Bronwyn R Griffin1, Cody C Frear2, Franz Babl3, Ed Oakley3, Roy M Kimble4. 1. Queensland University of Technology Faculty of Health, Centre for Children's Burns and Trauma Research, South Brisbane, Queensland, Australia. Electronic address: bronwyn.griffin@qut.edu.au. 2. Queensland University of Technology Faculty of Health, Centre for Children's Burns and Trauma Research, South Brisbane, Queensland, Australia. Electronic address: cody.frear@uqconnect.edu.au. 3. Murdoch Children's Research Institute, Royal Children's Hospital, and Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia. 4. Queensland University of Technology Faculty of Health, Centre for Children's Burns and Trauma Research, South Brisbane, Queensland, Australia.
Abstract
STUDY OBJECTIVE: First-aid guidelines recommend the administration of cool running water in the early management of thermal injury. Our objective is to analyze the associations between first aid and skin-grafting requirements in children with burns. METHODS: This cohort study used a prospectively collected registry of patients managed at a tertiary children's hospital. Multivariate logistic regression models were used to evaluate the relationship between first aid and the requirement for skin grafting. Secondary outcomes included time to re-epithelialization, wound depth, hospital admission and length of stay, and operating room interventions. Adequate first aid was defined as 20 minutes of cool running water within 3 hours of injury. RESULTS: In our cohort of 2,495 children, 2,259 (90.6%) received first aid involving running water, but only 1,780 (71.3%) were given the adequate duration. A total of 236 children (9.5%) required grafting. The odds of grafting were decreased in the adequate first aid group (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4 to 0.8). The provision of adequate running water was further associated with reductions in full-thickness depth (OR 0.4; 95% CI 0.2 to 0.6), hospital admission (OR 0.7; 95% CI 0.3 to 0.9), and operating room interventions (OR 0.7; 95% CI 0.5 to 0.9), but not hospital length of stay (hazard ratio=0.9; 95% CI 0.7 to 1.2; P=.48). CONCLUSION: Burn severity and clinical outcomes improved with the administration of cool running water. Adequate first aid must be prioritized by out-of-hospital and emergency medical services in the preliminary management of pediatric burns.
STUDY OBJECTIVE: First-aid guidelines recommend the administration of cool running water in the early management of thermal injury. Our objective is to analyze the associations between first aid and skin-grafting requirements in children with burns. METHODS: This cohort study used a prospectively collected registry of patients managed at a tertiary children's hospital. Multivariate logistic regression models were used to evaluate the relationship between first aid and the requirement for skin grafting. Secondary outcomes included time to re-epithelialization, wound depth, hospital admission and length of stay, and operating room interventions. Adequate first aid was defined as 20 minutes of cool running water within 3 hours of injury. RESULTS: In our cohort of 2,495 children, 2,259 (90.6%) received first aid involving running water, but only 1,780 (71.3%) were given the adequate duration. A total of 236 children (9.5%) required grafting. The odds of grafting were decreased in the adequate first aid group (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4 to 0.8). The provision of adequate running water was further associated with reductions in full-thickness depth (OR 0.4; 95% CI 0.2 to 0.6), hospital admission (OR 0.7; 95% CI 0.3 to 0.9), and operating room interventions (OR 0.7; 95% CI 0.5 to 0.9), but not hospital length of stay (hazard ratio=0.9; 95% CI 0.7 to 1.2; P=.48). CONCLUSION: Burn severity and clinical outcomes improved with the administration of cool running water. Adequate first aid must be prioritized by out-of-hospital and emergency medical services in the preliminary management of pediatric burns.
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Authors: Lisa Wm Leung; Mark M Gallagher; Pasquale Santangeli; Cory Tschabrunn; Jose M Guerra; Bieito Campos; Jamal Hayat; Folefac Atem; Steven Mickelsen; Erik Kulstad Journal: J Interv Card Electrophysiol Date: 2019-11-22 Impact factor: 1.900