Pediatric Emergency Fellow Beaumont Children's Hospital Troy, Michigan, United States
Background: Burn Centers (BC) with higher burn admissions have lower burn-related mortality. Inaccurate diagnosis causes negative outcomes. Excess BC referral can overburden these centers. The American Burn Association (ABA) has standardized burn center referral criteria. Minimal data exists on its application for patients at non-burn centers (NBC). Pre-hospital management of pediatric burns is also not well-defined in literature. Evidence suggests that an accurate assessment of burn size and depth can be made with photography. But its use has not been studied in relation to ED care, only being used for child protective services (CPS) reports with burns. Objective: Primary objective: to describe emergency center burn management at a non-burn center and apply ABA referral criteria to all visits to determine need for immediate transfer. Secondary objectives: to identify any patterns in burn injuries related to age/gender/ethnicity, if any disparities exist, how many get photographs taken into the chart, how many have CPS called, and what care ensues during and prior to the visit. Design/Methods: Study is an Observational Retrospective Chart review of Electronic Medical Health Records of patients < 18 years old with discharge diagnosis of burn injuries in the 8 Emergency Departments of Corewell Health East, which are not designated as specialized burn centers. Data obtained will be analyzed using descriptive statistics and comparison analysis using odds ratios and similar calculations with SAS software. This will be used to describe the emergency management of burns and compare them with ABA guidelines, particularly disposition, to determine appropriateness of transfer. Use of photography will be assessed. They will also be used to determine percentage and extent of injury to compare with initial assessment for accuracy of degree and quantity of fluid resuscitation provided. Attempt will also be made to describe prehospital management. Information regarding only whether a case was filed with CPS will be included. Institutional Review Board Approval has been obtained for the same.
