Burns : journal of the International Society for Burn Injuries
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Chaharshanbeh souri is a historical Persian firework festival which has several health and financial damages for Iranians near celebration of New Year. In this study we tried to find effectiveness of Chaharshanbeh souri educational campaign on decreasing burden of injuries due to fireworks of this day. In this before-after study, an educational campaign was done for 2017 focusing on children and students. ⋯ Disability adjusted life years was calculated and compared before and after intervention. The results of this study showed that mean age of injuries was increased from 27.75 to 32.65 years and DALY decreased significantly after the intervention (P=0.0460) showing that the intervention was effective. Educational programs might be effective to decrease burden of injuries related to Chaharshanbeh souri festival.
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Vancomycin empirical dosing studies in thermally injured patients have netted low successful target attainment and most excluded renal dysfunction, limiting applicability. In a previous study, the authors performed a retrospective analysis of 124 patients' measured pharmacokinetic parameters to calculate optimal dose and interval for intermittent infusion regimens and find predictors of clearance and total daily dose. The objective of this study was to improve the accuracy of attaining goal therapeutic targets with initial vancomycin regimens in patients with thermal injury through retrospective modeling. ⋯ The algorithm that resulted in the highest target attainment without overdosing recommended 15mg/kg dosed every 24h for CrCl≥30, every 12h for CrCl 31-79, every 8h for patients with CrCl≥80ml/min, and every 6h only if the patient with a CrCl≥80ml/min is also≤40 years old and has a SCr≤0.8. Caution is warranted for groups underrepresented in this study, such as those with very low CrCl, a low BMI, or receiving renal replacement therapy. This algorithm should be validated in other centers for patients with thermal injuries.
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The objective of this study is to broaden our understanding of psychiatric disorders due to work-related burn injury compensated by the Industrial Accident Compensation Insurance operated by the Korea Workers' Compensation and Welfare Service (KCOMWEL). ⋯ We analyzed the characteristics of the psychiatric disorders due to work-related burn injury for which compensation was received from 2005 to 2014 according to the approved results. To gain a long-term understanding of the management of workers' compensation status for psychiatric disorders due to work-related burn injuries, we should gather accurate information on the risk factors involved in order to achieve the needed systematic improvements.
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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.
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Prescription opioid misuse is an epidemic international health crisis. Although burn providers are increasingly mindful of balancing pain relief with risk of opioid dependence, several burn centers have noticed their patients are still receiving an increased amount of opioids, termed "opioid creep." We examined discharge narcotic prescriptions at a single burn center in the Midwest United States and found that patients discharged in 2015 received nearly twice the amount of narcotics (mean=600 morphine equivalents [ME]) than those discharged in 2008 (mean=350 ME), with a significantly increased likelihood of a more complex narcotic discharge regimen. ⋯ Although such increase in opioid prescription is undesirable, so too is regression to historical under-treatment of burn pain. Protocoled pain-management order sets on admission and discharge, as well as incorporation of alternatives adjuncts to lessen pain, may allow for better pain control with less opioid misuse.