Mrs Michelle Cork1, Ms Jane Porter1, Professor Fiona Wood1
1Fiona Stanley Hospital
Medical nutrition therapy is an essential component of multidisciplinary management of burns patients. The ANZBA Allied Health Practice Guidelines provide evidenced-based standards, however, it isn’t known if there is consistency throughout Australia and New Zealand. Comparison of current nutrition support practices can enhance knowledge-sharing, support consistency of care and inform research.
This project aimed to compare the nutritional management of adult burns patients throughout Australia and New Zealand. An online non-validated survey was distributed via purposive sampling to 11 dietitians working in burns. Response rate = 9/11.
The results indicated no consistent method for Dietetic referral. Patient assessment methods varied with 56% (n=5) units routinely using subjective global assessment, nil measuring handgrip strength and 56% (n=5) utilizing indirect calorimetry for enterally fed patients. Most dietitians used >1 predictive equation, with modified Schofield being the most common 78% (n=7), all adjusting for weight and 78% (n=7) recalculating to include donor sites. All patients received enteral feeding within 24-48 hours and most dietitians (78%, n=7) use the same enteral feed. 89% (n=8) sites reported multivitamin supplementation in major burns, and 78% (n=7) gave additional single nutrients. Glutamine wasn’t prescribed and only 1 unit (11%) sometimes supplemented arginine. Parenteral nutrition was used infrequently with 56% (n=5) reporting nil adults burns patients received PN in the previous 12 months.
This study showed many similarities in the nutritional management of burns patients however variations occur. Ongoing research is required, for continued development of guidelines for assessment, intervention and monitoring of adult burns patients.
Michelle Cork, Senior Dietitian for the State Adult Burns Unit WA. Accredited Practising Dietitian, Accredited Nutritionist.
I have 20+ years of Clinical Dietetics experience. My current area of interest is burns research however I’m early in this journey. I look forward to further developing my research skills in the coming years