Burns : journal of the International Society for Burn Injuries
-
Little is known about treatment decision-making experiences and how/why particular attitudes exist amongst specialist burn clinicians when faced with patients with potentially non-survivable burn injuries. This exploratory qualitative study aimed to understand clinicians' decision-making processes regarding end-of-life (EoL) care after a severe and potentially non-survivable burn injury. ⋯ The process of EoL decision-making for a patient with a potentially non-survivable burn injury was layered, complex, and tailored. Processes and approaches varied, although most used protocols to guide EoL decisions. Despite the reported complexity of EoL decision-making, palliative care teams were rarely involved or consulted.
-
The quality of burn care is highly dependent on the initial assessment and care. The aim of this systematic review was to investigate the agreement of clinical assessment of burn depth and %TBSA between the referring units and the receiving burn centres. ⋯ Overestimation of %TBSA at referring hospitals occurs very frequently. The overall certainty of evidence for accuracy of clinical estimations in referring centres is low for burn size and very low for burn depth. The findings suggest that the burn community has a significant challenge in educating and communicating better with our colleagues at referring institutions and that high-quality studies are needed.
-
Weight loss is difficult to quantify in critically ill burn patients, as the presence of edema can mask changes in dry body weight. We sought to estimate dry body weight using measured weights adjusted for reported extremity edema. We evaluated patients with at least 20% total body surface area (TBSA) burns admitted to our intensive care unit over a 3½-year period. ⋯ Logistic regression yielded the following formula for estimating dry weight (in kg): 0.66 x measured body weight + 25 - (3 for 1 + pitting edema or 4 for 2 + or 3 + pitting edema of either upper extremity) - (4 for any pitting edema to either lower extremity) (p < 0.01, R2 = 0.81). These results may allow us to better estimate dry body weight changes in our edematous patients with severe burns. Nutrition goals can be adjusted earlier, when appropriate, based on these estimated dry body weight changes.
-
Burn is one of the highly occurring injuries worldwide. In case of an acid attack, survivors are considered an embarrassing element for the family. In other words, survivors' dignity is judged by the scars on their faces and bodies. Burn survivors experience physical pain of wounds, along with unseen psychological agony. Here, resilience is the most captivating phenomenon that can lead the survivor to normalcy in life after experiencing such traumas. The current study is aimed to explore the role of resilience in the psychological distress of burn survivors. ⋯ The findings of current study would be helpful for the medical professionals, mental healthcare providers, and policymakers who can help to develop and implement rehabilitation programs and mental health demands for the said population and can initiate and plan resilience promoting programs that would help promote adaptive coping to deal with trauma.