Effect of Cool Running Water for 20 Minutes After Thermal Burns

Abstract

Research Article| June 01 2020 Effect of Cool Running Water for 20 Minutes After Thermal Burns AAP Grand Rounds (2020) 43 (6): 63. https://doi.org/10.1542/gr.43-6-63 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Effect of Cool Running Water for 20 Minutes After Thermal Burns. AAP Grand Rounds June 2020; 43 (6): 63. https://doi.org/10.1542/gr.43-6-63 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: burns, first aid, skin transplantation, thermal burn Source: Griffin BR, Frear CC, Babl F, et al. Cool running water first aid decreases skin grafting requirements in pediatric burns: a cohort study of two thousand four hundred ninety-five children. Ann Emerg Med. 2020; 75(1): 75– 85; doi: https://doi.org/10.1016/j.annemergmed.2019.06.028Google Scholar Investigators from Queensland and Melbourne, Australia, conducted a prospective cohort study to assess the impact of cool running water on the need for skin grafting in children with thermal burns. Participants were eligible if they presented to or were referred to the Queensland burn center between 2013 and 2016 with a thermal burn. Demographics were obtained via parent interviews at enrollment. Clinical characteristics were obtained from patients’ medical records. The primary exposure variable was use of cool running water within 3 hours of injury, as determined via paramedic, ED, or referral center documentation. Cool running water use was categorized as adequate or inadequate depending on duration. Adequate cool running water use was defined as use of cool running water for 20 minutes, consistent with first aid recommendations in Europe, Australia, and New Zealand. Inadequate cool running water use was defined as use for 11–19 minutes, 5–10 minutes (consistent with US first aid recommendations), <5 minutes, or no use of cool running water. The primary outcome variable was need for skin grafting. Secondary outcomes included time to re-epithelialization among ungrafted burns, full-thickness wound depth, hospital admission, and length of stay. The association between adequate cool running water use and outcomes was determined using logistic regression models. There were 2,495 participants included in analysis. The median age of participants was 2 years old, and the median total body surface area involved among participant burns was 1%. Adequate cool running water use was received by 71.3% of participants. Skin grafting was performed in 9.5% of participants. Adequate (vs inadequate) cool running water use was associated with significantly decreased odds of the need for skin grafts (odds ratio [OR], 0.6; 95% CI, 0.4–0.8). A dose-response relationship also was observed between the need for skin grafting and duration of cool running water, with incrementally increased odds of the need for skin grafting with nearly each duration interval of cool running water use <20 minutes. Adequate (vs inadequate) cool running water use also was associated with significantly decreased odds of full-thickness wound depth and hospital admission but not time to re-epithelialization or length of stay. The authors conclude that 20 minutes of cool running water within 3 hours of thermal injury in children resulted in significantly decreased odds of need for skin grafting. Dr Dubik has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Thermal burns are common in childhood, with scalds the most frequent.1 Even relatively small burns can be life-threatening and life changing.2 First aid is immediate treatment given before regular medical aid can be obtained. It must be readily available, effective, easy for... You do not currently have access to this content.