scholarly journals Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh

2010 ◽  
Vol 43 (3) ◽  
pp. 131 ◽  
Author(s):  
SR Mashreky ◽  
S Bari ◽  
SL Sen ◽  
A Rahman ◽  
TF Khan ◽  
...  
Keyword(s):  
Burn Patients ◽  
Disaster Experience ◽  
Fire Disaster ◽  
Burn Unit

scholarly journals Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh

2010 ◽  
Vol 43 (S 01) ◽  
pp. S131-S135
Author(s):  
S. R. Mashreky ◽  
S. Bari ◽  
S. L. Sen ◽  
A. Rahman ◽  
T. F. Khan ◽  
...  
Keyword(s):  
Medical College Hospital ◽  
Burn Patients ◽  
Successful Management ◽  
College Hospital ◽  
Burn Victims ◽  
Medical College ◽  
Disaster Experience ◽  
Fire Disaster ◽  
Frequent Event ◽  
Burn Unit

ABSTRACTAlthough burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.

627 Strategies for Reducing Emergency Department Lengths of Stay for Admitted Pediatric Burn Patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S169-S169
Author(s):  
Lisa M Shostrand ◽  
Brett C Hartman ◽  
Belinda Frazee ◽  
Dawn Daniels ◽  
Madeline Zieger
Keyword(s):  
Emergency Department ◽  
Gap Analysis ◽  
Burn Patients ◽  
Improvement Project ◽  
Burn Trauma ◽  
Charge Nurse ◽  
Lengths Of Stay ◽  
Burn Unit ◽  
Set Up ◽  
Trauma Activation

Abstract Introduction Various strategies to reduce emergency department (ED) lengths of stay (LOS) for admitted pediatric burn patients may be employed as a quality improvement project. Decreasing ED LOS may promote patient outcomes and reduce morbidity. Initial discussions were brought forth during trauma and burn multidisciplinary peer review rounds in March 2019 and have persisted to present day. Methods Several strategies, such as preparation of the burn unit staff within one hour of patient arrival in ED, notification to the burn unit by the burn attending of an incoming pediatric burn patient, allowing the PICU charge nurses or advisors to assist with room set up and admissions, and creating a checklist to assist PICU nurses and advisors in helping prepare for anticipating inpatient admissions. These strategies were designed and enforced in March/April 2019. In addition to these action plans, trauma activation alerts were added in December 2019 to the burn charge nurse phone for pediatric burn trauma one and trauma alerts for more expedient notifications. Finally, communication efforts between ED and burn leadership teams were conducted in June 2020 to help with additional mitigating of ED LOS, such as discussing the appropriateness of specialty consults while in the ED. Results Initial ED LOS was reduced from 209 minutes in March 1019 to 150 minutes in June 2019. Increased trends were noted in early 2020, with a peak at 244 minutes in July 2020. Additional interventions, such as trauma activation alerts and ED/Burn team communications, did not provide sustainable long-term reductions. Conclusions Recent strategies to reduce overall ED LOS trends have been beneficial, but not consistent, in sustaining downward trends. Action to perform a gap analysis to discover persistent barriers and to introduce additional structure, such as a burn trauma one algorithm, may provide stability to this metric.

An epidemiologic study of elderly burn patients in Ain Shams University Burn Unit, Cairo, Egypt

Burns ◽  
2003 ◽  
Vol 29 (7) ◽  
pp. 687-690 ◽  
Author(s):  
Amr Mabrouk ◽  
Ashraf Maher ◽  
Salah Nasser
Keyword(s):  
Epidemiologic Study ◽  
Burn Patients ◽  
Burn Unit

scholarly journals Pre-burn malnutrition increases operative mortality in burn patients who undergo early excision and grafting in a sub-Saharan African burn unit: Methodological issues

Burns ◽  
2018 ◽  
Vol 44 (6) ◽  
pp. 1615-1616
Author(s):  
Joanna Grudziak ◽  
Caroline Snock ◽  
Tiyamike Zalinga ◽  
Wone Banda ◽  
Jared Gallaher ◽  
...  
Keyword(s):  
Operative Mortality ◽  
Burn Patients ◽  
Methodological Issues ◽  
Burn Unit ◽  
Sub Saharan

26 Clogged Feeding Tubes: Why Does It Matter?

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S22-S23
Author(s):  
Sarah Zavala ◽  
Ashley Wang ◽  
Cheryl W Zhang ◽  
Jennifer M Larson ◽  
Yuk Ming Liu
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Nutritional Support ◽  
Total Body Surface Area ◽  
Tube Feeding ◽  
Feeding Tube ◽  
Admission Diagnosis ◽  
Burn Patients ◽  
Feeding Tubes ◽  
Burn Unit

Abstract Introduction Many patients treated on a burn unit require tube feeding as their primary caloric source or as supplemental feeding due to their injuries. Burn patients specifically require higher caloric intake due to the hypermetabolic state of burn injuries. Inadequate nutritional support contributes to longer ICU stays and higher mortality. Clogged feeding tubes reduce nutrition provided due to temporary discontinuation of feeding. The objective of this study was to identify risk factors for the incidence of tube clogging. Methods This was a single-center retrospective chart review of all patients admitted to an American Burn Association-verified Burn Unit between August 2017 and October 2019 who received tube feeds during their admission. Data collected included baseline demographics, clinical outcomes, and details about tube feed formulations, number of clogs, and details leading up to the clog. Baseline demographics were compared using descriptive statistics. Nominal data was compared using Chi-square test. Continuous data was analyzed using student’s t-test or Mann-Whitney U test. Results A total of 170 patients were included; admission diagnoses included burn (97), soft tissue infections (29), SJS/TEN (11), and others (33). At least one clogged feeding tube was experienced by 51 patients and some experienced up to seven separate clogs. SJS/TEN patients were less likely to experience a clog (9.2 vs 0%, p = 0.035) and frostbite patients were more likely to experience a clog (0 vs 5.9%, p = 0.026). Burn mechanism did not affect incidence of tube feed clog, but patients with larger total body surface area (TBSA) burned were more likely to have a clog (15.55 vs 25.03%, p = 0.004). It was a median of 12 days until the first clog occurred (IQR 7.8–17.3). Two tube feed formulas demonstrated an increased likelihood of clog: a renal formulation (16.8 vs 33.3%, p = 0.017) and a polymeric concentrated product (5.0 vs 17.6%, p = 0.008). Both products have a high viscosity. Patients who experienced a clog had a longer length of stay (21.5 vs 44.0 days, p = 0.001). Conclusions This study identified several risk factors associated with higher incidence of clogged feeding tube in the burn unit including tube feed formulation and viscosity, admission diagnosis, and larger TBSA in burn patients. This study also confirms that clogged feeding tubes, and the resultant insufficient nutritional support, may contribute to an increased length of stay.

scholarly journals Risk factors for thromboembolism in burn patients admitted to the burn unit at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia

2019 ◽  
Vol 40 (10) ◽  
pp. 1027-1031
Author(s):  
Thamer Althunayan ◽  
Saad AlQarni ◽  
Waleed Mohsenh ◽  
Ahmed Alkhalifah ◽  
Abdullmajeed Alsadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Burn Patients ◽  
Kingdom Of Saudi Arabia ◽  
Burn Unit ◽  
Medical City

scholarly journals Economic Burden of Drug Use in Patients with Acute Burns: Experience in a Developing Country

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Kolawole Olubunmi Ogundipe ◽  
Ismaila Abiona Adigun ◽  
Babatunde Akeeb Solagberu
Keyword(s):  
Drug Use ◽  
Developing Country ◽  
Economic Burden ◽  
Burn Injury ◽  
Burn Patients ◽  
Burn Unit ◽  
Antibiotics Use ◽  
The Cost ◽  
Financial Implication

Background/Objective. Burn injury is a devastating injury. The economic drain on the patient's purse is equally devastating. Few studies have examined the cost of managing burn patients particularly the drug component.Methods. The financial implication of drug use in the management of 69 consecutive patients admitted by the burn unit over a period of two years was retrospectively analysed.Results. Thirty-six (52.2%) patients were males and 33 (47.8%) females with a mean age of 17.9 years (). The patients spent an average sum of $91.21 to procure drugs; 84.3% of the costs were for antibiotics, 11.1% for analgesics, and 4.6% for others.Conclusion. Significant amount of money is spent on the procurement of drugs. Most of the money is spent on prescribed antibiotics. Measures that reduce antibiotics use in burn management might relief patients of the huge economic burden associated with its use.

602 Managing Hypothermia in the Surgical Burn Patient

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
Patricia Regojo ◽  
Molly Mohan
Keyword(s):  
Quality Assurance ◽  
Operating Room ◽  
Core Body Temperature ◽  
Temperature Management ◽  
Evidence Based ◽  
Burn Patients ◽  
Estimated Blood Loss ◽  
Increased Risk ◽  
Burn Unit ◽  
Burn Patient

Abstract Introduction It is known, hypothermia, core body temperature at or below 36oC/96.8oF, can lead to dangerous complications for burn patients. Due to loss of their protective thermoregulation, burn patients are at an increased risk of hypothermia during surgery. Findings from a Quality Assurance audit revealed burn patients were returning from surgery hypothermic and hemodynamically unstable. There was little evidence of intra-operative temperature management in the electronic medical record (EMR) or reported to the nurse upon the patients’ return from the operating room (OR). Only 73% of patients had temperatures recorded during their surgery and of those, 40% had a drop of temperature >2 degrees from their baseline. The purpose of this collaborative evidence-based quality assurance project was to improve temperature management in the operating room and prevent hypothermia in the intra and post operative periods. Our aim was to develop warming methods pre-operatively that would establish a goal for keeping the patients’s temperature within 2 degrees of their baseline preoperative temperature during surgery. Methods A literature search obtained from CINAHL, Cochrane, EMBASE, and MEDLINE from 2010–2018, provided current surgical guidelines and evidence-based practices for managing surgical hypothermia in burn patients (levels of evidence I, III, V, & VI). Recommendations from the burn unit staff for preoperative warming initiatives were listed and shared with the OR staff. Hemodynamic documentation, including core temperature, estimated blood loss, and intra-operative warming methods were monitored for twelve months after the Burn Unit Warming Protocol was implemented. Progress was reported quarterly in our Burn and Trauma Quality Committees. Results After implementing the Burn Unit Warming Protocol, temperature management of the burn patient improved. Intra-operative warming methods were initiated. Patients began returning from surgery warmer with improved hemodynamics. 96% of the patients had their temperatures recorded and managed intra-operatively. Of those patients, only 2.6% had a drop in temperature > 2 degrees from their pre-operative baseline. Conclusions Implementing a nurse-driven warming protocol from the pre-operative stage through surgery can aid in reducing post-operative hypothermia in burn patients. Applicability of Research to Practice Managing hypothermia will help reduce complications that can lead to increase morbidity and mortality in burn patients.

scholarly journals Risk Factors for the Antibiotic Resistant Gram-Negative Bacilli Associated Infections in Burn Patients and the In-Vitro Susceptibility of Colistin

2020 ◽  
Vol 15 (3) ◽  
Author(s):  
Mojtaba Varshochi ◽  
Alka Hasani ◽  
Parinaz Pour Shahverdi ◽  
Fateme Ravanbakhsh Ghavghani ◽  
Somaieh Matin
Keyword(s):  
Risk Factors ◽  
Infectious Complications ◽  
Test Methods ◽  
Burn Patients ◽  
In Vitro Susceptibility ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Burn Unit ◽  
Microbial Infections

Background: Burns patients are predisposed to infectious complications. Amongst microbial infections, Gram-negative bacilli are the most prevalent bacteria in the burn units. Objectives: The current study aimed to identify the risk factors associated with antibiotic-resistant Gram-negative bacilli in hospitalized burn patients and determine the in-vitro susceptibility of these organisms to colistin. Methods: Two hundred burn patients hospitalized in the burn unit and ICU burn ward were allocated to two groups (each with 100 patients) of patients with antibiotic-resistant Gram-negative bacilli infections and the other with antibiotic susceptible Gram-negative bacilli associated infections. The susceptibility of Gram-negative bacilli was done towards various antibacterial agents by the Kirby-Bauer method. Susceptibility of colistin was performed using both E-test and disc diffusion methods. Results: The history of antibiotic usage, length of ICU stay, mechanical ventilation, and catheter usage were the most important risk factors for infections associated with antibiotic-resistant Gram-negative bacilli. Pseudomonas aeruginosa and Acinetobacter baumannii were the most prevalent bacteria in the burn unit. Only one A. baumannii isolate was found resistant toward colistin by both disk diffusion and E-test methods. Conclusions: Burn patients are prone to infections, and Gram-negative bacilli predominates in patients harboring risk factors. These findings influence the choice of traditional therapeutic regimens in such patients. Colistin served as an appropriate antibiotic choice.

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