the healthcare system than non-NAs after a burn injury. The majority of these issues revolve around socioeconomic differences between the two groups.
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Animal studies indicate treating burn injuries with running water (first aid) for 20min up to 3h post-burn reduces healing time and scarring. There is a lack of human data to support such a recommendation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes. ⋯ Adequate first aid with 20min of running water is associated with improved outcomes. Benefits are seen in a reduction in wound depth, faster healing, and decreased grafting requirements. This has significant patient and health system benefits, and calls for promotion of 20min of running water globally in burns care.