A Rapid Review of Burns First Aid Guidelines: Is There Consistency Across International Guidelines? (original) (raw)
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First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients
Burns : journal of the International Society for Burn Injuries, 2018
Animal studies indicate treating burn injuries with running water (first aid) for 20min up to 3h post-burn reduces healing time and scarring. There is a lack of human data to support such a recommendation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes. Data was prospectively collected for patients with <10% total body surface area (TBSA) burns from 2007-2012. Multivariate regression analysis was used to determine the association of adequate first aid with four outcomes - wound depth, requirement for skin grafting, healing time (in non-grafted patients), and TBSA not grafted (in grafted patients). Adequate first aid was defined as the application of 20min of cool, running tap water up to 3h following the burn injury. 4918 patients were identified. Adequate first aid was received in 58.1% (2859) of patients. It was associated with a statistically significant reduction in burn wound depth (OR 1.39; 95% CI 1.24-1.55; P<0.001) but was n...
Emergency and early management of burns and scalds
BMJ, 2009
Burn injuries are an important global health problem. Most simple burns can be managed by general practitioners in primary care, but complex burns and all major burns warrant a specialist and skilled multidisciplinary approach for a successful clinical outcome. This article discusses the principles behind managing major burns and scalds using an evidence based approach and provides a framework for managing simple burns in the community.
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.8\_Aug2017/IJHSR\_Abstract.064.html, 2017
Burns are common occurrence and often the patient is rushed to a nearby medical practitioner or hospital for first aid. Some patients may receive first aid from their relatives or friends in correct or incorrect manner. Most of the time the first respondents in case of burns are family members, friends, by standers. Properly instituted first aid reduces the morbidity and even mortality in burn patients. Many simple interventions can make a great difference in the course of burns and improve patient outcome. This article is aimed to educate primary health care providers, accident and emergency departments, paramedicals and even the general public so that treatment for burn patients can start early.
Background: Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. Methods: An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. Results: A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender (r = 0.87, P < 0.001), younger age group (19-25 years) (r = 0.077, P < 0.001), from central region (r = 0.012, P < 0.001), and university graduate (r = 0.05, P = 0.002). Nearly half of those who knew of traditional remedies did not have previous knowledge of burn first aid. Conclusions: Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.
An Audit of First-Aid Treatment of Pediatric Burns Patients and Their Clinical Outcome
Journal of Burn Care & Research, 2009
This study describes the first aid used and clinical outcomes of all patients who presented to the Royal Children's Hospital, Brisbane, Australia in 2005 with an acute burn injury. A retrospective audit was performed with the charts of 459 patients and information concerning burn injury, first-aid treatment, and clinical outcomes was collected. First aid was used on 86.1% of patients, with 8.7% receiving no first aid and unknown treatment in 5.2% of cases. A majority of patients had cold water as first aid (80.2%), however, only 12.1% applied the cold water for the recommended 20 minutes or longer. Recommended first aid (cold water for >20 minutes) was associated with significantly reduced reepithelialization time for children with contact injuries (P ؍ .011). Superficial depth burns were significantly more likely to be associated with the use of recommended first aid (P ؍ .03). Suboptimal treatment was more common for children younger than 3.5 years (P < .001) and for children with friction burns. This report is one of the few publications to relate first-aid treatment to clinical outcomes. Some positive clinical outcomes were associated with recommended first-aid use; however, wound outcomes were more strongly associated with burn depth and mechanism of injury. There is also a need for more public awareness of recommended first-aid treatment. (J Burn Care
Managing Burns and Related Complications in Emergency
2019
A burn is a thermal injury caused by biological, chemical, electrical and physical agents with local and systemic repercussions. They have a greater incidence in economically and culturally marginalized countries. Knowing the kind of burn is vital for effective management. Following a burn, there's a huge production of free radicals that is harmful and involved in inflammation, systemic inflammatory response syndrome, immunosuppression, infection and sepsis, tissue injury and multiple organ failure. The aim of first aid is cessation of the burning process, cool the burn,(relieve the pain),and cover the burn. Treatment with cutaneous grafts focuses on avoiding granulation phase where there is contraction of wound. The definitive treatment of burns is tangential excision and early grafting, since they are the only measures that decrease the metabolic demand, infections, hospital stay and morbidity. Basic science studies have slowly begun to uncover the complex mechanisms involved ...
ISBI Practice Guidelines for Burn Care, Part 2
Burns, 2018
to be addressed, description of the terms of reference, visualization of the end product, and creation of a broad time frame for completion soon followed. The development and completion of the first international burn PGs followed. Part 2 of the guidelines was an extension of that process. These PGs, intended for a primary audience of health professionals responsible for providing acute care and rehabilitation for burn patients, focus on the multifaceted aspects of acute burn care. The PGs have been crafted to include recommendations germane to burn care, including in RLS. Development and application of global evidence-based recommendations that will improve patient care that accommodate all resource settings is not practical. Not every guideline can be followed by every person in every center. Local resources may indeed restrict what can be done. However, PGs can be the nidus for process improvement in all settings, including RLS. As such, guidelines are a guide, not a mandate, and should serve to help centers improve their care of the burn patient. These PGs can also be used by policy-makers, public health experts, and hospital managers to prioritize resources. The information in these PGs can be included in pre-and in-service training of health professionals to improve their knowledge, skills, and performance in burn care. First aid Topical agents in burn care Infections in burns a. Sepsis b. Pneumonia c. Urinary tract infection d. Wound infection Management of indwelling catheters Blood transfusion Metabolic manipulation Mobility, strength, and physical function Deep venous thrombosis Pain control Sedation Psychiatric disorders Outpatient burn care Electrical burns Chemical burns Skin soughing disorders 2 b u r n s x x x (2 0 1 8) x x x-x x x JBUR 5649 No. of Pages 90
Management of severe thermal burns in the acute phase in adults and children
Anaesth Crit Care Pain Med, 2020
Objectives: To provide recommendations to facilitate the management of severe thermal burns during the acute phase in adults and children. Design: A committee of 20 experts was asked to produce recommendations in six fields of burn management, namely, (1) assessment, admission to specialised burns centres, and telemedicine; (2) haemodynamic management; (3) airway management and smoke inhalation; (4) anaesthesia and analgesia; (5) burn wound treatments; and (6) other treatments. At the start of the recommendation- formulation process, a formal conflict-of-interest policy was developed and enforced throughout the process. The entire process was conducted independently of any industry funding. The experts drew up a list of questions that were formulated according to the PICO model (Population, Intervention, Comparison, and Outcomes). Two bibliography experts per field analysed the literature published from January 2000 onwards using predefined keywords according to PRISMA recommendations. The quality of data from the selected literature was assessed using GRADE1 methodology. Due to the current paucity of sufficiently powered studies regarding hard outcomes (i.e. mortality), the recommendations are based on expert opinion. Results: The SFAR guidelines panel generated 24 statements regarding the management of acute burn injuries in adults and children. After two scoring rounds and one amendment, strong agreement was reached for all recommendations. Conclusion: Substantial agreement was reached among a large cohort of experts regarding numerous strong recommendations to optimise the management of acute burn injuries in adults and children.