Prevalence of Psychiatric Disorders in Burn Patients in a Tertiary Care Hospital

2021 ◽  
Vol 15 (11) ◽  
pp. 3389-3391
Author(s):  
Imran Khan ◽  
Taimur Khan ◽  
Shakil Asif ◽  
Syed Azhar Ali Kazmi ◽  
Subhan Ullah ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Total Body

Background and Aim: Burn injuries patients generally suffer from various psychological and mental disorders especially in lower socio-economic groups. It can adversely affect their wellbeing and health. Proper consultation and clinical diagnosis need to be carried out on burns injuries patients from the early critical phase to rehabilitation phase recovery. The current study's aim was to determine the prevalence of psychiatric disorders in burn patients in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 82 attempted burn suicides, adult patients in Khattak Medical Center Peshawar, Khyber Teaching Hospital Peshawar and Divisional Headquarter hospital, Mirpur AJK for duration of six months from June 2020 to December 2020. All the patients admitted with suicides burns were of either gender and had ages above 15 years. The convenience technique was used for sampling. The patients’ demographic details such as psychiatric illness, self-immolation act motivation, burn injury depth, burn total body surface area, inhalation injury, hospitalization duration, and mortality was recorded on pre-designed proforma. Data analysis was carried out with SPSS version 20. Results: The mean age of all 82 patients was 28.9±5.2 with an age range of 14 to 55 years. Of the total, 66 (80.5%) were female while 16 (19.5%) were male. In this study, the most frequent suicidal attempt was made by the marital conflicted patients 50 (61%) followed by love affair failure 8 (9.7%). An overall mean of 53.6±19.6 was observed for total body surface area affected with a range of 15-100%. The hospital duration mean was 8.2±5.9 with a range of 1-38 days. Young, married, and rural area illiterate housewives were the most common self-inflicted/suicide burn injuries. The prime cause of such injuries was getting married. The mortality rate was found at 82.3%. Conclusion: Our study concluded that patient’s well-being and mental health could be severely affected by burn injuries. Prevalent depression was noted among severe burn injuries patients. Depression related to deformity could be prevented with early grafting, wound management, proper splinting, coping ability, intense physiotherapy, and long-term rehabilitation. Keywords: Burn; Depressed mood, Psychiatric morbidity, Posttraumatic stress disorder

scholarly journals Impact on fetal outcome following burns in pregnancy

2021 ◽  
Vol 8 (5) ◽  
pp. 1454
Author(s):  
Harsh Rajeev Mehta ◽  
Pravinkumar P. Wasadikar
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Reproductive Age ◽  
High Rate ◽  
Care Hospital ◽  
Burn Patients

Background: The incidence of female burn patients of reproductive age varies from 0.6%-15% in different series with highest incidence reported from India.Foetus is at high risk due to burns injury, which is often associated with a high rate of fetal mortality.Methods: All cases of burns injury encountered during pregnancy admitted at our tertiary care hospital were included in this study over a span of two years from 2017 to 2019. A total of 20 cases were included in the study. Patients with burns injury from 5 to 100% body surface area were included in this study.Results: Fetal deaths occurred in 11 out of the total 20 cases amounting to 55% overall fetal mortality.Conclusions: Burns during pregnancy requires adequate resuscitation especially in initial stages. There is 100% fetal death outcome for burns greater than 50% body surface area.

Accuracy of telemedicine for pediatric burn patients admitted to an emergency service

2021 ◽  
pp. 1357633X2110233
Author(s):  
Tugba Esberk ◽  
Koray Das
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Clinical Decision ◽  
Care Hospital ◽  
Burn Patients ◽  
Total Body

Introduction Telemedicine when properly implemented can be used to facilitate consultations from physicians with little or no burn experience by providing access to qualified physicians in burn care to reduce the workload in emergency departments or elsewhere. In this study, the role of telemedicine in the management and triage of pediatric burn patients admitted to the emergency department of a tertiary care hospital is investigated. Methods This cross-sectional study was conducted between 1 January 2019 and 31 December 2020 and a total of 210 patients were enrolled in the study. Patients were initially evaluated in the emergency room by a pediatrician and consulted by an experienced burn specialist using lesion images. An in-person assessment of the patients was performed by another burn specialist according to the clinical decision made via telemedicine. The data of both assessments and clinical data of the patients were examined. Results The mean age of our patients was 3.35 ± 3.7 years. Most of the burns were scalds with hot liquids (71%). After the consultations, 73 patients were discharged from the emergency room. The rest were decided as follow-up at the burn outpatient clinic ( n = 99) or hospitalization ( n = 35) and in-person assessment was performed for these patients. The inter-rater reliability value for “clinical decision” was almost perfect (Cohen's kappa value is 0.923). Also, the level of concordance between the two assessments was very high for burned total body surface area (interclass correlation coefficient = 0.999). Conclusion In the management and triage of pediatric burn patients admitted to the emergency department, telemedicine and in-person examination resulted in almost perfect agreement in terms of clinical decision and total body surface area. Legal arrangements and regulatory changes are essential to support the safe and wide adoption of telemedicine, which is a reliable method in emergency room settings.

scholarly journals Multimodal Analgesia and Discharge Opioid Requirements in Burn Patients

2020 ◽  
Vol 41 (5) ◽  
pp. 963-966
Author(s):  
Michael Wright ◽  
Jin A Lee
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Multimodal Analgesia ◽  
Burn Patients ◽  
Area Burned ◽  
Total Body ◽  
The Impact

Abstract Analgesia in burn patients is challenging given the complexity of burn pain and prolonged need beyond hospital admission. Given the risks of opioids, the impact of multimodal analgesia postdischarge needs to be further elucidated in this population. This retrospective, single-center cohort study evaluated adult burn patients who were consecutively admitted to the burn service with at least 10% total body surface area burned and subsequently followed in the burn clinic between February 2015 and September 2018. Subjects were separated into two cohorts based on discharge pain regimens: multimodal and nonmultimodal. The primary outcome was the change in opioid requirements (measured in oral morphine equivalents) between discharge and first follow-up interval. Secondary outcomes included the classes of multimodal agents utilized and a comparison of opioid requirements between the last 24 hours of admission and discharge. A total of 152 patients were included for analysis, 76 in the multimodal cohort and 76 in the nonmultimodal cohort. The multimodal cohort was noted to have increased total body surface area burned and prolonged number of days spent in the intensive care unit at baseline; however, the multimodal cohort exhibited a more significant decrease in opioid requirements from discharge to first follow-up interval when compared with the nonmultimodal cohort (106.6 vs 75.4 mg, P = .039).

scholarly journals Epidemiology and outcome of acute burn patients at a new dedicated burn centre in Nepal

2020 ◽  
Vol 23 (1) ◽  
pp. 19-29
Author(s):  
Budhi Nath Adhikari Sudhin ◽  
Sanjit Adhikari ◽  
Sushma Khatiwada
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Winter Season ◽  
College Teaching ◽  
Burn Patients ◽  
Permanent Disability ◽  
Total Body ◽  
Epidemiological Characteristics

Introduction: Burn injury remains one of the biggest health concerns in the developing world. It has been regarded as a formidable public health issue in terms of mortality, morbidity and permanent disability. We aim to provide an overview of the basic epidemiological characteristics of burn patients admitted at a dedicated burn center in Chitwan, Nepal. Methods: This was a retrospective, hospital-based observational study conducted at Chitwan Medical College Teaching Hospital (CMCTH) burn ward from September 2017 to August 2019. Patients’ records from admission/discharge book, admission/discharge summaries as well as patient’s individual files were reviewed to obtain the necessary data. Demographic data, clinical characteristics, treatments and outcomes were statistically analyzed. Results: Among the 202 patients, the number of males slightly predominated that of females with a ratio of 1.02:1. The median age was 24 years, and the median total body surface area (TBSA) burned was 15%.  Children less than 10 years comprised one third of all patients while more than one fifth were elderly. The commonest etiological factor was flame burn, closely followed by scald. The mortality rate was 12.38% for the period under review. Majority of the patients spent less than 10 days on admission and around one fifth needed surgical intervention aimed at earlier coverage. Binary logistic regression analysis showed that age, Body Mass Index (BMI) and total body surface area (TBSA) burnt were the major predictors of burn mortality. Conclusions: The outcome of burn injuries is poor. Appropriate preventive & therapeutic measures need to be taken in terms of social education & provision of quality healthcare to reduce the incidence & improve the survival outcome of burn patients which should focus on children and elderly especially during the winter season.

861 Analgesia After Burns: A Case Series and Development of a Multimodal Analgesic Enhanced Recovery Pathway

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S268-S269
Author(s):  
Andrew m Mendelson ◽  
Yasmin Elkhashab ◽  
William Hughes ◽  
Eugene R Viscusi
Keyword(s):  
Pain Management ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Oral Morphine ◽  
Opioid Consumption ◽  
Management Service ◽  
Burn Patients ◽  
Total Body

Abstract Introduction Burn pain is grossly undertreated which may result in poorer outcomes including chronic pain, anxiety and persistent opioid use. Opioids are currently the mainstay of treatment with many burn patients receiving long term opioid management even in the context of the opioid crisis. We retrospectively reviewed the charts of burn patients admitted to our hospital to evaluate the impact of our multimodal pain management approach on overall opioid consumption. Methods Following IRB approval, a retrospective chart review of all patients with burn injuries over a one year period was performed. The Acute Pain Management Service was consulted for analgesic management for all patients. Patient data was collected from their electronic medical records on Epic HyperSpace and included total body surface area of burn, age and gender, length of hospital stay, amount of opioid usage throughout admission, average verbal numerical score for pain, and use of adjuvant analgesics was gathered. The amount of opioid usage was obtained from the chart and then converted to oral morphine equivalents (OME) using the CDC Prevention Conversion Chart. Results During the study period, eight patients met inclusion criteria. The average patient age was 42.5 years, with a mean of 26.8 % TBSA (Total body surface area) burn and mean length of stay of 23 days. Our pain pathway consisted of non-opioid analgesic adjuncts that were given around-the-clock with opioids used only on an as-needed basis. The nonopioid analgesics include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), gabapentin or pregabalin, and a ketamine infusion. Initial opioid consumption (on day of APMS consult) as well as median hospital day was compared to opioid consumption on day of discharge. Six out of eight patients showed a reduction in their oral morphine equivalent (OME) following APMS consult usage from day of admission with average 76 OME to 44.6 OME on day of discharge. Conclusions We were able to reduce patient’s opioid requirement in 6 out of 8 patients upon discharge. These findings suggest that a further more rigorous study is warranted to demonstrate the benefits of multimodal therapy in burn pain. Applicability of Research to Practice The multimodal approach to pain control for burn patients may possibly be able to reduce the overall opioid requirements and theoretically the opioid associated side effects.

NON-ACCIDENTAL BURN INJURIES IN ADULTS ADMITTED AT MANKWENG BURNS UNIT

2020 ◽  
Vol 3 (9) ◽  
Author(s):  
Salathiel Zhou Mzezewa ◽  
Livhuwani Makhuvha
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Public Health Problem ◽  
Intimate Partner ◽  
Burn Injuries ◽  
Traditional Beliefs ◽  
Causative Agents ◽  
Total Body

Abstract IntroductionBurns are a serious public health problem responsible for mortality and morbidity such as infection, contractures, and psycho-social disability.Aims and ObjectivesTo obtain information on non-accidental burn injuries admitted to our burns unit.To record the outcome.MethodsAll patients with a history of non-accidental burn injuries from January 2019 to August 2020 were prospectively included in this study. A data collection tool was created which consisted of data on age, gender, causative agents of burns, mechanism/circumstances that led to injury, total body surface area (TBSA) involved, and the patient’s outcome. ResultsWe admitted 38 patients. 22 males and 16 females. The mechanisms were intimate partner related violence 21, religious and traditional beliefs 5, self-inflicted 3, mob assault 1, robbery 2, alcohol-related conflicts 3, unclear mechanisms 3. The causative agents were scald 20, open flame 15 and chemical burns 3. The median age was 35,63(19-64) years. The median total body surface area was 24,4 (3-80) %. Mortality was 11(29%). ConclusionBurn injuries as a result of intimate partner-related violence were the leading reason for admission at 55,26%. Mortality was highest among those admitted following religious and traditional beliefs burns. The mortality was 29%.

Total Body Surface Area Overestimation at Referring Institutions in Children Transferred to a Burn Center

2015 ◽  
Vol 81 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Douglas S. Swords ◽  
Edmund D. Hadley ◽  
Katrina R. Swett ◽  
Thomas Pranikoff
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Trauma Registry ◽  
Total Body Surface Area ◽  
Demographic Variables ◽  
Adverse Outcomes ◽  
Burn Patients ◽  
Burn Center ◽  
Total Body

Total body surface area (TBSA) burned is a powerful descriptor of burn severity and influences the volume of resuscitation required in burn patients. The incidence and severity of TBSA overestimation by referring institutions (RIs) in children transferred to a burn center (BC) are unclear. The association between TBSA overestimation and overresuscitation is unknown as is that between TBSA overestimation and outcome. The trauma registry at a BC was queried over 7.25 years for children presenting with burns. TBSA estimate at RIs and BC, total fluid volume given before arrival at a BC, demographic variables, and clinical variables were reviewed. Nearly 20 per cent of children arrived from RIs without TBSA estimation. Nearly 50 per cent were overestimated by 5 per cent or greater TBSA and burn sizes were overestimated by up to 44 per cent TBSA. Average TBSA measured at BC was 9.5 ± 8.3 per cent compared with 15.5 ± 11.8 per cent as measured at RIs ( P < 0.0001). Burns between 10 and 19.9 per cent TBSA were overestimated most often and by the greatest amounts. There was a statistically significant relationship between overestimation of TBSA by 5 per cent or greater and overresuscitation by 10 mL/kg or greater ( P = 0.02). No patient demographic or clinical factors were associated with TBSA overestimation. Education efforts aimed at emergency department physicians regarding the importance of always calculating TBSA as well as the mechanics of TBSA estimation and calculating resuscitation volume are needed. Further studies should evaluate the association of TBSA overestimation by RIs with adverse outcomes and complications in the burned child.

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