Exhausted! A five year review of the characteristics and clinical outcomes of paediatric vehicle exhaust burns.

Dr Bronwyn Griffin1, Ms Angelin Ooi2, Professor Roy Kimble1,3, Dr  Aoife Rice3

1Centre For Children’s Burns And Trauma Research, South Brisbane, Australia, 2University of Queensland, Herston, Australia, 3Lady Cilento Children’s Hospital, Brisbane, Australia

Abstract:

Vehicle exhaust burns are one of the more common causes of contact burn injuries in children. These burns have previously been associated with slower time to re-epithelialisation and higher rates of grafting compared to other burn mechanisms (Roberts et al. 2002; Rajan et al. 2011).

Queensland Paediatric Burns Registry data from January 2013 to December 2017, was used to identify burns. This paper aims to identify current demographics, injury characteristics and clinical outcomes to better inform prevention interventions.

In total n=259 children presented with an exhaust burn, significantly more male (n= 193, 75%, compared to other burn mechanisms, 59%, p<0.001) with a median age of seven years (IQR=3-11 years). The majority of cases occurred from motorbike (n=215), other vehicles included car (n=26), quadbike (n=5), mower (n=5). Median Total Body Surface Area (TBSA)% was 1% (IQR=1 to 1), highest TBSA 6%. Body region differed significantly by age group, 0-4 years more frequently injured hands (n=37, 45.7%) and >10 years more frequently lower limb (n=73, 82%, p<0.001). Patients with exhaust burns had higher proportions of theatre interventions compared to other burns mechanisms (33% versus 7%). Overall, 75% of burns occurred in metropolitan areas, however higher proportions of burns occurring in non-metropolitan areas required grafting (51% versus 31%, p=0.004). Exhaust burns were significantly more likely to occur in summer and spring (p<0.001).
Exhaust burns remain a serious risk of injury to children. Although small in size, these burns are associated with significantly higher morbidity, particularly patients in rural settings. A collaborative effort with community partners will highlight these findings in a prevention campaign.

1. Roberts, R, Kelson, E, Goodall-Wilson, D, Kimble, R 2002, ‘Motorcycle exhaust burns in children’, Burns, vol. 28, no. 4, pp. 367–369.
2. Rajan, V, Abeyasundara, SL, Harvey, JG, Holland, AJA 2011, ‘Exhaust burns in children’, Burns, vol. 37, no. 2, pp. 273–276.


Biography:

Dr Griffin has had over 10 years’ experience Nursing in paediatric emergency departments across Australia before completing her PhD with the Centre of Children’s Burns and Trauma Research. Dr Griffin is now the Clinical Research Manager of the Centre which is now located at Lady Cilento hildren’s Hospital, supervising 18 researchers. Her work supports the integrated spectrum of paediatric burn and trauma care from injury prevention/public health, first aid, acute care, scar management and psychosocial and cultural influences