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Burns
Published in Stephen M. Cohn, Alan Lisbon, Stephen Heard, 50 Landmark Papers, 2021
Brian Brisebois, Joyce McIntyre
Burn injuries remain one of the most common cause of trauma worldwide, disproportionately affecting low- or middle-income countries. In the United States, burn injuries result in the hospitalization of about 40,000 patients every year, with three quarters receiving treatment in a specialized burn center. In the United States, burn prevalence is distributed bimodally based on age, with the greatest incidence in young children and adults 20–59 years old (Greenhalgh). Treatments for burns have been described since ancient times including depictions in early cave paintings, as well as descriptions in early Chinese and Greek texts. The Egyptian Ebers papyrus, written around 1500 BC, describes a topical mixture of dung, wax, horn, and porridge soaked in resin as a burn treatment. It wasn't until the middle of the 20th century that advances in burn care resulted in remarkable improvements in mortality (Liu).
Inhalation Injury
Published in Stephen M. Cohn, Matthew O. Dolich, Kenji Inaba, Acute Care Surgery and Trauma, 2016
II is one of the American Burn Association criteria for burn center referral [76]. Although we are not aware of prospective data comparing the outcomes of II patients treated in burn centers versus those treated elsewhere, many of the modalities mentioned in this paper are not routinely available outside of burn centers—to include, most importantly, the expertise of respiratory therapists and other health-care professionals with the experience to provide optimal care to patients with this highly lethal injury. Certainly, smoke-exposed patients with an unremarkable physical examination, alert mental status, and normal blood gases and COHb levels may safely be discharged home [77]. For all those II patients requiring admission, we recommend at a minimum prompt consultation with the regional burn center.
Paper 1 Answers
Published in James Wigley, Saran Shantikumar, Andrew Paul Monk, Stuart Blagg, Get Through, 2014
James Wigley, Saran Shantikumar, Andrew Paul Monk, Stuart Blagg
The American Burn Association gives the following list of types of burn injury that require transfer to a burn centre: Partial-thickness and full-thickness burns on greater than 10% of the body surface area in any patientPartial-thickness and full-thickness burns involving the face, eyes, ears, hands, feet, genitalia, and perineum, as well as those that involve skin overlying major jointsFull-thickness burns of any size in any age groupSignificant electrical burns, including lightning injury (significant volumes of tissue beneath the surface can be injured and result in acute renal failure and other complications)Significant chemical burnsInhalation injuryBurn injury in patients with pre-existing illness that could complicate treatment, prolong recovery, or affect mortalityAny patient with a burn injury who has concomitant trauma poses an increased risk of morbidity or mortality, and may be treated initially in a trauma centre until stable before being transferred to a burn centreChildren with burn injuries who are seen in hospitals without qualified personnel or equipment to manage their care should be transferred to a burn centre with these capabilitiesBurn injury in patients will require specialized social and emotional or long-term rehabilitative support, including cases involving suspected child maltreatment and neglect
The Critical Intervention Screen: A Novel Tool to Determine the Use of Lights and Sirens during the Transport of Trauma Patients
Published in Prehospital Emergency Care, 2022
Shane Urban, Heather Carmichael, Martin Moe, Andrea Kramer, Omar Al-Azzawi, Robbie Dumond, Angela Wright, Robert McIntyre, Catherine Velopulos
This single-center, retrospective study was reviewed and approved as exempt by the Colorado Multiple Institutional Review Board (COMIRB #19-2096) prior to data collection and analysis. We included records over an 18-month period (August, 2017–December, 2018), and collected data from the hospital trauma registry, prehospital trip-sheets, and the electronic health record (EHR). We included adult patients transported to our urban Level I trauma center by ground ambulance with an EMS trip sheet available for review. Exclusion criteria included all aeromedical transports, inter-facility transfers, patients less than 15 years old, and thermal injuries. Thermal injuries were excluded as our center is the only American Burn Association verified burn center in our region; EMS crews will often bypass closer hospitals to bring significant burn injuries to our center.
Resiliency in burn recovery: a qualitative analysis
Published in Social Work in Health Care, 2018
Thereasa E. Abrams, Dhitinut Ratnapradipa, Heather Tillewein, Alison A. Lloyd
Patients are typically overwhelmed by emotions during their initial recovery from burns. He, Cao, Feng, Guan, and Peng (2013) found that 10–44% of Chinese burn patients experienced some psychological symptoms or posttraumatic stress disorder (PTSD) in early recovery. They concluded that subjects who expressed the resilient protective factor of optimism were more likely to recover and that optimism helped them adapt to their changing environments. Much like the previous cited study (He et al., 2013), current burn care literature primarily focuses on short-term psychosocial outcomes for subjects living in urban areas near the burn center. The balance of more current studies on resilience in burn recovery surveyed hospitalized or recently discharged burn patients who had received recent psychosocial support and/or rehabilitation (Johnson, Taggert, & Gullick, 2016; Din, Sha, & Bilal, 2015; Masood, Masud, & Mazahir, 2016; He et al., 2013; Xia et al., 2014). This leaves a gap in knowledge about long-term psychosocial outcomes for burn patients who live in rural and/or underserved communities in the United States. Greater understanding of how resilience is experienced by long-term burn survivors will enhance social workers’ abilities to develop interventions that will build, support and promote resiliency, long-term health and recovery for burned individuals from all demographics.
Acute chemical skin injuries in the United States: a review
Published in Critical Reviews in Toxicology, 2018
Alan H. Hall, Laurence Mathieu, Howard I. Maibach
A Swiss study examined the epidemiology and costs of work-related burns (de Roche et al. 1994). The authors found that 4.6% of all accidents in Switzerland were burns and that 3% of all work-related accidents were burns. Based on population demographics, these authors estimated that there were approximately 36,000 burn injuries per year with 5% of these requiring hospital admission and one-third of those requiring treatment in a specialized burn center. Of 6,814 burn injuries in 1984, 58% (3,952) were work-related. The total cost for burn care was 17.7 million Swiss Francs (approximately 1.78 million $US at the exchange rate of 1 Swiss Franc = $US 0.99382), with 19% for medical care and the rest for other compensation. These authors did not separate chemical skin injuries from other burn etiologies (de Roche et al. 1994).