Burns : journal of the International Society for Burn Injuries
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The aim of this study was to evaluate the impact of outpatient care on activities at the Adults' Regional Burns Centre and the Children's Regional Burns Unit, Mid Yorkshire Hospitals NHS Trust UK, where outpatient and inpatient responsibilities are shared between the nursing staff. Data for all inpatient and outpatient interactions (all care related activities with the presence of a Registered Nurse (RN)) was collected prospectively by the attending RN for two consecutive months (October and November 2014). We also retrospectively collected data related to daily RN staffing levels, and Centre/Unit admissions and discharges. ⋯ Considering this burden and collating it with daily RN staffing levels, we highlighted an understaffing in 42.6% (26/61) of the days for the Adult Regional Burn Centre and in 100% (61/61) of the days and nights for the Children Regional Burn Unit. The impact of outpatients on the activities of a Burns Centre/Unit is a factor that should be taken into account when evaluating staffing needs and planning services. This is a variable not currently considered in any guideline for safe staffing.
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Negative pressure has been employed in various aspects of burn care and the aim of this study was to evaluate the evidence for each of those uses. ⋯ Negative pressure can improve autograft take when used as a bolster dressing. There is limited data to suggest that it may also improve the rate of revascularization of dermal substitutes and promote re-epithelialization of skin graft donor sites. Other uses suggested by studies that did not meet our inclusion criteria include improving vascularity in acute partial-thickness burns and as an integrated dressing for the management of large burns. Further studies are warranted for most clinical applications to establish negative pressure as an effective adjunct in burn wound care.
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Multicenter Study
Modifiable risk factors for scald injury in children under 5 years of age: A Multi-centre Case-Control Study.
To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. ⋯ Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children.
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Fatigue has been identified as an outcome of concern following burn but is rarely captured in outcomes studies. We aimed to: (i) describe the prevalence, and predictors, of moderate to severe fatigue in the first 12 months following burn, and (ii) establish the association between fatigue and health-related quality of life and work outcomes. ⋯ More than a quarter of participants reported moderate to severe fatigue on the BFI at 12-months and fatigue was strongly associated with poorer health-related quality of life and greater work-related disability.
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Observational Study
Upon admission coagulation and platelet function in patients with thermal and electrical injuries.
There has been increased focus on hemostatic potential and function in the initial assessment of the patient with traumatic injuries, that not been extensively studied in patients with burns. We proposed to determine the hemostatic potential of patients with burns upon admission to the emergency department and contrasted their condition with that of healthy controls and patients with other traumatic injuries. In addition we assessed differences due to thermal versus electrical injury and evaluated the effect of burn size. ⋯ Upon admission patients with burns are in a hyper-coagulable state similar to that of other trauma patients. Employing demonstrated cut points of hemostatic potential in trauma patients associated with increased risk of poor outcomes demonstrated the incidence in burn patients to be similar, suggesting that these values could be used in the early assessment of the patient with burns to guide treatment interventions.