The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Sep 2004
A survey of airway and ventilator management strategies in North American pediatric burn units.
A survey was used to gather information regarding airway management patterns in thermally injured children. North American pediatric burn centers listed by the American Burn Association were sent a survey designed to examine patterns of pediatric airway management in children with acute respiratory failure. The sample population means for the number of patients ventilated more than 48 hours and the number of patients ventilated more than 48 hours with inhalation injury were used to separate centers into large and small pediatric burn centers. ⋯ There were divergent of practice patterns between large and small pediatric burn centers regarding the use of cuffed endotracheal tubes and the timing of tracheostomy. There was agreement between large and small pediatric burn centers in tracheostomy use in children older the age of 7 and the use of steroids as an adjunct to extubation in patients with lingering airway edema. Pediatric burn patients may benefit from clinical trials that clarify the advantages and disadvantages of various ventilator modes, the use of cuffed tubes, and the timing of tracheostomy.
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Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. ⋯ The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.
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Scald injuries in children often occur as the result of them pulling a container of hot liquid off a countertop or stove. To date, there have been no studies that have specifically examined the impact of the burning agent after this mechanism of injury on the magnitude of injury or the hospital resources consumed in caring for these patients. In this study, we sought to compare the extent and depth of injury, hospital resources consumed, and outcomes of children burned by pulling a container of grease or other liquid onto themselves. ⋯ Mean length of stay was 16.8 +/- 2.5 days and 9.1 +/- 1.0 days for the grease and nongrease groups, respectively (P <.001). Scalds caused by children pulling a grease fryer onto themselves result in more extensive and deeper injuries and greater consumption of hospital resources than those from other liquids. These findings support the need for safer product design and more specific warnings in product labeling and instructions as to the danger of severe scald injury to minimize the occurrence of such injuries.
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J Burn Care Rehabil · Jul 2004
Case ReportsEarly-onset unilateral electric cataract: a rare clinical entity.
Electrical injury may result in cataracts, which usually occur bilaterally. In this report, we present a rare complication of such an injury presenting as a unilateral cataract in a 33-year-old woman with a painless but gradual worsening of vision in her left eye 3 weeks after sustaining a high-voltage electrical injury. ⋯ Electrical injuries may result in the formation of a unilateral cataract and therefore an ophthalmic examination should be performed regularly in the early recovery period of such injuries. Cataract surgery with intraocular lens implantation results in an excellent return of vision in patients with electrical cataract who do not have any other ocular damage.
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A large number of burns are sustained every year as the result of kitchen grease. A review of a 13-month period at the Joseph M. Still Burn Center in Augusta, Georgia, revealed 60 cases (9.4% of acute burn admissions). ⋯ Spilling grease on children in the kitchen was a frequent problem. Burns due to ignition of grease was also a cause of injury. Most of the injuries were potentially preventable, and therefore the importance of burn appropriate safety programs is stressed.