Dr Lisa Murphy1, Mr David Read1,2, Ms Margaret Brennan1, Mrs Linda Ward2,3, Mrs Kathleen McDermott2
1Royal Darwin Hospital, Tiwi, Australia, 2National Critical Care and Trauma Response Centre, Tiwi, Australia, 3Menzies School of Health Research, Tiwi, Australia
Background: Rates of interpersonal violence (IPV) in the Northern Territory are high. Burns due to IPV constitute 7.4% of admissions to the Royal Darwin Hospital (RDH) Burns Service. This study aims to describe demographics, circumstances and burn wound characteristics of IPV burn victims admitted to RDH and assess the adequacy of their care.
Methods: Identification of IPV burns through retrospective Burns Registry analysis of all RDH patients meeting BRANZ criteria from 2010-2015, with intent recorded as ‘assault’; supplemented by medical case note review; children (<16yo) excluded. Characteristics of the IPV cohort were compared against those of non-IPV burns in the Registry during the same timeframe.
Results: Fifty-three patients met IPV criteria. IPV burn victims were 2.3 times more likely to be female than non-IPV victims (95% CI: 1.2-4.3), and 16.7 times more likely to be Indigenous (95% CI: 7.9-35.3). Alcohol or drug use was involved in almost 60% of IPV cases. Approximately half (53%) of IPV burns were classified as family or domestic violence. Scalding was the most common mechanism in family and domestic violence. Scald to the back was nine times more likely to be due to IPV (95% CI: 3.4-25.4). A total of 10 patients (19%) had incomplete burn care through self-discharge, all of whom identified as Indigenous. Twenty percent of patients had no documented inpatient psychosocial support.
Conclusions: Women and Indigenous persons are at increased risk of IPV burn. Burns from IPV have a high rate of incomplete burn wound treatment in Indigenous persons. This study explores the challenges of providing care to the IPV burn population, which extend beyond burn wound closure.
Lisa is a current Medical/Surgical Intern at the Royal Darwin Hospital, where she has previously worked from 2010 to 2017 as a theatre nurse, with a special interest in burns.
She has been formally involved in the delivery of EMSB at RDH since 2013 and deployed with the National Critical Care and Trauma Response Centre to Tacloban following typhoon Haiyan in 2013.