Prevention and education
Recommendations
| Identify and Treat the Cause | ||
|---|---|---|
| 1 | Know and practice fire safety and burn prevention. | Level of Evidence Not Assessed |
| Address patient-centered concerns | ||
|---|---|---|
| 2 | Stress importance of preventative measures. | Level of Evidence Not Assessed |
| 3 | Consider psychosocial factors. | Level of Evidence Not Assessed |
| Provide Local Wound Care | ||
|---|---|---|
| 4 | NA | Level of Evidence Not Assessed |
| Provide Organizational Support | ||
|---|---|---|
| 5 | Support community burn prevention and education programs | Level of Evidence Not Assessed |
Background
Many burns are superficial and do not involve a significant body surface are. These burns do not generally require hospitalization. More serious burns involve deeper tissues and a greater body surface area. Approximately 70,000 Americans suffer burns serious enough to require hospital or burn centre admission. Serious burns are associated with substantial morbidity, mortality and lifelong consequences. As a result, fire safety and burn prevention education is a critical issue for everyone. A commitment to supporting community burn prevention and education programs is a component of the team approach to patient care and hospital commitment to community health.Education about burn prevention is critical for parents, children, medical and emergency professionals, and employees at workplaces where burn injuries are a risk. Educational programs and information are available from a variety of sources, including community and fire department programs; the Learn Not to Burn® (LNTB) Program, which is designed to teach children about burn prevention; school programs and workplace initiatives.
Burn prevention tips for the home include the following:
Install smoke detectors on every floor of the home and test them monthly.
Have an escape plan from each room of the house and ensure the entire family knows it.
Never leave a child unattended near an open flame or any other heat source.
Use flame-resistant sleepwear for infants and children.
Never leave a burning candle unattended, and keep candles away from clothes, hair and curtains.
Screen fireplaces with metal or glass. Use caution with wood stoves, fireplaces and portable heaters, as they can become very hot on the outside.
Ensure that your home has appropriate and working fire extinguishers in the kitchen and other areas where fires may start and learn how to use them.
Practice burn prevention in the kitchen:
Remain in the kitchen while cooking.
Place pots on back burners whenever possible and keep pot handles turned inward.
Remove hot foods from stove and oven carefully.
Avoid wearing loose clothing that can catch fire, and roll up long sleeves when cooking.
Keep flammable items, such as dishcloths and curtains, at least 3’ away from the stove top.
Do not reach over burners or other hot surfaces or over boiling pots or kettles. Invisible steam is hotter than visible steam (which has already cooled) and can cause serious burns.
Use extreme caution when deep frying foods or heating cooking oil, as hot oil can burst into flame. Water or other liquids dropped into hot oil are instantly converted to steam and can violently spray hot oil around.
Use caution with hot syrups as boiling sugar sticks to skin and can cause severe burns.
Careless smoking is the leading cause of fire-related deaths in homes. Dispose of cigarettes and matches carefully.
Protect children by keeping matches, lighters, chemicals and flammable liquids out of reach.
Ensure travel mugs have tight lids when drinking hot beverages around children.
Hot water can cause serious burns. Do not set hot water heaters higher than 120° F. Supervise children in the bathtub.
Do not overload electrical outlets. Ensure that electrical wires and cords have no damage. Use child-safety covers on wall outlets if young children are in the home.
Use and handle gasoline carefully and store it safely.
Do not use accelerants to start outdoor or indoor fires.
Know first aid for burns:
Eliminate the heat source and run cool water over burns to stop initial burning process. Do not use ice.
Stop, drop and roll to smother flames if clothes catch on fire.
Never use butter or salves on burns, as they can seal in heat.
References
| Essential Publications |
|---|
| 1 | Community-based interventions |
Quality Indicator
|
Type: Systematic review |
| Turner C, Spinks A,McClure R, Nixon J. Community-based interventions for the prevention of burns and scalds in children. Cochrane Database of Systematic Reviews 2004, Issue 2. | |||
| This well conducted systematic review involved two controlled trials in the community. When measuring injury rates, significant decreases in pediatric burn and scald injuries were found with intervention compared to the control group (1.26, 95% CI 0.84-1.90). Since only two studies met the inclusion criteria, the need for more quality studies with greater study time-frame and with adequately implemented counter-measures in the communities is required. | |||
| 2 | Burns- return to work |
Quality Indicator
|
Type: Systematic review |
| Brych SB, Engrav LH, Rivara FP, Ptacek JT, Lezotte DC, Esselman PC, Kowalske KJ, Gibran NS. Time Off Work and Return to Work Rates After Burns: Systematic Review of the Literature and a Large Two-Center Series. Journal of Burn Care & Rehabilitation 2001; 22(6): 401-5. | |||
| The systematic review is based on RCT studies that found employment disruption after burn injury to be significant. 10 manuscripts with objective data showed a mean time off work of 17 weeks and found that the probability of returning to work was reduced by psychiatric history and extremity burns. Recommendations for future studies are made. | |||
| 3 | Burns-Psychological adjustment |
Quality Indicator
|
Type: Systematic review |
| Noronha DO, Faust J. Identifying the Variables Impacting Post-Burn Psychological Adjustment: A Meta-Analysis. Journal of pediatric psychology 2007; 32(3): 380-91. | |||
| In this systematic review variables associated with risk for psychological adjustment were identified, including body location of burn, burn injury type, parental adjustment and child psychological function. More studies in this area are however required. | |||
| 4 | Burns-Psychological adjustment |
Quality Indicator
|
Type: Systematic review |
| Thombs BD, Bresnick MG, Magyar-Russell G. Depression in Survivors of Burn Injury: A Systematic Review. General hospital psychiatry 2006; 28(6): 494-502. Study design: Systematic Review | |||
| This systematic review examined psychological adjustment in burn victims using depression questionnaires and two rating scales (Beck Depression Inventory (BDI) or the Hospital Anxiety and Depression Scale (HADS-D)). Major depression was identified in 10-40% of adults. The prevalence of significant depression systems in studies that used the HADS-D post discharge was 4-13% , whereas studies that used the BDI generally produced substantially higher rates between 13-26%. This study was of low quality study and requires a larger sample size in the future to better assess prevalence rates and risk factors. | |||