Cool Running Water as a First Aid Treatment for Burn Injuries.

Area of Science:

• Emergency medicine
• Burn care research
• Implementation science

Background:

• Cool running water for 20 minutes is a proven first aid for burns.
• Integrating this practice into US emergency medical services (EMS) and emergency departments (EDs) is crucial.
• Barriers and facilitators to its routine use need identification.

Purpose of the Study:

• Identify barriers and facilitators to implementing 20 minutes of cool running water in EMS and EDs.
• Codesign strategies for routine use in acute burn first aid.
• Improve patient burn-related outcomes through enhanced implementation.

Main Methods:

• Sequential mixed-methods design.
• Online questionnaire for EMS and ED clinicians (n=371) using the Consolidated Framework for Implementation Research.
• Semistructured interviews with clinicians (n=22) to examine determinants and codesign strategies.

Main Results:

• Twelve key determinants identified across 4 CFIR domains.
• Barriers: lack of resources, adaptation challenges, absence of external policies.
• Facilitators: clinician motivation, professional networks, supportive culture.
• Codesigned strategies: portable irrigation, nursing protocols, policy updates.

Conclusions:

• Clinician motivation exists, but infrastructure, workflow, and policy challenges impede adoption.
• Targeted, codesigned strategies are necessary for integration into EMS and ED settings.
• Successful implementation will improve acute burn first aid and patient outcomes.