Do emergency services and general practitioners follow current first-aid guidelines in the early management of paediatric burns?

Mr Cody Frear1Dr Bronwyn Griffin1, Professor Roy Kimble1

1Centre For Children’s Burns And Trauma Research; The University Of Queensland


Background: In the treatment of burns, the provision of cool running water (CRW) first-aid is known to significantly improve clinical outcomes. Due to poor knowledge of and adherence to appropriate first-aid guidelines among the Australian public, it frequently falls to ambulances, general practitioners (GPs), and Emergency Departments (EDs) to provide patients with adequate CRW.
Objective: This study aims to determine the effectiveness of healthcare providers involved in the early burns management in ensuring the delivery of adequate CRW to children with acute burns.
Methods: A retrospective analysis was performed using a registry containing first-aid details for every patient presenting to the burns centre of a quaternary children’s hospital.
Results: Of the 3,205 children referred to the burns centre, 71.2% received adequate first-aid, 30.4% at the scene of injury. Both paramedics and GPs administered appropriate CRW in less than 25% of cases among patients with previously inadequate first-aid. ED clinicians were generally more effective at rectifying prior lapses in first-aid protocol, although the quality of first-aid varied significantly between EDs. Notably, patients were significantly more likely to receive adequate CRW at the quaternary hospital’s ED than at a referral centre ED (80.9% vs. 54.2%; p<0.05).
Conclusion: Among the healthcare providers studied, only the quaternary hospital’s ED administered adequate CRW to a large majority of its patients, with paramedics and GPs falling well short of current first-aid guidelines. This discrepancy highlights the potential value of disseminating the hospital’s burns-related training programs and educational resources to other providers of acute burns care.


Cody C. Frear is an MD/PhD candidate at The University of Queensland. He joined the Centre for Children’s Burns & Trauma Research in 2016.

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