Adequacy of cool running water first aid by healthcare professionals in the treatment of paediatric burns: A cross‐sectional study of 4537 children. (15th November 2020)

• Record Type: Journal Article
• Authors: Frear, Cody C; Griffin, Bronwyn; Kimble, Roy
• Is Part Of: Emergency medicine Australasia. Volume 33:Number 4(2021)
• Page Start: 615
• Page End: 622
• Publication Date: 2020-11-15
• Subjects: burn -- emergency -- first aid -- general practice -- paediatric -- paramedic; Emergency medicine -- Periodicals; Emergency medicine -- Australasia -- Periodicals; 616.025
• DOI: 10.1111/1742-6723.13686
• Languages: English
• ISSNs: 1742-6731

Abstract

Abstract: Objective: To determine the adequacy of cool running water first aid provided by healthcare professionals in the early management of children with thermal burn injuries. Methods: A cross‐sectional study was undertaken using a prospectively collected registry of children who presented with a thermal burn to the only major paediatric burns centre in Queensland, Australia, from January 2013 to December 2018. Main outcome measures included the type and duration of first aid administered by paramedics, general practitioners and emergency providers at local general hospitals and a children's hospital. In accordance with current Australian guidelines, adequate cooling was defined as 20 min of cool running water within 3 h of the injury. Results: Of the 4537 children who presented to the paediatric burns centre, 3261 (71.9%) received adequate first aid, including 1502 (33.1%) at the scene of injury. Paramedics and general practitioners administered adequate cooling to 184 (25.0%) and 52 (24.2%) of their patients, respectively. ED clinicians adhered to guidelines in the treatment of 1019 (56.3%) children at general hospitals and 411 (76.0%) at the children's hospital. Among ED patients who presented with incomplete prior first aid, the risk of inadequate cooling was significantly greater for those transported via ambulance ( P < 0.001). Conclusion: Deficiencies remain in the cooling of paediatric burns patients at all levels of initial management. There is a need in the healthcare community for improved education regarding the parameters and clinical benefits of cool running water first aid. Abstract : In the management of burns, first‐aid guidelines recommend the application of 20 min of cool running water up to 3 h following injury. This cross‐sectional study of 4537 paediatric burns patients in Queensland determined that deficiencies remain in the cooling of paediatric burns at all levels of initial care. Adequate cooling was provided to only 25% of children seen by paramedics and general practitioners, 56% of children who presented to a local general hospital and 76% of children treated at the children's hospital.