The treatment of minor burns in rural Alabama emergency departments

Abstract

The purposes of this descriptive survey were to determine the treatments for minor burns in rural Alabama emergency departments, to assess how closely those treatments correspond with recommendations for burn therapy noted in the literature, and to identify specific deficits in the burn research literature. A descriptive survey consisting of open-ended questions was used to gather data on current practices for treating outpatient burn wounds. A researcher-developed questionnaire organized into seven categories of burn care was pilot-tested in an urban burn center; the questionnaire was then mailed to 96 rural Alabama hospitals, addressed to the ED nurse manager. The seven categories--initial cooling, analgesics, cleansing agents, topical antimicrobial therapy, wound dressings, blister debridement, and referrals--were identified from both major and minor burn care literature, because little research has been published about minor burns. Simple frequencies were used to analyze results from the 20% (n = 21) of the sample that responded. Seven categories of burn care are common to all respondent facilities, with wide variation in the details. Most practices proceed logically from the treatments recommended for major burn care, with a few notable and potentially dangerous exceptions, but there is no definitive research available to guide the clinician in the care of outpatient burns. Research questions were generated that can provide direction for measurement of outcomes in the care of minor burns treated on an outpatient basis.