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Published on: February 23, 2024
Prehospital paediatric burn care: New priorities in paramedic reporting
Mikaela Fein1, Jamie Quinn, Kerrianne Watt
1Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia.
Insights
Paramedic documentation of first aid and patient temperatures for pediatric burn patients in Queensland was often incomplete. Consistent use of burn dressings was also lacking, despite their importance in patient outcomes.
Area of Science:
- Emergency Medicine
- Pediatric Burn Care
- Prehospital Care
Background:
- First aid (FA) significantly impacts burn progression and patient outcomes.
- Hypothermia is a critical risk factor in pediatric burn patients.
- Effective prehospital care is crucial for minimizing burn severity.
Purpose of the Study:
- To evaluate the prehospital care of pediatric burn patients in Queensland.
- To specifically examine first aid (FA) treatment and hypothermia risk in paramedic management.
- To identify areas for improvement in pediatric burn patient care.
Main Methods:
- Retrospective analysis of 117 electronic ambulance response forms (eARFs).
- Data collected for pediatric burn patients (0-5 years) attended by Queensland Ambulance Service (QAS) from 2008-2010.
- Focus on incidents in Brisbane, Townsville, and Cairns regions.
Main Results:
- First aid (FA) measures documented in 77.8% of cases; cool running water used in 56.4%.
- FA duration documented in only 29.9%, shorter in Northern QLD than Brisbane.
- Patient temperatures documented in 24.8%, with 5% showing hypothermia (≤ 36.0°C).
- Burnaid™ used in 55.6%, with inconsistent outer dressings; less frequent in Brisbane.
Conclusions:
- Paramedic documentation of FA and patient temperatures in pediatric burn cases is often incomplete.
- Inconsistent application of burn dressings was observed.
- There is a need for improved standardization and documentation in prehospital pediatric burn care.
Objective:
The present study evaluates the prehospital care of paediatric burn patients in Queensland (QLD). As first aid (FA) treatment has been shown to affect burn progression and outcome, the FA treatment and the risk of associated hypothermia in paediatric patients were specifically examined in the context of paramedic management of burn patients.
Methods:
Data were retrospectively collected from electronic ambulance response forms (eARFs) for paediatric burn patients (0-5 years) who were attended by Queensland Ambulance Service (QAS) from 2008 to 2010. Data were collected from 117 eARFs of incidents occurring within the Brisbane, Townsville and Cairns regions.
Results:
Initial FA measures were recorded in 77.8% of cases, with cool running water FA administered in 56.4% of cases. The duration of FA was recorded in 29.9% of reports. The duration of FA was significantly shorter for patients in Northern QLD (median = 10 min, n = 10) compared with Brisbane (median = 15 min, n = 18), P = 0.005. Patient temperatures were recorded significantly more often in Brisbane than in other regions (P = 0.041); however, in total, only 24.8% of all patients had documented temperature readings. Of these, six (5%) were recorded as having temperatures ≤ 36.0°C. Burnaid(TM) was the most commonly used dressing and was applied to 55.6% of all patients; however, it was applied with a variety of different outer dressings. Brisbane paramedics applied Burnaid significantly less often (44.3%) compared with paramedics from Northern QLD (72.7%) and Far Northern QLD (60.9%), P = 0.025.
Conclusions:
Despite FA and patient temperatures being important prognostic factors for burn patients, paramedic documentation of these was often incomplete, and there was no consistent use of burns dressings.
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