Impact of first-aid on clinical outcome of large burns

Sepehr S. Lajevardi1, Peter Kennedy2, Peter K.M. Maitz3

1 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137, sepehrlaj@gmail.com
2 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137, pkennedy@lexicon.net
3 Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2137, peter.maitz@sydney.edu.au

Introduction

Australia and New Zealand Burns Association (ANZBA) recommend giving first-aid to all burns within three hours of the injury by applying a minimum of 20 minutes of cool running tap water to the burn wound. Many animal studies have shown the benefits of first-aid on burn wound healing and scarring. The aim of this study is to assess the clinical outcome of first-aid in adult patients with large burns.

Methods

A database of all adult patients admitted to Concord Hospital burns unit in Sydney from 1/1/07 to 31/12/12 with burns equal or greater than 20% total body surface area (TBSA) was analysed.

Results

Of the 279 patients recorded 140 received adequate and 139 received inadequate first-aid as per ANZBA guidelines. Inadequate first aid was more likely in older patients (73%) and those with TBSA > 50% (63%). The inadequate group has a significant increase in: hospital length of 36.4 vs 27.5 days (p=0.05), ICU length of stay 9.9 vs 6.1 days (p<0.01) and wound infections 18% vs 12.9% (p<0.05). There was a relationship between inadequate first aid and poorer outcome in mortality 18.7% vs 3.6% (p=0.16).

Discussion

Despite the widespread recommendation worldwide for the use of first-aid in burns this is the first review of first-aid outcome in adult patients with large burns and shows only half the patients transferred had received adequate first aid as per ANZBA criteria. This study further suggests that first-aid reduces mortality and the hospital and ICU length of stay and the rate of wound infections.

Conclusion

This study provides evidence for continued use of first-aid in large burns and illustrates the need further research in this area.

Key Words

First aid, Large Burns, Outcome

Biography

Dr Sepehr Lajevardi is a Plastics Surgical Trainee with Royal Australasian College of Surgeons. He is undertaking a PhD in early management of burns at The University of Sydney and has an interest in improving the care of burns patients before transfer to a burns unit.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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