Burn Unit admission and management protocol during COVID-19 pandemic. Issue 1 (February 2021)

• Record Type: Journal Article
• Authors: Azzena, Bruno; Perozzo, Filippo Andrea Giovanni; De Lazzari, Alberto; Valotto, Giovanni; Pontini, Alex
• Is Part Of: Burns. Volume 47:Issue 1(2021)
• Page Start: 52
• Page End: 57
• Publication Date: 2021-02
• Subjects: COVID19 coronavirus disease 2019 -- SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 -- ARDS acute respiratory distress syndrome -- ICU intensive care unit -- BU Burn Unit -- CT computer tomography -- BAL broncho-alveolar lavage -- RT-PCR real time polymerase chain reaction -- SD standard deviation -- TBSA total body surface area -- ER emergency room -- PPE personal protection equipment; COVID-19 -- Burns -- Viral infections -- Epidemic control -- Management strategies -- Experience; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2020.09.004
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: COVID-19 is an adjunctive risk factor for burn injured patients. Isolation of suspected cases and development of management procedures are essential preventive measures to reduce viral spread. We developed an admission protocol to our Burn Unit which proved itself effective in minimizing the contagion between patients and healthcare workers. Abstract: Background: The actual epidemic outbreak is the third time in the last two decades in which a coronavirus results in a major global spread with serious consequences in terms of vastity of affected patients, life losses, health system organization efforts and socio-economic implications. Lacking effective therapies and vaccinations, during viral outbreak the major and most incisive mean for viral spread control is spread prevention, especially for the fragile burn-injured patients we are called to care for in Burn Units. Methods: We developed an admission and inpatient management protocol to preserve burn patients from SARS-CoV-2 contagion, in order to avoid additional morbidity and mortality in patients with already compromised health conditions. Data from burn-injured patients admitted to our Unit following this new protocol were retrospectively analyzed in order to verify its effectiveness in prevention of viral spread. Results: From the 8th of March to the 8th of June, we admitted 18 patients in the Burn Unit ICU and semi-ICU and 17 patients in the Burn Ward. Two of them resulted positive to COVID-19 nasopharyngeal swab and bronchoalveolar lavage collected immediately on admission, for both the extension of burns and their general clinical conditions implied ICU admission. Moreover, a caregiver of an admitted child resulted positive to the nasopharyngeal swab. No other cases of SARS-CoV-2 positivity have been reported neither between hospitalized patients nor between healthcare workers. Conclusion: The evidence of high ICU admission rate and high mortality in patients affected by SARS-CoV-2 combined with the fragile clinical conditions of burn patients required the development of an admission and hospitalization management protocol.