Burn Injuries In Children Research Articles

Швидка нейтралізація травмуючих гіпертермічних чинників ушкодження при опіках у дітей на етапах само-, взаємо- та першої долікарської допомоги

Occupying a leading position in the structure of general injuries, burn injuries in children remain an urgent issue of combustiology in particular and medicine in general. At the same time, many issues related to the organization of first aid to such patients still remain unregulated. To this end, a study aimed at conducting a comparative analysis of the clinical effectiveness of emergency care for children with burn injuries, including the use of the suggested algorithm, was conducted. Materials and methods. 153 cases of burn injuries with boiling water of IIab–III degree on the area of 10–40% of the body surface in children aged from 8 months to 16 years, who were treated at the Clinical Center for Thermal Injury and Plastic Surgery of the Municipal Non-profit Enterprise «Vinnytsia Regional Pirogov Clinical Hospital Vinnytsya Regional Council» in the period of 2015–2020 were analyzed. All patients underwent comprehensive diagnosis and treatment including surgery. Depending on the nature of first aid, children were divided into two groups: patients of the main group (n=97) underwent prompt neutralization of the traumatic effects of exogenous hyperthermic factors on the injured areas from the moment the injury was sustained. Childrenin the control group (n=56) sought help on the 5th–14th day after the injury. The duration of prompt neutralization did not exceed 15 minutes or was not performed at all. It was often combined with the irrational use of pharmacological agents and folk remedies. Results. Comparative analysis of the course of the disease in children of the main group and the comparison group reliably confirmed the benefits of prompt neutralization of traumatic effects of hyperthermic exogenous and endogenous damage factors in burn injuries manifested by a more favorable course of the disease, faster improvement, lower local and systemic inflammatory response, shorter hospital stay with less occurrence of various complications, repeated surgical interventions, better aesthetic and functional results. Conclusions. The obtained results objectively confirmed the importance and effectiveness of the suggested system of organization of care for children with burn injuries, especially at the stages of self-help, mutual assistance and first aid. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: burn injuries, children, first aid, traumatic hyperthermic agents, neutralization.

Determination of factors affecting prevention of burns among children under five years old using PRECEDE model: A cross-sectional study in urban and rural populations

BackgroundBurns are one of the most important childhood injuries that can be controlled and prevented. Mothers play an important role in preventing child burns. Health education and promotional theories facilitate a precise recognition of the behavioral factors in mothers that help preventing burn injury in their children. Burns in children under five years old and the factors in prevention of burn by their mothers were examined using PRECEDE Model. The study environment was rural and urban areas of Kermanshah, Iran. MethodsThis cross-sectional study was conducted on 330 mothers in urban and rural areas of Kermanshah County in the west of Iran. The participants were randomly selected among mothers who had at least one child younger than five years old. Data was collected through interviewing the mothers using a valid and reliable questionnaire. The questionnaire included questions on demographic characteristics, PRECEDE Model, and history of burn. The data were analyzed using SPSS-16. ResultsThe mean age of the mothers in urban areas (29.33 ± 5.987) was higher than that of those in rural areas (28.77 ± 6.236). More than 90% of the mothers were housewives, both in urban and rural areas. The rate of a history of burn in rural children under the age of five (8.3%) was greater than that in urban children (5.2%). Most of the burn cases in urban areas were mild whereas those in rural areas were moderate. The majority of burn cases had happened at home in children 1−3 years’ age range; this rate was higher in boys. The majority of burns cases had happened when the child was playing (urban: 64.3%, rural: 100%). In addition, liquids and hot objects were the main causes of the burns (urban: 78.5%, rural: 100%). Among the constructs of PRECEDE models in the urban areas, knowledge (P < 0.001), attitudes (P = 0.027), and environmental factors (P = 0.03) had a significant relationship with burn-preventive behaviors in mothers. In addition, in the rural areas, attitudes (P = 0.038) had a significant relationship with burn-preventive behaviors in mothers. ConclusionBurn was an important injury in the study population, especially in the rural areas. The PRECEDE model can help us to identify the factors in burn injuries in children and the preventive behaviors in mothers. The findings can be used to develop preventive interventional programs to better protect this vulnerable group in society.

Lower Risk of Burn Injury in Children and Adolescents with Autism Spectrum Disorder: A Nationwide Population-Based Study.

Little research has examined burn injury in the pediatric population with autism spectrum disorder (ASD). We used data from Taiwan's National Health Insurance Research Database to identify 15,844 participants aged <18years with ASD and 130,860 participants without ASD. Our results revealed that the hazard ratios differed across three age ranges. The ASD group had a lower risk of burn injury than the non-ASD group when they were less than 6years of age, a higher risk from 6years to 12years of age, and no difference when they were older than 12years of age. More research is required to study the characteristics and causes of burn injury in the pediatric population with ASD.

Clinical Profile of Pediatric Burn Patients in Burn Care Unit of Halibet Hospital in 2018: Asmara, Eritrea.

BackgroundPediatric burn injuries result in severe and long-term complications in the developing world, especially in sub-Saharan Africa. Accurate data on burn injuries are either unavailable or incomplete in Eritrea.ObjectiveThe objective of this study was to define the clinical characteristics of pediatric burn injuries in the Burn Care Unit of Halibet hospital in 2018 in Asmara, Eritrea.MethodsThe study design was a retrospective cross-sectional descriptive study. The medical records of pediatric patients aged 15 years and below admitted to the Burn Care Unit of Halibet hospital between January 2018 and December 2018 were assessed.ResultsIn the study period, 524 children with burn injuries were admitted to the Unit. The mean age of the study group was 4.2±3.7 years. Nearly 75% of the patients were in the age group 1–5 years. In 95.3% of the patients, scalds were the most common type of burn with burn injury occurring mostly indoor in 98.1% of cases. The average length of hospital stay was 4.6±8.4 days with a median of 1 day. In 94.8% of the patients, the body surface area involved was 1–10%, and the most body part involved was the extremity in 80.7% of the cases. Patients with body surface involvement >10% and who came from rural areas stayed longer in hospital and those with scald burns have a shorter hospital stay. Patients with body surface area involvement >10% and who came from rural areas also have more complications.ConclusionThe most affected age group were 1–5 years old children with scalds being the most common type of burns with injury occurring mostly indoors in this population. Teaching parents about household safety, seeking early medical attention, and raising public awareness could decrease the incidence of burn injury in children.

Instant Cup of Soup: Can Kids Safely Prepare and Carry?

Scalds are a common cause of burn injury in children. Instant soup and noodle products have been identified as a common cause of pediatric burn injuries, with both the preparation process and product packaging implicated as predisposing factors. A cohort of children was observed simulating the preparation of a cup of noodle soup to identify steps in the process in which injury was mostly likely to occur. Nineteen percent of participants spilled the simulated soup onto themselves, representing potential burn injuries had the liquid been hot. The upper extremity was the most commonly affected body area and spillage occurred most commonly while the participant was transporting the cup of simulated soup. Targeted caregiver education about the potential dangers to children from instant soup and noodle products and investigation into safer packaging are needed to decrease the risk of these injuries in children.

Incidence of childhood burn injuries and modifiable household risk factors in rural Ghana: A cluster-randomized, population-based, household survey

BackgroundWe aimed to determine the incidence of childhood burn injuries in rural Ghana and describe modifiable household risk factors to inform prevention initiatives. MethodsWe performed a cluster-randomized, population-based survey of caregivers of children in a rural district in Ghana, representing 2713 households and 14,032 children. Caregivers were interviewed regarding childhood burn injuries within the past 6 months and household risk factors. Results357 households were sampled. Most used an open fire with biomass fuel for cooking (85.8%). Households rarely cooked in a separate kitchen (10%). Stove height was commonly within reach of children under five years (<1 m; 96.0%). The weighted annualized incidence of CBI was 63 per 1000 child-years (6.4% of children per year); reported mean age was 4.4 years (SD 4.0). The most common etiology was flame burn. Older age (OR 0.89, 95% CI 0.8–1.0) and households with an older sibling ≥12 years (OR 0.58, 95% CI 0.3–1.3) seemed to be associated with lower odds of CBI. ConclusionsChildhood burn injury is common in rural Ghana. Opportunities exist to reduce the risk of childhood burn injury childhood burns in rural settings by supporting the transition to safer cooking arrangements, child barrier apparatuses in homes without older children, and/or development of formal childcare programs.

Randomized clinical trial of negative pressure wound therapy as an adjunctive treatment for small-area thermal burns in children

BackgroundThe efficacy of negative pressure wound therapy (NPWT) in the acute management of burns remains unclear. The purpose of this trial was to compare standard Acticoat™ and Mepitel™ dressings with combined Acticoat™, Mepitel™ and continuous NPWT to determine the effect of adjunctive NPWT on re‐epithelialization in paediatric burns.MethodsThis two‐arm, single‐centre RCT recruited children with acute thermal burns covering less than 5 per cent of their total body surface area. The primary outcome was time to re‐epithelialization. Blinded assessments were performed using photographs captured every 3–5 days until discharge. Secondary measures included pain, itch, grafting, perfusion and scar management referrals.ResultsSome 114 patients were randomized. Median time to re‐epithelialization was 8 (i.q.r. 7–11) days in the NPWT group and 10 (8–14) days in the control group. In a multivariable model, NPWT decreased the expected time to wound closure by 22 (95 per cent c.i. 7 to 34) per cent (P = 0·005). The risk of referral to scar management was reduced by 60 (18 to 81) per cent (P = 0·013). Four participants in the control group and one in the NPWT group underwent grafting. There were no statistically significant differences between groups in pain, itch or laser Doppler measures of perfusion. Adverse events were rare and minor, although NPWT carried a moderate treatment burden, with ten patients discontinuing early.ConclusionAdjunctive NPWT hastened re‐epithelialization in small‐area burn injuries in children, but had a greater treatment burden than standard dressings alone. Registration number: ACTRN12618000256279 ( http://ANZCTR.org.au).

Identifying Abuse and Neglect in Hospitalized Children With Burn Injuries

BackgroundThe purpose of this study was to identify the pattern of injuries that relates to abuse and neglect in children with burn injuries. MethodsThe Nationwide Readmissions Database for 2010-2014 was queried for all patients aged less than 18 y admitted with burn injuries. The primary outcome was child maltreatment identified at the index admission. The secondary outcome was readmission for maltreatment. A subgroup analysis was performed on patients without a diagnosis of maltreatment during the index admission. Multivariable logistic regression was performed for each outcome. ResultsThere were 57,939 admissions identified and 1960 (3.4%) involved maltreatment at the index admission. Maltreatment was associated with total body surface area burned >20% (odds ratio (OR) 2.79, P < 0.001) and burn of the lower limbs (OR 1.37, P < 0.001). Readmission for maltreatment was found in 120 (0.2%), and the strongest risk factor was maltreatment identified at the index admission (OR 5.11, P < 0.001). After excluding the patients with maltreatment identified at the index admission, 96 (0.17%) children were found to have a readmission for maltreatment that may have been present on the index admission and subsequently missed. The strongest risk factor was burn of the eye or ocular adnexa (OR 3.79, P = 0.001). ConclusionsThis study demonstrates that a portion of admissions for burn injuries in children could involve maltreatment that was undiagnosed. Identifying these at-risk individuals is critical to prevention efforts.

Social Determinants Associated with Pediatric Burn Injury: A Population-Based, Case-Control Study.

Social determinants of health (SDoH) influence risk of injury. We conducted a population-based, case-control study to identify which social determinants influence burn injury in children. Children (≤16 years of age) admitted to a Canadian regional burn center between January 1, 1999 and March 30, 2017 were matched based on age, sex, and geographic location 1:5 with an uninjured control cohort from the general population. Population-level administrative data describing the SDoH at the Manitoba Center for Health Policy (MCHP) were compared between the cohorts. Specific SDoH were chosen based on a published systematic review conducted by the research team. In the final multivariable model, children from a low-income household odds ratio (OR) (95% confidence interval) 1.97 (1.46, 2.65), in care 1.57 (1.11, 2.21), from a family that received income assistance 1.71 (1.33, 2.19) and born to a teen mother 1.43 (1.13, 1.81) were significantly associated with an increased risk of pediatric burn injury. This study identified SDoH that are associated with an increased risk of burn injury. This case-control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Identifying children at increased potential risk allows targeting of burn risk reduction and home safety programs.

Childhood burns in Shisong, Northwestern Cameroon

Objective: The study aimed to highlight the pattern and treatment outcome of childhood burn injuries in northwestern Cameroon. Such reports are expected to provide preventive and improvement guidelines in our settings in the long run. Methods: Forty-two consecutive patients under fifteen with burns injuries managed at our facility were prospectively enrolled in the study. Results: The study population was 42 patients, which consisted of 23 (54%) male and 19 (46%) female, with the median 2.40±3.05 years, interquartile range of 1-14 years. The most frequent timing of burns was about mid-day (median 11:50 am). The majority of injuries were right at the patient's homes (70% cases). Interestingly, 4%, 15%, and 20% applied raw-egg, ice, and nothing as the first intervention for their children burns, respectively. Scald burns were the leading category of wounds (p&lt;0.012). The majority of the cases were minor burns injuries with TBSA of 1-12% (p=0.002), with a mortality rate of 4%. Conclusion: Burns is still a significant health problem among children in northwestern Cameroon. Considering the application of raw egg and others like local herbs, therefore pre-hospital interventions may be harmful in our settings. Early and prompt response may be desirable, with strong advocacy for aggressive and urgent public health enlightenment campaigns on the prevention of childhood.

59 Annual Incidence of Childhood Burn Injuries and Prevalence of Household Risk Factors in Rural Ghana: A Population-based Cluster-randomized Survey

Abstract Introduction Childhood burns are a leading cause of injury in low- and middle-income countries. Many childhood burns can be prevented by modifications in the household environment and targeted education. Therefore, we aimed to determine the incidence of childhood burn injuries and describe the prevalence of potentially modifiable household risk factors. Methods We performed a population-based, cluster-randomized, household survey of 358 households in a rural district in Ghana. From the district, 6 of 11 community clusters were randomly selected. Within these clusters, a census of all households with a caregiver of at least one child &amp;lt; 5 years of age was conducted. Caregivers were interviewed regarding childhood burn injury (CBI) within the past 6 months and potentially modifiable household risk factors. Results Of the 358 households sampled, most households lived in completed structures they owned (67%, 95% CI 61.9–71.6%). The adjusted annual incidence of childhood burn injury was 7.9%. The median age of burn injury was 3 years. The most common etiology of CBI was flame burn (53%, 95% CI 36.8–67.7%). Increasing year of age (AOR 0.92, 95% CI 0.84–1.01) and households with an older sibling ³12 years (AOR 0.53, 95% CI 0.24–1.17) were weakly associated with lower odds of CBI. The majority of households (84%, 95% CI 80.5–88%) used an open fire with firewood as fuel arrangement for cooking. In most households there was not a separate room used as a kitchen (90%, 95% CI 86–92.4%) and the stove/cooking arrangement height was within reach of children under five (&amp;lt; 1 meter; 96%, 95% CI 94.6–97%). Female gender (AOR 1.37, 95% CI 0.71–2.64), outdoor cooking arrangement (AOR 1.05, 95% CI 0.42–2.62) and an increased number of children under caregiver supervision (≥5 children; AOR 1.32, 95%CI 0.42–2.62) were not predictive of CBI. Conclusions Burns are a common cause of childhood injury in rural Ghana. There may be opportunities to reduce the risk of burn injuries in rural settings by supporting the transition to safer cooking arrangements, child barrier apparatuses (e.g. playpens that separate children from cooking arrangements), and/or health promotion initiatives. Given the high incidence of childhood burn injuries, strategic burn-related healthcare capacity development is also required to limit preventable death and disability. Applicability of Research to Practice These findings, which differ somewhat from similar studies in other LMIC communities, suggest that there is not a one-size-fits-all solution for the prevention of childhood burn injuries. Community-specific and contextually relevant interventions that aim to prevent childhood burn injuries can be identified by results from population-based surveys of injury epidemiology and potentially modifiable risk factors.

573 Frequency of Burn Injuries in Children with Autism Spectrum Disorders and Attention Deficit/hyperactivity Disorder and Implications on Treatment Compliance

Abstract Introduction Children with autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD) are at a higher risk of burn injuries, compared to children with neurotypical development, but little is known about the epidemiology of burn injuries in children diagnosed with ASD and ADHD. Research within the pediatric burn population using the Burn Outcomes Questionnaire (BOQ) has been successful in capturing levels of risk on burn-recovery specific domains such as compliance to treatment, pain, and parental concerns. Methods The current study retrospectively assessed a subsample of BOQ data in children with burn injuries who also had a diagnosis of ASD or ADHD. This project was undertaken at our institution as an exempt project under 45 CFR 46.101 and, as such, it was not formally supervised by an Institutional Review Board. Results Of the 593 patients who completed a BOQ, 186 patients were identified with a diagnosis of ASD or ADHD. 127 patients had multiple parent-reported symptoms which align with diagnoses of ASD and ADHD, including 116 (63.4%) with attention or behavioral problems, 42 (23.3%) with a developmental delay, 7 (3.9%) with an intellectual disability and 90 (49.7%) had learning problems. 66 (37.3%) patients had pre-existing comorbid psychiatric diagnoses of depression. Conclusions Results indicated that a large portion of patients have a diagnosis of ASD/ADHD with significantly higher levels of parental concern regarding compliance compared to youth without an ASD/ADHD diagnosis. Results suggest that modified curriculum may be necessary to assure effective prevention education for children with ASD and ADHD. Applicability of Research to Practice While it is important to educate all children in burn prevention efforts, special attention may be necessary to assure training with children at greater risk for burn injury. Specific parent training would be imperative to understand the critical burn care needs of children with developmental disabilities.

754 Social Determinants Associated with Paediatric Burn Injury: A Population Based, Case-control Study

Abstract Introduction Children are disproportionately represented as victims of burn injury compared to adults. Life-long sequelae post-burn manifest as increased rates of mental and physical illness, substance abuse, and suicide. Social determinants of health (SDoH) influence risk of injury, however the extent and influence of SDoH on burn injury is less clear. To determine which social determinants influence burn injury in children, a retrospective case-control study was conducted. Methods Children (&amp;lt; 17 years of age) admitted to a regional burn centre between January 1 1999 and March 30 2017 were matched based on age, sex and geographic location 1:5 with an uninjured cohort. Population level administrative data describing the SDoH, at the regional administrative multifaceted data repository were compared between the cohorts. Thirteen SDoH were chosen based on a systematic review conducted by the research team. Results No significant differences existed in descriptive statistics between the burn and control cohorts. Mean age at burn injury = 5.46 (± 5.23), average TBSA (%) = 10.5 (± 13.4). The most common mechanism of burn injury was scald (42.03%) Upon multivariable logistic regression, children: from a low-income household (O.R. 1.97 (1.46, 2.65)); in foster care (O.R. 1.57 (1.11, 2.21)); from a family that received income assistance (O.R. 1.71 (1.33, 2.19)); or born to a teen mother (O.R. 1.43 (1.13, 1.81)) were associated with an increased risk of burn injury. Conclusions This study identified SDoH associated with an increased risk of burn injury. This case-control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Applicability of Research to Practice Identifying children at increased potential risk provides an opportunity to prevent burn injuries, bypassing the associated long-term physical disfigurement, life-long mental health consequences and mortality. This study also has merit in maximizing the efficiency of a burn prevention budget through targeted burn safety and risk reduction programs.

28 Childhood Burn Injuries: The Uninjured Sibling Perspective

Abstract Introduction When considering burn-injured children as part of a larger family unit, it is expected their injury will stress the system; yet the focus has mainly been on the injured child and treated as incidental for the family. Though research on the family is evolving, less is known from the uninjured sibling perspective. Sibling relationships have a unique impact on development. This study aimed to understand the experience of growing up with a burn-injured sibling in childhood, with attention to how identity was shaped. Acquiring knowledge from uninjured siblings will facilitate a more integrative understanding and holistic approach to aid families. Thus, this exploratory study fills a gap by engaging the uninjured sibling’s perspective with implications for program enhancement/development. Methods Narrative inquiry was utilized to explicate the narratives of adults who grew up with a burn-injured sibling in childhood via semi-structured interviews (N=7). The research questions were: 1) What are the experiences, or stories, of identified adults whose sibling experienced a burn injury? 2) What do the narratives of identified adults whose sibling experienced a burn injury reveal about how their identities were shaped? 3) What are the implications for program/service development and/or enhancement elucidated by identified adults whose sibling experienced a burn injury? A purposeful criterion sampling method was used, but challenges accessing participants resulted in sequential and emergence-driven strategies. Participants’ self-identified as Caucasian (n=7), female (n=4), and male (n=3). Age ranged from 20 to 57 (M=33.14, SD=14.32) at the time of the interview and 0 to 13 (M=5.25, SD=4.25) at the time of their siblings’ injury. Interviews queried the burn incident, family relations, communication, and support received. Riessman’s thematic approach to narrative inquiry was employed for analysis. Results Findings supported five themes: 1) separation and alternative caregiving, 2) altered interactions and ambivalent roles, 3) (r)evolving emotional pain, 4) communication concerns, and 5) identity through autobiographical reasoning. The data suggest uninjured siblings have their own unique narratives that have failed to be acknowledged in research and practice, though identity clarity and meaning-making were articulated in their reflections. Moreover, findings support consideration of many experiences as a primary trauma. Conclusions The needs of uninjured siblings—specifically related to inclusion, identity, and resource acquisition—should be addressed to mitigate the impact of burn trauma. The family system remains a critical area for research and program enhancement/development. Applicability of Research to Practice Findings can contribute to program planning for the family with increased attention to the uninjured sibling’s experience and concern for their specific needs.

578 Childhood Burn Injuries: The Parent Perspective

Abstract Introduction Interventions for burn-injured children (BIC) largely focus on the child with the physical injury while consideration for family systems appears incidental. This study aimed to gain insight into the perspectives and needs of parents/caregivers of pediatric burn patients (PPBP). When considering BIC within the context of a family system, it is reasonable to expect the injury to engulf everyone. The literature emphasizes the acute and lasting physical and emotional impact of burns. Moreover, research suggests PPBP experience an emotional response to the incident that is often complicated by physical absence from their other uninjured children. Thus, this exploratory study fills a gap by engaging the unique perspective of the PPBP and posits direct implications for essential program enhancement/development. Methods PPBP attending a family program participated in semi-structured interviews (N=11) guided by the research question: What are the experiences of PPBP? Participants’ self-identified as African American (n=4), Caucasian (n=5), and Latino (n=2). Age ranged from 29 to 48 (M=38.36, SD=6.14). Interviews involved queries regarding the burn incident, from injury to present (M=7.12 years, SD=4.61), including support received, what they wish people understood about the experience, and ideas for programming. Interviews were recorded and transcribed. Data were analyzed using van Manen’s hermeneutic phenomenological approach. Results Findings supported PPBP’s unique experience coalescing into one theme—the never-ending trip from hell—conceptualized as, “I didn’t mean to get here—none of this is familiar and I can’t find anyone I know. What’s going on and when will it be over?” Mutual painful insights were parental guilt, sensory experiences related to the acute incident and aftercare, unknown prognosis and medical treatment expectations, physical/emotional health problems, family members insensitivity, managing the cruelty of others, isolation, marital strains, and sibling tensions. Families also reported positive outcomes: strength of informal support networks, empowerment through educating others, and creating new allies. PPBP emphasized the benefits associated with meeting other families who also endured a burn injury and the importance of mutual support. Conclusions Programs should address the needs of all family members, not just BIC. In order to mitigate the impact of burn trauma, the family system impact remains a critical primary consideration for research and interventions. Applicability of Research to Practice Findings can contribute to program planning with increased consideration of the family system. As a result of findings from this study, siblings are now included in a summer camp program historically serving only BIC.

Management Outcome of Burn Injury and Associated Factors among Hospitalized Children at Ayder Referral Hospital, Tigray, Ethiopia.

Background Burn injuries are a global public health problem, accounting for an estimated 265,000 deaths. Globally, over half of the disability-adjusted life years lost from fire-related burns which occurred between the ages of 0 and 14 years. The rate of child deaths from burns is currently over 7 times higher in low- and middle-income countries than in high-income countries. In Ethiopia, burn was the second leading cause of death among children from the unintentional injuries. So far, no research had been conducted in terms of assessing the outcome of burn injury in children in Ethiopia and particularly in Tigray region. The aim of this study was to assess the outcome of burn injury and associated factors among hospitalized children of under 18 years at Ayder Referral Hospital in Mekelle, Ethiopia. Method A retrospective document review was used to assess the outcome of burn injury and associated factors in Ayder Referral Hospital. A total of 382 hospitalized children's chart from 2011 to 2015 were reviewed using a structured check list. To select the patients' chart, a simple random sampling technique was used and a sampling frame was prepared based on a registration book. Data was entered, cleaned, and analyzed using SPSS version 20. Result Almost 70% of the burns were caused by scald, and 45.3% of the burns were confined to the upper extremities. Eighty-two percent of the patients were discharged without complication. Lack of fluid resuscitation within 24 hours (AOR = 2.767; 95% CI (1.276-5.999)) and a burn patient with malnutrition (AOR = 0.252; 95% CI (0.069-0.923)) were statically significant with the outcome of burn injury. Conclusion Majority of the pediatric burn patients were discharged without complication. The most causative agent of these accidents was scald; upper extremities also were the most affected area. The factors associated with the outcome of burn injury according to this study were lack of fluid resuscitation and malnourishment of burn patients.

Clinical audit on management of post-burn sepsis in pediatric intensive care unit

The aim of this study: Is to assess how much the adopted protocol of management of post. burn sepsis in pediatrics is applied in intensive care unit in AUCH and to detect outcomes of these admitted cases. Objectives: To review the specific infections common in pediatric burns, including their categorization, diagnosis, and treatment. Background: Burn injury in children continues to be a major epidemiologic problem around the globe. Nearly a fourth of all burn injuries occur in children under the age of 16, the majority are under the age of five (1) . Children account for almost half of the population with severe burn injury and children below five years of age account for 50–80% of all childhood burns . Most childhood burns occur in the home; scalds are the most common burn type (accounting for 60–70% of all hospitalized burn patients, followed by flame and contact burns (2). .Burn sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection. (3). Methods: The target population were all pediatrics patient who referred to PICU in AUCH after 24 hours post burn for management of septic shock along the peroid of one year from August 2015 to July 2016. Data is collected by reviewing medical records of burned patients admitted to PICU during the study duration. Result: The study included 50 cases with post burn sepsis diagnosed according to criteria in the recommended guideline. Their ages ranged from 1-18 years, 30 cases were males and 20 cases were females. Scald burn represented 76% of the studied cases. Conclusion: Among hospitalized pediatric burn patients , the majority were below 6 years and commonest cause of burn was scald.. Mortality was 44% among the studied cases .Sepsis is common in the pediatric burn patient and can markedly increase morbidity and mortality.

Methylphenidate and the risk of burn injury among children with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is associated with a higher risk of burn injury than in the normal population. Nevertheless, the influence of methylphenidate (MPH) on the risk of burn injury remains unclear. This retrospective cohort study analysed the effect of MPH on the risk of burn injury in children with ADHD. Data were from Taiwan's National Health Insurance Research Database (NHIRD). The sample comprised individuals younger than 18 years with a diagnosis of ADHD (n = 90 634) in Taiwan's NHIRD between January 1996 and December 2013. We examined the cumulative effect of MPH on burn injury risk using Cox proportional hazards models. We conducted a sensitivity analysis for immortal time bias using a time-dependent Cox model and within-patient comparisons using the self-controlled case series model. Children with ADHD taking MPH had a reduced risk of burn injury, with a cumulative duration of treatment dose-related effect, compared with those not taking MPH. Compared with children with ADHD not taking MPH, the adjusted hazard ratio for burn injury was 0.70 in children taking MPH for <90 days (95% confidence interval (CI) 0.64-0.77) and 0.43 in children taking MPH for ≥90 days (95% CI 0.40-0.47), with a 50.8% preventable fraction. The negative association of MPH was replicated in age-stratified analysis using time-dependent Cox regression and self-controlled case series models. This study showed that MPH treatment was associated with a lower risk of burn injury in a cumulative duration of treatment dose-related effect manner.

Epidemiology and outcome of 1442 pediatric burn patients: A single-center experience.

Burns are common injuries among children resulting with significant mortality and morbidity, especially in developing countries. Epidemiological data may guide for the preventive measures and contribute reducing the incidence of burns in children. The aim of this study is to report the epidemiological features of pediatric burn patients treated in a tertiary burn center and to suggest preventive measures. Between January 1, 2015, and June 30, 2019, a total of 1442 children hospitalized in our burn center were evaluated retrospectively. Demographic, epidemiological, and clinical data including burn etiology, percentage of burned total body surface area (TBSA), hospital stay, infection, and mortality rate were reported. The percentage of burned TBSA was 11.23±10.70 and the length of hospital stay was 14.38±18.1 days. In total, 89.18% of the patients (n=1286) experienced burn injury indoors. With regard to the etiology, scalding with hot water and tea was the most common in all age groups. Flame burn incidence increases after infancy, and electrical burns occur more in school age. A total of 10 patients (0.69%) were died and seven of them were delayed referrals from other hospitals. Infants and males consist of the majority of our pediatric burn patients. The percentage of burned TBSA and length of hospital stay increased as the patient age increased. Childhood burn injuries are mainly scald burns that occur indoors, while their parents were nearby. Therefore, education programs focusing on primary prevention addressing family members are required to avoid pediatric burns.

A Decade Epidemiological Study of Pediatric Burns in South West of Iran.

BACKGROUNDBurn is one of the most traumatic injuries and life-threatening states which expose children at a higher risk. The aim of this study was evaluating the epidemiology of pediatric burns in age less than eighteen years old during the last decade. METHODSThis cross-sectional study was carried out during 2008-2017 in Amir-al Momenin Burn Center, affiliated by Shiraz University of Medical Sciences, Shiraz, Iran. The subjects consisted of burn victims under 18 years old who were registered as outpatients and inpatients. RESULTSDuring the study period, 1893 and 12431 patient were registered as inpatients and outpatients of the hospital. The burn victims were males. Children under 5 years old were prone to scald injuries more than children in any other age. More than 90% of inpatients children burned accidentally, while 116 (6.12%) burn injuries were suicidal; which was mostly seen in girls (75%, 87 out of 116). CONCLUSIONMost burns involved scalds from hot liquids especially in children age less than 5 years. Different strategies can be executed by means of broadcast flashes in mass media and educational programs through schools to show risk situation and statements calling attention to prevent childhood burn injuries.