Related Experiment Video
Updated: Feb 8, 2026
Severe Burn Injury in a Swine Model for Clinical Dressing Assessment
Published on: November 6, 2018
Barriers to adequate first aid for paediatric burns at the scene of the injury
Cody C Frear1, Bronwyn Griffin1, Kerrianne Watt2
1Centre for Children's Burns & Trauma Research, Centre for Children's Health Research, The University of Queensland, Brisbane, Qld, Australia.
Insights
Cool running water (CRW) is crucial first aid for burns. Many children, especially the very young, very old, and those in rural or low-socioeconomic areas, do not receive adequate CRW, highlighting a need for better public education.
Area of Science:
- Pediatric emergency medicine
- Burn care and treatment
- Public health interventions
Background:
- Cool running water (CRW) for 20 minutes within 3 hours of injury is recommended first aid for burns.
- Effective CRW application significantly improves health outcomes for burn victims.
- Inadequate CRW therapy remains a concern, particularly among vulnerable pediatric populations.
Purpose of the Study:
- To identify patient and injury characteristics associated with inadequate CRW therapy in children with thermal burns.
- To pinpoint specific populations at higher risk of receiving suboptimal burn first aid.
- To inform targeted public health education strategies for burn prevention and management.
Main Methods:
- A cross-sectional study involving 2522 children treated at a tertiary pediatric burns center (2013-2016).
- First aid adequacy was categorized as 'adequate' or 'inadequate' based on CRW application.
- Descriptive analyses examined associations between CRW adequacy and demographic/injury factors.
Main Results:
- Only 31.3% of children received adequate CRW at the scene.
- Inadequate CRW was significantly associated with very young age (0-2 years), early adolescence (15-16 years), rural/remote locations, and low socioeconomic status.
- Radiant heat, flame burns, and burns in recreational, industrial, or street settings were linked to inadequate first aid.
Conclusions:
- Despite proximity to water sources, burn first aid was frequently inadequate across demographics.
- Highest undertreatment rates were observed in the youngest children, adolescents, rural residents, and socioeconomically disadvantaged groups.
- There is a critical need for enhanced public education on proper burn first aid, emphasizing CRW application.
Issue Addressed:
The recommended first aid for burns, consisting of 20 minutes of cool running water (CRW) delivered within three hours of the injury, offers a simple yet effective means of improving health outcomes. The aim of this study was to determine patient and injury characteristics associated with inadequate CRW therapy among children with thermal burns, with the goal of identifying populations at greatest risk of undertreatment.
Methods:
A cross-sectional study was performed on children treated at a large tertiary paediatric burns centre. First aid was evaluated as either "adequate" or "inadequate", and then descriptive analyses were conducted to examine differences between the groups in age, ethnicity, location and socioeconomic status, among others.
Results:
From 2013 to 2016, the families of 2522 patients were interviewed. Overall, 31.3% of children received adequate CRW at the scene of the injury. Provision of adequate CRW did not significantly differ with sex, ethnicity or nationality. Factors that were associated with inadequate first aid included very young age and early adolescence (P < 0.001), rural or remote location (P = 0.045), low socioeconomic status (P = 0.030), radiant heat and flame burns (P < 0.001), as well as burns occurring at recreational sites, on farm/trade/industrial properties and in the street (P = 0.001).
Conclusions:
Although most burns occurred in close proximity to sources of CRW, first aid was poor across all demographics. The highest levels of undertreatment were found in children aged 0-2, adolescents aged 15-16, those living rurally or remotely, and the socioeconomically disadvantaged. SO WHAT?: The study highlights the need for improved public education of first aid for burn injuries.
Related Concept Videos
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:25Physiological Barriers
The blood endothelial barrier is the most porous of these. It allows all small ionized, un-ionized, and lipophilic molecules to pass through the endothelial lining into the interstitial space...
01:25Mucosal Barrier of the Stomach
Within parietal cells, carbonic acid is first formed through the reaction of water and carbon dioxide. The dissociation of carbonic acid releases bicarbonate and hydrogen ions. The bicarbonate...
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:18Surface Membrane Barriers
The outer layer of the skin, the epidermis, is a robust barrier comprising layers of closely packed keratinized cells. This dense arrangement prevents microbes from penetrating the body. The periodic shedding of epidermal cells...
00:49The Blood-brain Barrier