National programme for prevention of burn injuries

ABSTRACTThe estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI) would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.

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102 Wildfire Burns: Implications for Burn Care

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.105 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S67-S67

Author(s):

Tina L Palmieri ◽

Kathleen S Romanowski ◽

Soman Sen ◽

David G Greenhalgh

Keyword(s):

Length Of Stay ◽

Burn Injury ◽

Total Body Surface Area ◽

Ventilatory Support ◽

Mass Casualty ◽

Inhalation Injury ◽

Burn Injuries ◽

Injury Incidence ◽

Burn Centers ◽

Burn Care

Abstract Introduction Climate change, the encroachment of populations into wilderness, and carelessness have combined to increase the incidence of wildfire injuries. With the increased incidence has come an increase in the number of burn injuries. Prolonged extrication, delays in resuscitation, and the extreme fire and toxic air environment in a wildfire has the potential to cause more severe burn injury. The purpose of this study is to examine the demographics and outcomes of wildfire injuries and compare those outcomes to non-wildfire injuries. Methods Charts of patients admitted to a regional burn center during a massive wildfire in 2018 were reviewed for demographic, treatment, and outcome. We then obtained age, gender, and burn size matched controls from within 2 years of the incident, analyzed the same measures, and compared treatment and outcomes between the two groups. Results A total of 20 patients, 10 wildfire (WF) burns and 10 non-wildfire (NWF) burns, were included in the study. Age (59.6±7.8 WF vs. 59.4±7.4 years), total body surface area burn (TBSA) (14.9±4.7 WF vs. 17.2±0.9 NWF) and inhalation injury incidence (2 WF and 2 NWF) were similar between groups. Days on mechanical ventilation (24.3±19.4 WF vs. 9.4±9.8 NWF), length of stay (49.9±21.8 WF vs. 28.2±11.7 days) and ICU length of stay (43.0±25.6 WF vs 24.4±11.2 NWF) were higher in the WF group. WF patients required twice the number of operations. Mortality was similar in both groups (1 death/group). Conclusions Wildfire burn injuries, when compared to age, inhalation injury, and burn size matched controls, require more ventilatory support and have more operations. As a result, they have longer lengths of stay and have a prolonged ICU course. Burn centers should be prepared for the increased resource utilization that accompanies wildfire injuries. Applicability of Research to Practice All burn centers must be prepared for the possibility of wildfires and the increased resource utilzation that accompanies mass casualty events.

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Epidemiology of burn injury in older adults: An Australian and New Zealand perspective

Scars Burns & Healing ◽

10.1177/2059513120952336 ◽

2020 ◽

Vol 6 ◽

pp. 205951312095233

Author(s):

Lincoln M Tracy ◽

Yvonne Singer ◽

Rebecca Schrale ◽

Jennifer Gong ◽

Anne Darton ◽

...

Keyword(s):

Older Adults ◽

New Zealand ◽

Older Adult ◽

Surgical Management ◽

Surgical Procedure ◽

Burn Injury ◽

Burn Injuries ◽

Younger Patients ◽

Care Community ◽

Burn Care

Introduction: The ageing global population presents a novel set of challenges for trauma systems. Less research has focused on the older adult population with burns and how they differ compared to younger patients. This study aimed to describe, and compare with younger peers, the number, causes and surgical management of older adults with burn injuries in Australia and New Zealand. Methods: The Burns Registry of Australia and New Zealand was used to identify patients with burn injuries between 1 July 2009 and 31 December 2018. Temporal trends in incidence rates were evaluated and categorised by age at injury. Patient demographics, injury severity and event characteristics, surgical intervention and in-hospital outcomes were investigated. Results: There were 2394 burn-injured older adults admitted during the study period, accounting for 13.4% of adult admissions. Scalds were the most common cause of burn injury in older adults. The incidence of older adult burns increased by 2.96% each year (incidence rate ratio = 1.030, 95% confidence interval = 1.013–1.046, P < 0.001). Compared to their younger peers, a smaller proportion of older adult patients were taken to theatre for a surgical procedure, though a larger proportion of older adults received a skin graft. Discussion: Differences in patient and injury characteristics, surgical management and in-hospital outcomes were observed for older adults. These findings provide the Australian and New Zealand burn care community with a greater understanding of burn injury and their treatments in a unique group of patients who are at risk of poorer outcomes than younger people. Lay Summary The number and proportion of older persons in every country of the world is growing. This may create challenges for healthcare systems. While burn injuries are a unique subset of trauma that affect individuals of all ages, less is known about burns in older adults and how they differ from younger patients. We wanted to look at the number, type, management, and outcomes of burns in older adults in Australia and New Zealand. To do this, we used data from the Burns Registry of Australia and New Zealand, or BRANZ. The BRANZ is a database that collects information on patients that present to Australian and New Zealand hospitals that have a specialist burns unit. Our research found that one in eight adult burns patients was over the age of 65, and that the rate of burn injuries in older adults has increased over the last decade. Older adult burns patients were most commonly affected by scalds after coming in contact with wet heat such as boiling liquids or steam. Fewer older adults went to theatre for an operation or surgical procedure compared to their younger counterparts. However, a larger proportion of older adults that went to theatre had a skin graft (where skin is removed from an uninjured part of the body and placed over the injured part). This research provides important information about a unique and growing group of patients to the local burn care community. It also highlights potential avenues for injury prevention initiatives.

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A Model for Diabetes Health Care Delivery in Developing Countries

The Diabetes Educator ◽

10.1177/014572178701300309 ◽

1987 ◽

Vol 13 (3) ◽

pp. 286-291

Author(s):

Ratimir Kovacevic ◽

Mate Granic ◽

Zdenko Skrabalo

Keyword(s):

Health Care ◽

Developing Countries ◽

Health Care Delivery ◽

Care Delivery ◽

Program Planning ◽

National Level ◽

Health Care Delivery System ◽

Research Education ◽

Transfer Programs ◽

Developed Nations

Developing countries can make considerable progress in providing diabetes health care if they adopt ideas and technologies already being applied in diabetes health care in other parts of the world, but they must adapt them to their own particular circumstances. Too often efforts in this direction fail because it is not possible to transfer programs from developed nations intact and expect them to function in the circumstances of less developed nations. Success on a national level requires the application of a systematic health care model tailored to the needs of the developing country. As discussed in this paper, the model's elements include organization of the available national health care delivery system; education of health care personnel, patients, their families, and communities; diabetes-related epidemiological research; education program planning; and continuous program evaluation and adjustment.

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Perception and Practice among Community People and Health Service Providers on Care and Management of Burn Injuries in Nepal: A Qualitative Study

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v17i3.1640 ◽

2019 ◽

Vol 17 (3) ◽

pp. 315-319

Author(s):

Santosh Bikram Bhandari ◽

Sujit Kumar Sah ◽

Khakindra Bahadur Bhandari ◽

Jaswan Sakya ◽

Laxmi Raj Pathak ◽

...

Keyword(s):

Health Service ◽

Qualitative Study ◽

Service Providers ◽

Burn Injury ◽

Good Practice ◽

First Aid ◽

Burn Injuries ◽

Burn Care ◽

Health Service Providers ◽

Community People

Background: According to WHO, burns are a serious public health problem and the second most common cause for injury in rural Nepal, accounting for 5% of disabilities. The overall objective of the study is to assess the prevailing perception and practice among community people and health service providers on care and management of burn injuries in Nepal. Methods: This was a qualitative study conducted in 2016 representing all eco-development regions. A total of 40 key informants interviews with health personnel and 18 focus group discussions with the community people were conducted.Results: There are very limited dedicated burn care facilities in Nepal. During discussion, the service providers and community people mentioned that a burn injury can affect any one irrespective of their age and socioeconomic status. The study showed that females are at higher risk for burn injury which is associated mostly with wood fire cooking.The burn cases in the hospitals were more during winter than insummer season. Among all the ethnic groups, Dalit and indigenous population were found more vulnerable towards burn injuries. Intentional burn injuries such as self-inflicted burns/suicidal attemptwere found to occur more in females.The community people had a good practice of taking the majority ofpatients having burn injury immediately to the hospital,if not, they at least provided them with a first aid treatment. Conclusions: Majority of burn injured cases are getting first aid treatment at the incident places and taking hospital immediately. Main reasons, who reached late, are unaware about seeking services and financial constraint. Overall, the community people are partially aware about the burn injury.Keywords: Burn injuries; community practice; hospitals; incident and types.

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A Review of Burn Patients Requiring Extracorporeal Membrane Oxygenation at a Burns Facility

European Journal of Burn Care ◽

10.3390/ebj2040021 ◽

2021 ◽

Vol 2 (4) ◽

pp. 293-300

Author(s):

Stephen Frost ◽

Liz Davies ◽

Claire Porter ◽

Avinash Deodhar ◽

Reena Agarwal

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Burn Injury ◽

Burn Injuries ◽

Burn Patients ◽

Review Of The Literature ◽

Respiratory Compromise ◽

Burn Care ◽

Membrane Oxygenation ◽

Regular Time ◽

Major Burn

Respiratory compromise is a recognised sequelae of major burn injuries, and in rare instances requires extracorporeal membrane oxygenation (ECMO). Over a ten-year period, our hospital trust, an ECMO centre and burns facility, had five major burn patients requiring ECMO, whose burn injuries would normally be managed at trusts with higher levels of burn care. Three patients (60%) survived to hospital discharge, one (20%) died at our trust, and one patient died after repatriation. All patients required regular, time-intensive dressing changes from our specialist nursing team, beyond their regular duties. This review presents these patients, as well as a review of the literature on the use of ECMO in burn injury patients. A formal review of the overlap between the networks that cater to ECMO and burn patients is recommended.

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Pre-hospital care in burn injury

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699457 ◽

2010 ◽

Vol 43 (S 01) ◽

pp. S15-S22

Author(s):

Prabhat Shrivastava ◽

Arun Goel

Keyword(s):

Hospital Care ◽

Burn Injury ◽

Care Facility ◽

First Aid ◽

Vital Role ◽

Burn Injuries ◽

Care Providers ◽

Care Centre ◽

Burn Care ◽

Management Plans

ABSTRACTThe care provided to the victims of burn injury immediately after sustaining burns can largely affect the extent and depth of the wound. Although standard guidelines have been formulated by various burn associations, they are still not well known to public at large in our country. In burn injuries, most often, the bystanders are the first care providers. The swift implementation of the measures described in this article for first aid in thermal, chemical, electrical and inhalational injuries in the practical setting, within minutes of sustaining the burn, plays a vital role and can effectively reduce the morbidity and mortality to a great extent. In case of burn disasters, triage needs to be carried out promptly as per the defined protocols. Proper communication and transport from the scene of the accident to the primary care centre and onto the burn care facility greatly influences the execution of the management plans

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Abstract P863: Did Covid 19 Highlight Disparities in Stroke Care: A Real-World Study of Telehealth Utilization Between Urban and Suburban Populations in a Health Care System

Stroke ◽

10.1161/str.52.suppl_1.p863 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Maryika I Gibson ◽

Ruchi Wanchoo

Keyword(s):

Health Care ◽

Health Care System ◽

Care Delivery ◽

Small Sample Size ◽

National Level ◽

Stroke Care ◽

Small Sample ◽

Acute Stroke Care ◽

Significant Difference ◽

Care System

A viable alternative to in person assessments, telemedicine offered providers cost effective and safe alternative to patient care delivery during COVID19. Resource limitations, state and organizational safety precautions accelerated our system adoption of video visits for stroke post hospitalization assessments. Utilizing mixed methods we aimed to investigate an association between patients characteristics (age, gender, race, Modified Rankin Score-mRS, residence) and their choice for post-acute care during a five-month period. The subset selecting in-person visits was further interviewed regarding perceptions of barriers to telehealth. We analyzed data from 85 patients’ records (45 in the urban telehealth and 40 in the suburban clinic visit groups) according to ICD10 codes. While total volume of televisits increased during COVID 19, stroke accounted for <1% of them. There was no significant difference in the mean age between the two groups-68.5 years in the clinic and 64.4 in the tele. The clinic subset had 42% of patients age greater than 75 years. Significant difference was detected in disabilities (t=3.5, p<.001) with one-point higher mean mRS (1.7 vs .7) and stronger positive correlation of age to disabilities in the suburban group (r2=.26 vs r2=.16). Patients selecting in-person care outlined as barriers to telehealth a lack of technology, poor connectivity, no caregiver availability for tele exam, inability to communicate or other major co-morbidities, family’s perception of complexity of patient’s condition, fragmentation of care during the period. Patients selecting video assessment were more connected with a health care system and from the urban center. Strengths of the study are the application of mix methods and investigation of suburban patients’ perceptions of barriers to telehealth. Limitations consist of small sample size and 90% Caucasian population. Current technology advancements, software applications, and the goal of Healthy People 2030 of removing disparities in heart and stroke disease will require a new multipronged approach to improving stroke telehealth at population level. Further studies at national level including social determinates of health need to examine barriers to telemedicine in post-acute stroke care.

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Teleophthalmology: A Model for Eye Care Delivery in Rural and Underserved Areas of India

International Journal of Family Medicine ◽

10.1155/2011/683267 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 26

Author(s):

Vijayaraghavan Prathiba ◽

Mohan Rema

Keyword(s):

Health Care ◽

Local Community ◽

Care Delivery ◽

National Level ◽

Community Outreach ◽

Community Empowerment ◽

Eye Care ◽

Quality Health Care ◽

Related Data ◽

Quality Health

Objectives. To describe the application of teleophthalmology in rural and underserved areas of India. Study Design. This paper describes the major teleophthalmology projects in India and its benefits. Results. Teleophthalmology is the use of telecommunication for electronic transfer of health-related data from rural and underserved areas of India to specialities in urban cities. The MDRF/WDF Rural Diabetes Project has proved to be very beneficial for improvement of quality health care in Tamilnadu and can be replicated at the national level. This community outreach programme using telemedicine facilities has increased awareness of eye diseases, improved access to specialized health care, helped in local community empowerment, and provided employment opportunities. Early detection of sight threatening disorders by teleophthalmology and prompt treatment can help decrease visual impairment. Conclusion. Teleophthalmology can be a very effective model for improving eye care delivery system in rural and underserved areas of India.

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A qualitative study of health professionals’ views on using iPads to facilitate distraction during paediatric burn dressing changes

Scars Burns & Healing ◽

10.1177/2059513118764878 ◽

2018 ◽

Vol 4 ◽

pp. 205951311876487 ◽

Cited By ~ 2

Author(s):

Elizabeth Green ◽

Julia Cadogan ◽

Diana Harcourt

Keyword(s):

Health Professionals ◽

Burn Injury ◽

Burn Injuries ◽

Management Technique ◽

Burn Care ◽

Paediatric Burns ◽

Wide Range ◽

Pharmacologic Pain Management ◽

Care Training ◽

Burns Unit

Introduction: Distraction is a non-pharmacologic pain management technique commonly used to avert a person’s attention from procedural pain and distress during stressful procedures such as treatment after a burn injury. In recent years, computer tablets (such as iPads) have been used within paediatric burns services to facilitate distraction by way of apps, games, cartoons and videos during dressing changes. However, we know very little about health professionals’ experiences of using them in this context. Methods: The current study explored health professionals’ experiences of using iPads to facilitate distraction during paediatric burn dressing changes. Fifteen health professionals from a single paediatric burns unit were interviewed. Thematic analysis revealed two key themes: (1) the iPad is a universal panacea for distraction; and (2) trials and tribulations. Discussion: Participants considered iPads to be potentially useful and effective distraction tools, suitable for use with a wide range of patients with burn injuries including young children, adolescents and young adults. However, issues including health professionals’ understandings of one another’s roles, the challenge of working in a busy burns service, and lack of experience and confidence were identified as possible barriers to their use within routine burn care. Training for staff on the use of iPads as a means of facilitating distraction, development of guidelines and a review of how they are incorporated into routine burn care are recommended.

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Trends in Teledermatology Utilization in the United States (Preprint)

10.2196/preprints.35439 ◽

2021 ◽

Author(s):

Akash D Patel ◽

Chandler W Rundle ◽

Meenal Kheterpal

Keyword(s):

Health Care ◽

American Academy ◽

Care Delivery ◽

Demographic Data ◽

National Level ◽

The United States ◽

Younger Patients ◽

Care Delivery Model ◽

Level Data ◽

Total Data

BACKGROUND Teledermatology is an effective health care delivery model that has seen tremendous growth over the last decade. This growth can be attributed to a variety of factors, including but not limited to an increased access to dermatologic care for those with socioeconomic or geographic barriers, a reduction in health care costs for both the patient and the physician, and the delivery of high-quality dermatologic care. However, the associated barriers include practice reimbursements, interstate licensing, and liability. Despite these apparent barriers, the emergence of COVID-19 afforded teledermatology a surge of demand and loosened regulations, allowing dermatologists to see higher volumes of teledermatology patients. In this paper, we analyzed the American Academy of Dermatology’s DataDerm registry teledermatology utilization and patient demographic trends throughout the COVID-19 pandemic. OBJECTIVE The aim of this paper was to characterize national-level teledermatology demographic data in the setting of the COVID-19 pandemic. METHODS National-level data were curated for all practices enrolled in the American Academy of Dermatology’s DataDerm registry from April 1, 2020, through June 30, 2021. Encounter utilization rates were collected for visit type (ie, teledermatology versus in person), sex, race, age, insurance provider, and location (ie, in state versus out of state). The aggregate total data, as opposed to individual encounter data, were collected. RESULTS The proportion of women who utilized services via teledermatology (65,023/98,642, 65.9%) was greater than that of those who utilized in-person services (29,40,122/50,48,450, 58.2%). Non-White patients made up a higher percentage of teledermatology utilizers (8920/62,324, 15%) when compared with in-person utilizers (3,94,580/35,08,150, 11.7%). Younger patients (aged <40) contributed more to teledermatology service utilization (62,695/75,319, 83.2%) when compared with in-person services (13,29,218/33,01,175, 40.3%). Medicare was a larger payor contributor for in-person services (8232/1,53,279, 25.2%) than for teledermatology services (10,89,777/43,30,882, 5.4%). Utilization by out-of-state patients was proportionally higher for teledermatology services (19,422/1,33,416, 14.6%) compared with in-person services (5,80,358/1,38,31,400, 4.2%). CONCLUSIONS Teledermatology services may reach and benefit certain populations (female, younger patients, those with non-White racial backgrounds, and out-of-state patients) more so than others. These baseline demographics may also serve to highlight populations for potential future teledermatology outreach efforts.

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