One Team: Identifying Prehospital Provider Needs for Burn Patient Outreach and Education

Burns are among the most common traumatic injuries and are associated with significant morbidity and mortality; however, many prehospital providers remain unfamiliar with current management algorithms. Proper resuscitation is crucial to clinical outcomes, but care guidelines vary widely. We sought to characterize and evaluate the burn care provided by emergency medical service (EMSs) agencies in our metropolitan region to identify opportunities for improvement and education. Surveys were distributed to prehospital professionals, and EMSs clinical protocols were obtained for qualitative analysis. Survey design and analysis were conducted with Qualtrics. The 38 survey responses were from providers representing 19 EMS agencies; 8 protocols were obtained and analyzed. Respondents were primarily paramedics (61%), and 34 (89.5%) had renewed their license in the past two years. Notably, 35/38 (92.1%) reported transporting five or fewer burn patients within the past year, and 28/35 (80.0%) stated they were not comfortable establishing vascular access over a burn wound. Continuing education (CE) was most commonly obtained through formal courses (65.7%), podcasts (42.1%), and departmental training (34.2%). Qualitative review of the protocols revealed varied formulas for fluid resuscitation. Approved pain medications included morphine, ketamine, and fentanyl; two agencies mentioned hydroxocobalamin in their protocol. Thermoregulation measures were mentioned in three protocols. Prehospital providers lack high-volume exposure to this patient population and exhibit low comfort levels. Minimal information on burns is included in regular CE. Practices differ between EMS agencies, even though the quality of prehospital care has a sizeable impact on outcomes.