Dr Jikol Friend1, Prof Andrew Holland1,2
1Department of General Surgery, Westmead Children’s Hospital, Sydney, Australia, 2University of Sydney, Sydney, Australia
Background: The diagnosis and management of burns may be delayed in trauma patients due to other life threatening injuries. Improved recognition of common patterns of simultaneous burns and trauma may facilitate early identification and treatment.
Methods: The Children’s Hospital at Westmead (CHW) is the only burn referral centre and a major tertiary pediatric trauma centre in New South Wales (NSW). A retrospective review of all patients admitted with trauma and an associated burn injury between January 2014 and January 2020 was performed to identify patterns in mechanism of injury and management.
Results: A total of 2441 patients were recorded on the trauma registry from January 2014-January 2020. When correlated with the burns registry, 115 of these patients sustained 118 burns. The majority of traumatic injuries occurred in males (67%) aged 12-15 years of age. Common mechanisms of injury were motorvehicle (MV) crash passengers (2.6%), falls (0.9%), MV versus pedestrian (15.7%), motorbike (MB) (3.5%) and bicycle (4.3%) crashes. These resulted in recognisable patterns of injury: MV passengers sustained airbag chemical (0.1%) and friction burns (0.3%); MB injuries included exhaust contact (0.4%) and tyre friction (0.7%) burns; pedestrians (5.2%) and cyclists (2.6%) dragged behind vehicles sustained friction burns; rope friction burns occurred in hanging; non-accidental injury (NAI) burns had a high median Injury Severity Score (ISS 29).
Conclusions: Nearly 5% of pediatric trauma patients sustain burn injuries. This study identified typical patterns depending on the mechanism of injury. Improved recognition should facilitate earlier recognition and treatment of burns in pediatric trauma patients.
A Pediatric Surgery Trainee with an interest in Burn Surgery. Her research at Westmead Children’s Hospital aims to increase recognition of burns injuries in pediatric trauma patients. Particularly to provide guidance for those who see pediatric trauma patients but may not have burns experience.