551 Mixed Methods Assessment of Pediatric Scald Burns

Abstract

Abstract Introduction CDC estimated more than 87,000 fire/burn injuries in 2017 among children 0–15 years old. Scald burns are the most common form of burn injury for children in the United States and are estimated to cost $44 million annually. Understanding the circumstances surrounding burn incidents and caretakers’ responses to them are needed to better guide prevention and education offerings. Methods We used a mixed methods approach to better understand pediatric scald burn mechanisms along with caregivers’ general knowledge, first aid responses and ability to accurately report characteristics of their child’s injury. Caregivers of children < 15 year old attending a burn follow up clinic with their child were recruited. Participants completed a 39-item, iPad-based survey that captured information about the circumstances, location and cause of the scald burn, whether first aid was provided, and caregiver/child demographics. With permission of the caregiver, the child’s medical record was accessed to collect burn descriptors (e.g., burn severity, total body surface area (TBSA), etc) to compare with parent self-report. Data collection occurred between May 2018 - May 2019. The study was approved by our institutional review board. Results Surveys were completed by 55 parents; 75% agreed to medical record review. The typical respondent was the female caregiver (80%) with more than a high school education (67%). The typical burn incident occurred in the kitchen (60%) of the family’s home (80%) and in the presence of the caregiver (71%). Seventy percent of respondents reported applying first aid; among those, 50% administered the proper first aid (using cool water on the burn) despite most (44%) reporting feeling “not confident” in the ability to do so. More than half (53%) didnot know their child’s TBSA; of those who did, self-reported TBSA ranged from 1 to 50%. Medical record review revealed that only 5 participants accurately reported their child’s TBSA. Conclusions Our data reveal that most scald burns occurred in the kitchen, of the child’s home, and in the presence of a caretaker. Half received incorrect first aid and few parents could accurately report their child’s TBSA. These results support the need to strengthen primary prevention offerings and improve parents’ understanding of their child’s burn injury. Applicability of Research to Practice The results of this research can help guide education efforts for primary prevention programs related to pediatric scald burn injuries. Furthermore, results can guide education practices for caregivers of children being treated for a scald burn injury.