Burns first aid treatment in remote dwelling and Indigenous Northern Territorians

Mr David Read1,2, Dr Victor Tan2, Kathleen McDermott1, Linda Ward1

1National Citical Care & Trauma Response Centre, Darwin, Australia, 2Royal Darwin Hospital, TIWI, Australia

Background and objective: It is well demonstrated that adequate burns first aid treatment (BFAT) improves clinical outcomes for the injured but adequacy remains low in many studies.  This study presents a twelve month assessment of the adequacy of burns first aid treatment for patients managed by the Burns Service, Royal Darwin Hospital (RDH).

Methods: Prospective study design of both inpatients and outpatients managed by the Burns Service, Royal Darwin Hospital for the period 1 January 2014 – 31 December 2014. A multivariate logistic regression model was used to examine the association between adequacy of first aid and gender, age, ethnicity, remoteness, burn mechanism and burn depth.

Results: Overall 310 cases were analysed. Adequate BFAT occurred in 41% of cases.  Adults (p=0.044), contact burns (p<0.001) and those where the burn injury occurred in the remote regions (p<0.001) were less likely to receive adequate BFAT.  Indigenous persons were less likely to attempt any BFAT at all (p=0.04) and when they did receive BFAT it was more likely applied by an emergency responder or health professional (p=0.004).

Conclusion: Overall adequacy of BFAT is low in the Top End of the Northern Territory.  Remote dwellers and Indigenous persons are at increased risk of not applying or receiving adequate BFAT.  The poor level of adequate BFAT demonstrated in this study suggests that the Top End community particularly remote and Indigenous persons would benefit from targeted BFAT education programs that are delivered in a culturally appropriate fashion. A pilot of this programme will be shown.

David Read is a General and Trauma Surgeon and is the head of the Burns Service of the Royal Darwin Hospital. He has an interest in service delivery and outcomes for remote dwelling persons in Indigenous communities.

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