The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Sep 2002
A survey of risk factors for burns in the elderly and prevention strategies.
Elderly burn patients suffer from greater morbidity and mortality than younger patients with similar burn extents. The purpose of this study was to identify risk factors for burn injuries in the elderly to develop an effective preventive program. A cross-sectional survey was conducted among 20 elderly (> or =65 years of age) burn survivors on the circumstances surrounding their burn injury and on burn prevention. ⋯ Compared with the burn group, the control group had more risk factors for burn injury. However, the control group also took more active preventive measures. Burn prevention campaigns for elderly should focus on reducing flame and scald burns that occur in the home, preferably using television, news, and poster media.
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Temporary closure of our burn unit allowed evaluation of the effect of a closed unit on infection rates. During renovations, burned patients were treated either in private ward rooms or in the intensive care unit by burn unit nursing staff using the same wound care practices as used in the burn unit. Data regarding burn severity and outcome were collected and compared for all patients treated before (Group A), during (Group B), and after (Group C) renovations. ⋯ Mortality rates were not significantly different. Despite consistent wound care the incidence of infection increased nearly two-fold to four-fold when patients were treated out of the unit. We recommend a temporary isolation unit during renovations if possible.
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J Burn Care Rehabil · Jul 2002
How well does the Parkland formula estimate actual fluid resuscitation volumes?
We had anecdotally observed that fluid resuscitation volumes often exceed those estimated by the Parkland Formula in adults with isolated cutaneous burns. The purpose of this study was to compare estimated and actual fluid resuscitation volumes using the Parkland Formula. We performed a retrospective study of fluid resuscitation in patients with burns > or = 15% TBSA. ⋯ Both the DCR and INCR groups received significantly more fluid than predicted, (5.6 +/- 2.1 ml/kg/%TBSA and 7.7 +/- 3.1 ml/kg/%TBSA respectively). The INCR patients had significantly larger full thickness burns (14 +/- 11% vs 3 +/- 6%, P < 0.001). Our findings reveal that despite its effectiveness, the Parkland Formula underestimated the volume requirements in most adults with isolated cutaneous burns, and especially in those with large full thickness burns.
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J Burn Care Rehabil · Jul 2002
Serious occupational burn injuries treated at a regional burn center.
This article will present the epidemiology of occupational burn injuries among patients admitted to a regional burn center. Patients admitted to University of Alabama at Birmingham University Hospital Burn Center between November 1994 and December 1999 for occupational burn injuries were studied. Descriptive statistics were generated for demographic, clinical, and outcome characteristics. ⋯ Burn type varied with occupation. Over $16 million in hospital charges was accrued by patients sustaining occupational burn injuries. Understanding the epidemiology of serious burn injuries in the workplace is crucial to directing prevention efforts toward worker groups at highest risk.
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Burn injuries are often associated with multisystemic complications, even in otherwise healthy individuals. It is therefore intuitive that for the diabetic patient, the underlying pathophysiologic alterations in vascular supply, peripheral neuropathy, and immune function could have a profoundly devastating impact on patient outcome. The effects of diabetes on morbidity and mortality of the burn-injured patient have not been examined in great detail. ⋯ Deeper burns, delayed presentation, higher rates of infection, graft failure and operations, and longer lengths of stay translate into an increased cost to society both economically and in lives. This data would suggest a need for better burn education for diabetics and health care professionals, recognizing the elderly population as a "high-risk" group. We believe that targeted prevention measures and treatment strategies, emphasizing earlier and more aggressive intervention for this population, may have a favorable effect on morbidity and mortality.