An evaluation of management of transferred paediatric burn patients

Area of Science:

• Pediatric Surgery
• Burn Management
• Emergency Medicine

Background:

• Effective initial management and safe transfer are crucial for pediatric burn patient outcomes.
• Referral systems and pre-hospital care significantly impact patient survival rates.

Purpose of the Study:

• To evaluate the adequacy of initial management and safety of transfer for pediatric burn patients.
• To identify deficiencies in the care pathway from initial injury to specialized treatment.

Main Methods:

• Prospective study evaluating pediatric burn patients transferred to a specialized department.
• Data collection on burn percentage calculation, fluid resuscitation, intravenous access, interventions (catheterization, fasciotomy, intubation), mode of transport, and sepsis presence.
• Statistical comparison of initial fluid resuscitation with patient survival.

Main Results:

• Significant discrepancies in burn percentage calculation (90.4%).
• Widespread inadequacy in fluid administration (75.4% no IV fluids) and access (71.1% no IV access).
• Suboptimal interventions: Foley's catheterization (72.8% needed, 2 used), fasciotomy (10.5% needed, not performed), endotracheal intubation (2 needed, not passed). High incidence of sepsis (28.9%) and ambulance transfer (49.1%). High mortality rate (38.2%).

Conclusions:

• Initial burn management, transfer, and referral systems are fraught with errors.
• Inadequate initial fluid resuscitation is significantly associated with mortality.
• Systemic improvements are urgently needed in pediatric burn care pathways.