Burns : journal of the International Society for Burn Injuries
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The clinical outcome after thermal injury depends significantly on bystander action at the scene of the initial burn. Bystander action may save life, by rescue or by extinguishing flames; or by reducing medical complications which lead to death from respiratory injury or from secondary infection. Best-practice first aid may reduce the need for skin grafting; and can modify the rate and quality of healing. ⋯ Most secondary threats to the victim and risks to the rescuer come from high-energy sources [such as flames], and most involve a repetition of the primary incident. Current doctrine teaches four elements of how best to act in the rescue phase of a casually suffering from thermal injury. These imperatives are: (a) Assess for danger (b) Use protection if a rescue is undertaken; (c) Train in techniques for extinguishing the flames of the burning casualty; and (d) Train in the methods of physical retrieval to a safe place - where the standard dictates of DRSABCD can continue.
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A burn injury is a very painful experience, with subsequent emotional problems, which have been gaining relevance to the extent that survival from burns has improved. Among the alterations of the mental sphere in this population is Acute Stress Disorder (ASD) that has been described in up to one-third of patients with major burns. ⋯ Acute stress disorder is frequent in the hospitalised burn population, and is more frequent than in other types of trauma. Associated factors with the presentation of Acute Stress Disorder are the feeling of life threat at the time of the burn, having pain classified as strong (Visual Analog Scale (VAS) 5-10), electrical burn, and burns in special areas.
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Burn injury was shown to affect a patient's sexuality. Cultural and social inhibitions may mean this topic is often overlooked. ⋯ Currently no standardized method is in common use to address sexual function concerns of adult burns victims. The authors suggest this topic may be included in future information leaflets for patients and in burns awareness courses for medical professionals.
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Previous articles assessed the evidence-base for the treatment of burns, but the latest was published in 2010, examining data up to and inclusive of 2008. The aim of this article is to examine the trend in the number of high-evidence publications over the subsequent 11-year period and quality-assess RCTs within this timeframe. ⋯ This study observes a positive trend in high-evidence publications. The reporting of several CONSORT criteria in RCTs remains poor. Observation to standard reporting guidelines is advocated to improve the quality of reporting.
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Regular functional status and muscle strength assessments should be performed with burn victims. ⋯ The CPAX scale was sensitive to changes in functionality throughout the hospital stay in severely burned patients, in the present study. The assessment of global muscle strength was more sensitive than handgrip strength and the ABSI was associated with length of stay in this population.