scholarly journals Firecracker injuries during Diwali festival: The epidemiology and impact of legislation in Delhi

2012 ◽  
Vol 45 (01) ◽  
pp. 097-101 ◽  
Author(s):  
R. Tandon ◽  
K. Agrawal ◽  
R.P. Narayan ◽  
V.K. Tiwari ◽  
V. Prakash ◽  
...  
Keyword(s):  
Public Awareness ◽  
Total Body Surface Area ◽  
Family Welfare ◽  
National Capital Region ◽  
Burn Care ◽  
Number Of Patients ◽  
Management Protocol ◽  
National Capital ◽  
Diwali Festival ◽  
Total Body

ABSTRACT Setting and Design: A hospital-based retrospective study of firecracker-related injuries was carried out at a government sponsored hospital in Delhi. Materials and Methods: 1373 patients attended the emergency burn care out-patients clinic during 2002-2010 pre-Diwali, Diwali and post-Diwali days. Every year, a disaster management protocol is revoked during these 3 days under the direct supervision of the Ministry of Health and Family Welfare, Government of India. Results: There was an increase in the number of patients of firecracker-related injuries in Delhi national capital region from the year 2002 to 2010, based on the hospital statistics. During the study period, the hospital received approximately one patient with firecracker-related injury per 100,000 population of the city. 73.02% of the victims were 5-30 years old. Majority (90.87%) of them sustained <5% total body surface area burn. Conclusions: In spite of legislations and court orders, the number of patients is on the rise. The implementation agencies have to analyse the situation to find a way to control this preventable manmade accident. Websites, emails, SMS, social sites, etc. should be used for public education, apart from conventional methods of public awareness.

scholarly journals Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices

2021 ◽  
Vol 10 (3) ◽  
pp. 476
Author(s):  
Ioana Tichil ◽  
Samara Rosenblum ◽  
Eldho Paul ◽  
Heather Cleland
Keyword(s):  
Blood Transfusion ◽  
Surgical Management ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Perioperative Period ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Burn Care ◽  
Transfusion Requirements ◽  
Total Body

Objective: To determine blood transfusion practices, risk factors, and outcomes associated with the use of blood products in the setting of the acute management of burn patients at the Victorian Adult Burn Service. Background: Patients with burn injuries have variable transfusion requirements, based on a multitude of factors. We reviewed all acute admissions to the Victorian Adult Burns Service (VABS) between 2011 and 2017: 1636 patients in total, of whom 948 had surgery and were the focus of our analysis. Method and results: Patient demographics, surgical management, transfusion details, and outcome parameters were collected and analyzed. A total of 175 patients out of the 948 who had surgery also had a blood transfusion, while 52% of transfusions occurred in the perioperative period. The median trigger haemoglobin in perioperative was 80mg/dL (IQR = 76–84.9 mg/dL), and in the non-perioperative setting was 77 mg/dL (IQR = 71.61–80.84 mg/dL). Age, gender, % total body surface area (TBSA) burn, number of surgeries, and intensive care unit and hospital length of stay were associated with transfusion. Conclusions: The use of blood transfusions is an essential component of the surgical management of major burns. As observed in our study, half of these transfusions are related to surgical procedures and may be influenced by the employment of blood conserving strategies. Furthermore, transfusion trigger levels in stable patients may be amenable to review and reduction. Risk adjusted analysis can support the implementation of blood transfusion as a useful quality indicator in burn care.

scholarly journals The predisposing factors of AKI for prophylactic strategies in burn care

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9984
Author(s):  
Shin-Yi Tsai ◽  
Chon-Fu Lio ◽  
Shou-Chuan Shih ◽  
Cheng-Jui Lin ◽  
Yu-Tien Chen ◽  
...  
Keyword(s):  
Burn Injury ◽  
Laboratory Data ◽  
Total Body Surface Area ◽  
Kidney Injury ◽  
Inhalation Injury ◽  
Predisposing Factors ◽  
Dust Explosion ◽  
Burn Care ◽  
Hospital Patients ◽  
Total Body

Background Acute kidney injury (AKI) is one of the most severe complications of burn injury. AKI with severe burn injury causes high mortality. This study aims to investigate the incidence of and predisposing factors for AKI in burn patients. Methods This is a single-center, retrospective, descriptive criterion standard study conducted from June 27, 2015, to March 8, 2016. We used Kidney Disease Improving Global Outcomes criteria to define and select patients with AKI. The study was conducted by recruiting in hospital patients who suffered from the flammable cornstarch-based powder explosion and were treated under primary care procedures. A total of 49 patients who suffered from flammable dust explosion-related burn injury were enrolled and admitted on June 27, 2015. The patients with more than 20% total body surface area of burn were transferred to the intensive care unit. Patients received fluid resuscitation in the first 24 hours based on the Parkland formula. The primary measurements were the incidence of and predisposing factors for AKI in these patients. Demographic characteristics, laboratory data, and inpatient outcomes were also evaluated. The incidence of AKI in this cohort was 61.2% (n = 30). The mortality rate was 2.0% (n = 1) during a 59-day follow-up period. The multivariate analysis revealed inhalation injury (adjusted OR = 22.0; 95% CI [1.4–358.2]) and meeting ≥3 American Burn Association (ABA) sepsis criteria (adjusted OR = 13.7; 95% CI [1.7–110.5]) as independent risk factors for early advanced AKI. Conclusions The incidence rate of AKI was higher in this cohort than in previous studies, possibly due to the flammable dust explosion-related burn injury. However, the mortality was lower than that expected. In clinical practice, indicators of inflammation, including ABA sepsis criteria may help in predicting the risk of AKI in patients with burn injury.

66 The Effect of Transfer on Outcomes in Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S43-S43
Author(s):  
Elizabeth Bruenderman ◽  
Selena The ◽  
Nathan Bodily ◽  
Matthew Bozeman
Keyword(s):  
Tertiary Care ◽  
Total Body Surface Area ◽  
The United States ◽  
Infectious Complications ◽  
Burn Care ◽  
Burn Center ◽  
Total Body ◽  
Tertiary Care Centers ◽  
Inhalation Burn ◽  
Time From Injury

Abstract Introduction Burn care in the United States takes place primarily in tertiary care centers with specialty-focused burn capabilities. Patients are often initially transported to centers without burn capabilities, requiring subsequent transfer to a higher level of care. This study aims to evaluate the effect of this treatment delay on outcomes. Methods Under IRB approval, adult burn patients meeting American Burn Association (ABA) criteria for transfer at a single burn center were retrospectively identified. Cohorts were divided into patients who were initially taken to a non-burn center and subsequently transferred versus patients taken immediately to a burn center. Outcomes between the groups were compared. Results A total of 122 patients were identified, 61 in each cohort. There was no difference between the transfer and direct admit cohorts with respect to median age (52 vs. 46, p = 0.45), percent total body surface area burn (10% vs. 10%, p = 0.08), concomitant injury (0 vs. 4, p = 0.12), or intubation prior to admission (5 vs. 7, p = 0.76). Transfer patients experienced a longer median time from injury to burn center admission than directly admitted patients (1 vs. 8 hours, p &lt; 0.01). Directly admitted patients were more likely to have inhalation burn (18 vs. 4, p &lt; 0.01), require intubation after admission (10 vs. 2, p = 0.03), require an emergent procedure (18 vs. 5, p &lt; 0.01), and develop infectious complications (14 vs. 5, p = 0.04). However, there was no difference between transfers and direct admits in ventilator days (9 vs. 3 days, p = 0.37), number of operations (0 vs. 0, p = 0.16), length of stay (3 vs. 3 days, p = 0.44), or mortality (6 vs. 3, p = 0.50). Conclusions This study suggests that significantly injured, hemodynamically unstable patients were more likely to be immediately identified and taken directly to a burn center. Patients who otherwise met ABA criteria for transfer were not affected by short delays in transfer to definitive burn care. Applicability of Research to Practice Initial triage and evaluation of hemodynamically stable patients at non-burn centers does not negatively impact outcomes in patients who meet ABA criteria for transfer to a burn center.

Management of burns in the ICU

2016 ◽  
Author(s):  
Shahriar Shahrokhi ◽  
Marc G. Jeschke
Keyword(s):  
Total Body Surface Area ◽  
The Elderly ◽  
Similar Data ◽  
Burn Patients ◽  
Burn Care ◽  
Future Developments ◽  
Appropriate Treatment ◽  
Total Body ◽  
Critical Components ◽  
Current Standards

Outcomes of burn patients have significantly improved over the last two decades. A recent study in The Lancet showed that a burn size of over 60% total body surface area (TBSA) burned is now recognized as being associated with high risks; a decade ago similar risks resulted from a 40% TBSA burned. Similar data have been obtained in severely-burned adults and the elderly. This chapter discusses current standards, recent evidence, and future developments in burn care to improve outcomes of these patients. Critical components in the management of patients with burns are early adequate resuscitation, recognition and management of airway burns and appropriate treatment of the different stages of burn care—prehospital, early, and late management.

scholarly journals Are there any differences in the provided burn care between men and women? A retrospective study

2018 ◽  
Vol 6 ◽  
Author(s):  
Laura Pompermaier ◽  
Moustafa Elmasry ◽  
Islam Abdelrahman ◽  
Mats Fredrikson ◽  
Folke Sjöberg ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Mortality ◽  
Total Body Surface Area ◽  
University Hospital ◽  
Panel Regression ◽  
Independent Factor ◽  
Men And Women ◽  
Burn Care ◽  
Use Of Resources ◽  
Total Body

Abstract Background Disparity between medical treatment for men and women has been recorded worldwide. However, it is difficult to find out if the disparities in both the use of resources and outcome depend entirely on sex-related discrimination. Our aim was to investigate if there are differences in burn treatments between the sexes. Methods All patients admitted with burns to Linköping University Hospital during the 16-year period 2000–2015 were included. Interventions were prospectively recorded using the validated Burn SCoring system (BSC). Data were analysed using a multivariable panel regression model adjusted for age, percentage total body surface area (%TBSA), and in-hospital mortality. Results A total of 1363 patients were included, who generated a total of 22,301 daily recordings while they were inpatients. Males were 70% (930/1363). Sex was not an independent factor for daily scores after adjustment for age, %TBSA, and mortality in hospital (model R2=0.60, p &lt; 0.001). Conclusion We found no evidence of inequity between the sexes in treatments given in our burn centre when we had adjusted for size of burn, age, and mortality. BSC seems to be an appropriate model in which to evaluate sex-related differences in the delivery of treatments.

scholarly journals Syndromic Trends in the Sexually Transmitted Diseases (STD) among Patients Visiting STD Clinic of a Tertiary Hospital in the National Capital Region

2020 ◽  
Vol 06 (02) ◽  
pp. 28-34
Author(s):  
Ameeka Shereen Lobo ◽  
Keyword(s):  
Sexually Transmitted Diseases ◽  
Tertiary Hospital ◽  
Similar Proportion ◽  
New Delhi ◽  
National Capital Region ◽  
Sexually Transmitted ◽  
The Public ◽  
Major Threat ◽  
Number Of Patients ◽  
National Capital

Sexually transmitted diseases or infections are a major threat to the public. Every year more than one million people acquire it globally. The objectives of this study were: a) to identify the number of patients tested for STDs, b) to assess the number of patients tested positive for STDs, c) to understand the trends of STD syndrome among the patients from January 2018 to June 2019. Data of patients visiting the STD Outpatient Department (OPD) of Safdarjung Hospital, New Delhi with symptoms related to STI/ STD was analysed. Data of patients who visited the OPD for consultation was available, and was used as proxy denominator to guide the analyses. Descriptive analyses were conducted using this dataset. The total number of patients in 2018 was 7363, out of which 4089 (55.53%) were males. In 2019, the total number of patients between January and June was 4346, with an almost similar proportion of males (2241- 51.56%). Of 7363 patients that visited the clinic, 19.7% of patients tested positive for one or the other STD in 2018, whereas from January to June 2019, 18.38% patients tested positive for STD. A total of 1561 cases of Vaginal/ Cervical discharge was seen across the span of 18 months in 2018. This analysis gives an understanding of the number of patients with STD symptoms and syndromes over a period of 18 months at a tertiary level STD centre in Delhi. Since the data available is only for one centre, the results cannot be generalized to the wider population.

22 16-year State-wide Population-based Analysis of Burn and Inhalation Injury – Demographics, Injury Characteristics, Management, and One-year Outcomes

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S17-S18
Author(s):  
Philip D Hewes ◽  
Derek Bell
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Population Based ◽  
Inhalation Injury ◽  
Post Injury ◽  
Case Volume ◽  
Burn Care ◽  
Total Body

Abstract Introduction Estimates on frequency and outcomes of burn or inhalation injury in the United States are limited since reported databases are confined to specific phases of care, included facilities, length of follow-up, facility/provider/patient identification and/or lack of longitudinal tracking. A population-based database addresses these issues. Methods We queried a statewide mandated-reporting database for the years from 2000 through 2015 at the time of injury using a set of ICD9-CM codes for second degree or deeper burns, inhalation injury, and chemical and electrical burns. Burn total body surface area percentage by anatomical region was assigned as appropriate using modified and age-stratified Lund and Browder charts. Records for each patient were extracted out to one year pre- and post-injury, as available. Provider and facility burn volume and survival was stratified into quartiles. We applied the Committee on Trauma/American Burn Association referral criteria to the index presentation. Kaplan-Meier curves were generated to 1-year post injury for testing combinations of burn percent total body surface area of 20% and inhalation injury for age ranges &lt; 15, 15 - 60, and &gt;60 years. Regression models were developed to model the probabilities of in-patient, 90-day, and 365-day mortality and readmission. Results 56,712 patients were included. Overall, 22% of patients meeting referral criteria were never seen at a burn center within 1-year post-injury. The greatest positive predictors of in-patient mortality were facility case volume and burn percent total body surface area. The greatest negative predictors were high provider burn case volume (for highest quartile, adjusted odds ratio 0.08, 95% confidence intervals 0.06 – 0.12). The highest risk of unscheduled 30-day readmission was associated with index presentation to a non-burn care facility (p &lt; 0.001). For all groups, the first 100 days had the greatest mortality rate, the most severe being among patients of age greater than 60 with &gt;20% burn percent total body surface area and inhalation injury, with a 40% survival rate. Conclusions This study is the first to be able to simultaneously evaluate in-patient, post-discharge, and facility-based parameters for outcomes. A significant number of patients are not accounted with current databases. Applicability of Research to Practice A population-based approach with longitudinal tracking allows for greater realization of the outcomes of all patients following burn injury. Existing association-supported or government databases fail to account for a significant portion of burn victims, motivating further evaluation of burn care efforts.

scholarly journals Paediatric injuries due to home treadmill use: an emerging problem

2012 ◽  
Vol 94 (2) ◽  
pp. 121-123 ◽  
Author(s):  
P Lohana ◽  
S Hemington-Gorse ◽  
C Thomas ◽  
T Potokar ◽  
YT Wilson
Keyword(s):  
Surgical Intervention ◽  
Public Awareness ◽  
Total Body Surface Area ◽  
Home Exercise ◽  
Patient Demographics ◽  
Burn Units ◽  
Total Body ◽  
The Uk ◽  
Type Of Injury ◽  
Exercise Equipment

INTRODUCTION The use of home exercise equipment is increasing and treadmills are becoming more popular. This has brought with it an emerging but preventable problem. We present our experience, highlight the importance and promote public awareness of this type of injury. To our knowledge this has not been reported previously in the UK. METHODS A retrospective review was conducted of the medical records at two regional burn units of children who sustained treadmill-related injuries between July 2003 and July 2009. Data on patient demographics, mechanism of injury, management, surgical intervention and outcome were recorded. RESULTS Twenty-nine children (15 boys, 14 girls) sustained treadmill-related injuries. The mean age was 3.8 years (range: 1–13 years). All injuries occurred at home and the majority of children trapped their hand under the running belt when an adult was using the machine. Most of the injuries were to the upper limb (97%) with less than 1% of the total body surface area burnt. More than two-thirds of patients had deep burns and 17 (58%) required surgical intervention. Five patients developed hypertrophic scars. All patients achieved a good functional outcome. CONCLUSIONS Treadmills can pose a significant danger to children. These injuries are preventable. Regulatory authorities, manufacturers and parents should take steps to prevent this emerging health problem.

820 Transgender Patients with Assault by Burn

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S249-S249
Author(s):  
Uriel J Sanchez ◽  
Clifford C Sheckter ◽  
Yvonne L Karanas
Keyword(s):  
United States ◽  
Medical Care ◽  
Partner Violence ◽  
Public Awareness ◽  
Total Body Surface Area ◽  
The United States ◽  
Care Providers ◽  
Burn Care ◽  
Major Burn

Abstract Introduction The transgender population is estimated at 25 million worldwide and 1 million in the United States. Transgender individuals or those experiencing gender dysphoria are at a higher risk of intimate partner violence and assault (60%) as well as suicide (40%), with reports of 18 transgender individuals killed this year alone in the United States. Trauma and burn care providers need to be aware of this population’s unique medical and surgical needs. To our knowledge, we describe the first reports of burn injuries in transgender patients. Methods We performed a retrospective review of all transgender or gender dysphoric patients admitted to a regional burn center from 2010 to 2019 with a major burn diagnosis (&gt;20% total body surface area). Patients were identified by International Classification of Disease codes in addition to self-identification at time of admission. We describe the mechanism of injury, circumstances surrounding the incident, hospital course, disposition at discharge, and outcomes in clinic follow up. Results The cohort consisted of two patients who were transgender females (i.e. born biologic male and identified as female), aged 31 and 36. Both patients were homeless and had histories of substance abuse and mental health issues. The burn sizes were 20% and 80% and both were flame injuries. One was injured by her domestic partner. The other was injured in a tent fire from a camping stove. The 20% TBSA patient underwent 3 surgeries and was discharged to medical respite on PBD #55. The 80% TBSA patient underwent 9 surgeries and was discharged to inpatient rehabilitation on PBD #75. Regarding their transgender medical care, neither patient was actively being treated by a medical professional although they both reported taking estrogens. Neither patient had undergone transgender surgery. Hormone therapy was not continued during their hospital stay due to lack of information surrounding prior use and limited knowledge regarding the safety of hormonal therapy during burn treatment. Both patients were initially lost to follow up but subsequently reentered our health care system. Both patients have since been referred to our county transgender clinic and are now actively followed by a transgender provider. Conclusions Transgender patients are at high risk for violence and assault, which includes burn. These patients are more difficult to identify and may have inadequate transgender medical care. Burn providers of all levels should be aware of the unique needs of this population and involve transgender medical providers in the acute and rehabilitative care when feasible. Applicability of Research to Practice Raise public awareness regarding assault by burn in the transgender population.

scholarly journals Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 551
Author(s):  
Gloria Pelizzo ◽  
Elettra Vestri ◽  
Giulia del Re ◽  
Claudia Filisetti ◽  
Monica Osti ◽  
...  
Keyword(s):  
Average Length ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Treatment Team ◽  
Pediatric Hospital ◽  
Regional Network ◽  
Burn Treatment ◽  
Burn Care ◽  
Management Protocol ◽  
Set Up

Considerable reorganization of the regional network for pediatric burn treatment during the pandemic was required to cope with severe burn injuries in small children. In support of the emergency network for burns during the COVID-19 pandemic, we referred to regional indications for centralization in our hospital for all children aged less than 5 years who presented with severe burns, >15% of total body surface area (TBSA), or who necessitated admittance to the pediatric intensive care unit (PICU). A new service with a dedicated management protocol was set up to treat pediatric burns in our SARS-CoV-2 pediatric hospital during the lockdown period. A multidisciplinary burn treatment team was set up to offer compassionate and comprehensive burn care. Patient’s clinical data, burn features, treatment and follow up were recorded. A higher number of admissions was recorded from February to December 2020 compared with the same period in 2019 (52 vs. 32 admissions). Eighteen patients were admitted to the COVID-19 Service (10 M/8 F; 3.10 ± 2.6 yrs); ten children (55.5%) were hospitalized in the ward and eight in the ICU (44.5%). Fifty percent of the cases presented with lesions extending over >15% TBSA; in one case, TBSA was 35%. All patients suffered 2nd-degree burns; while five patients also had 3rd degree lesions covering more than 15% TBSA. All of the injuries occurred at home. No major secondary infections were recorded. Successful treatment was achieved in 94.4% of cases. The average length of stay was 15.2 ± 12.6 days. A proactive, carefully planned service, involving a multidisciplinary team, was created to ensure appropriate care in a pediatric hospital during the COVID-19 period, despite the effective pandemic associated challenges. Better health promotion in pediatric burn cases should also include dedicated TBSA assessment and a database of children’s burn characteristics.

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