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Severe Burn Injury in a Swine Model for Clinical Dressing Assessment
Published on: November 6, 2018
Problems of management of burns injuries among children
C N Okoromah1, E O Grange, A A Ogburo
1Department of Paediatrics and Child Health, Lagos University Teaching Hospital.
Insights
Pediatric burn management faces challenges, with delayed expert care and inadequate critical support contributing to a high mortality rate. Improving early multidisciplinary care and pain control is crucial for better outcomes in child burn victims.
Area of Science:
- Pediatric Burn Care
- Clinical Management
- Public Health
Background:
- Published data indicate improved survival rates in major burn management globally.
- Local data suggest significant challenges in pediatric burn care.
- This study investigates issues in managing pediatric burns.
Purpose of the Study:
- To examine the problems and challenges in pediatric burn management.
- To identify factors contributing to poor outcomes in children with burns.
- To highlight areas for improvement in pediatric burn care protocols.
Main Methods:
- Retrospective analysis of 44 pediatric burn cases.
- Data extraction included sociodemographic, clinical, management, and outcome variables.
- Review of treatment protocols and critical care support utilization.
Main Results:
- 86% of burns were thermal, often accidental and domestic.
- Average burn surface area (BSA) was 35.9%, predominantly second-degree.
- Delayed expert involvement, inadequate critical care (25%), and infections (septicemia, pneumonia) led to a 36.4% case fatality rate. Mortality was 100% for BSA 50-100%.
Conclusions:
- Early multidisciplinary care is essential for pediatric burn patients.
- Enhanced critical care support and aggressive wound management are vital.
- Adequate pain control and prevention strategies must be prioritized to reduce mortality.
Background:
Contrary to our local experience, published data elsewhere show increased survival rates from major burns due to improvements in management. This study aimed at examining problems of burns management in children.
Design:
Relevant data extracted from the records of 44 children included sociodemographic, clinical, management characteristics and outcomes.
Results:
There were 86.0% thermal burns due to accidental, domiciliary events in 36 (81.8%. Mean (range) BSA was 35.9% +/- 4.0 (1%-95%), mostly 2nd degree burns in 34 (77.3%). Mean (range) duration of symptoms before presentation was 1.1 +/- 0.3 days (1-7 days). Following hospitalisation, involvement of key experts in acute burns care was either delayed or omitted. Intensive care monitoring and support including mechanical ventilation were unavailable for 11 (25.0%) cases with cardiorespiratory compromise. Septicaemia & pneumonias were associated with death in 9 (56.3%) of the 16 deaths. Klebsiella, pseudomonas and coliform organisms were isolated from most burns wound. Oral acetominophen and intramuscular dipyrone were the main analgesics used in 24 (54.6%) and 8 (18.2%) cases respectively. Anxiolytics were used in only 2 94.5%). Case fatality rate was 36.4%. Mortalities were 100% with BSA 50-100% (p=0. 000).
Conclusion:
Prevention and improvements in management of burns including early multidisciplinary care, critical care support, aggressive wound care and adequate pain control should be emphasised.
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