Abstract
ObjectiveTo determine the adequacy of cool running water first aid provided by healthcare professionals in the early management of children with thermal burn injuries.MethodsA cross‐sectional study was undertaken using a prospectively collected registry of children who presented with a thermal burn to the only major paediatric burns centre in Queensland, Australia, from January 2013 to December 2018. Main outcome measures included the type and duration of first aid administered by paramedics, general practitioners and emergency providers at local general hospitals and a children's hospital. In accordance with current Australian guidelines, adequate cooling was defined as 20 min of cool running water within 3 h of the injury.ResultsOf the 4537 children who presented to the paediatric burns centre, 3261 (71.9%) received adequate first aid, including 1502 (33.1%) at the scene of injury. Paramedics and general practitioners administered adequate cooling to 184 (25.0%) and 52 (24.2%) of their patients, respectively. ED clinicians adhered to guidelines in the treatment of 1019 (56.3%) children at general hospitals and 411 (76.0%) at the children's hospital. Among ED patients who presented with incomplete prior first aid, the risk of inadequate cooling was significantly greater for those transported via ambulance (P < 0.001).ConclusionDeficiencies remain in the cooling of paediatric burns patients at all levels of initial management. There is a need in the healthcare community for improved education regarding the parameters and clinical benefits of cool running water first aid.
Highlights
Among children treated in EDs, the odds of adequate cooling were decreased in those transported via ambulance
5293 children presented to the paediatric burns centre
The initial care provided by most general practitioners (GPs) and paramedics, as well as many ED clinicians, fell short of current guidelines calling for 20 min of cooling with running water
Summary
Burns are among the most common form of injury in Australian children, often resulting from domestic accidents involving hot liquids, food and cooking surfaces.[1,2] they account for nearly 4% of all injuryrelated hospital admissions,[3] most. Cody C Frear, BA, MD-PhD Student; Bronwyn Griffin, PhD, Senior Research Fellow; Roy Kimble, DMed (Res), MBChB, FRCS, FRACS (PaedSurg), Director of Paediatric Surgery, Urology, Burns and Trauma.
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