Dr Thanya Sritharan, Dr Nam Kyu (Daniel) Yang, Dr Varun Harish1
1Conjoint Lecturer: University of Sydney
The impact of adequate first aid on clinical outcomes in burn injuries has been demonstrated in large cohort studies in the adult population. Its effect on outcomes has not been as thoroughly explored in the paediatric population. The purpose of this study was to assess the effect of first aid on wound depth, need for grafting, and time to healing.
Data was prospectively collected for patients with <10% TBSA burns from 2006 to 2019 presenting to the outpatient service of the Burns Unit at the Children’s Hospital at Westmead. Multivariate regression analysis was performed to determine the association of adequate first aid with four key outcomes; wound depth, need for skin grafting, time to re-epithelialisation (in non-grafted patients), and TBSA not needing grafting (in grafted patients).
Data from a total of 2458 patients were included in this retrospective analysis. 68.6% of patients received adequate first aid treatment. The mean TBSA was 2.9%.
Adequate first aid was associated with a reduction in the comparative amount of superficial and mid dermal burns to full thickness burns (p<0.01), and need for grafting (OR 0.29; 95% CI -2.00 to 0.14; p=0.047). There was also a 0.25% reduction in TBSA (95% CI 0.05 to 0.45; p=0.014) and 1.55 fewer days to healing in the non-grafted group (95% CI 0.2 to 2.9; p=0.024).
This is the largest study to corroborate the beneficial effects of adequate first aid on clinical outcomes in paediatric burns, and adds to the growing body of clinical evidence for first aid. Results indicate that first aid is associated with reduction in TBSA, wound depth, and healing time, and support the need for increased education of the general populace as well as medical profession.
Junior Medical Officer working in the Severe Burns Unit at Royal North Shore Hospital, Sydney.