Burns : journal of the International Society for Burn Injuries
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Delirium is defined as a disturbance of attention and awareness that develops over a short period of time, is a change from the baseline, and typically fluctuates over time. Burn care involves a high prevalence of known risk factors for delirium such as sedation, inflammation, and prolonged stay in hospital. Our aim was to explore the extent of delirium and the impact of factors associated with it for adult patients who have been admitted to hospital with burns. ⋯ We found a strong association between delirium and older age, provision ofr intensive care, and number of interventions under anaesthesia. A further 5% of patients who did not receive intensive care also showed signs of delirium, which is a finding that deserves to be thoroughly investigated in the future.
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Burn injury in developing countries is a major cause of morbidity and mortality. Pakistan faces a widespread problem of burn complications. The objective of this cross sectional study was to assess knowledge and attitudes in medical students regarding burn complications. ⋯ Out of 353 respondents, the proportion of students that were aware of burn complications was the following, with an expected response of 100% for each complication: depression [86%], fear [53.3%], post-traumatic stress disorder [40.8%], suicidal tendencies [35.1%], sleep disorder [30%], anxiety [27%], guilt [12.7%], personality changes [7%], eating disorder [5.4%], cardiac arrest [68%], hypothermia [64.3%], contractures [61%], infection [43.6%], chronic pain [41.6%], scarring [33%], chronic inflammation [24.9%], and muscle wasting [22.9%]. Most students were of the view that scarring occurs in third-degree burns [68%] only; being unaware of its presence in second-degree burns. 19.3% of the students incorrectly thought that surgery is needed for the healing of all burn patients. There appears to be a lack of basic knowledge about the physiological and psychological complications of burns among medical students of Pakistan.
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Due to the increased mortality and morbidity associated with blood transfusion, identifying modifiable predictors of transfusion are vital to prevent or minimise blood use. We hypothesised that burn patients with diabetes mellitus were more likely to be prescribed a transfusion. These patients tend to have increased age, number of comorbidities, infection risk and need for surgery which are all factors reported previously to be associated with blood use. ⋯ This study showed that diabetic patients with burn injuries ≤20% TBSA have a higher probability of receiving packed red blood cell transfusion compared to patients without diabetes. This effect was compounded in burns with higher percentage TBSA.
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Ocular burns are ophthalmological emergencies, owing to their potentially serious visual complications. Prompt recognition, irrigation and comprehensive examination including fluorescein staining is recommended to optimise outcomes. Burns standards recommend ophthalmological services be available in a 'timely' manner. ⋯ Mean time from admission to review was 45.0h, with 10 (52.6%) patients being seen within 24h. Of 80 patients, 50 (62.5%) patients had no documented fluorescein examination. Further prospective studies are necessary to inform clinical guidelines and optimise management of facial burns.
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Our primary aim was to investigate, using a commercial radiometer, the ultraviolet C (UVC) dose received in different areas in a burn ICU ward room after an automated UVC decontamination. The secondary aim was to validate a disposable UVC-dose indicator with the radiometer readings. ⋯ The amount of UVC radiation that is received in surfaces depends on their locations in the room (ie distance from the UVC emitter) and whether any objects shadow the light. In this study we suggest that quality controls should be used to assure that enough UVC radiation reaches all surfaces.