Journal of burn care & research : official publication of the American Burn Association
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Multicenter Study
Multiregional Utilization of a Mobile Device App for Triage and Transfer of Burn Patients.
Technology and telehealth have the potential to optimize burn care in areas limited by lack of expertise and geographic distance from a Burn Center. This study reports a multicenter, multiregional experience using a mobile phone app to facilitate triage of patients by allowing referring providers to send encrypted photos, thus enhancing the telephone consultation process. A retrospective review was conducted on referrals from August 2016 to July 2017 at three regional Burn Centers that utilize the same mobile phone app. ⋯ Regional differences included a higher percentage of frostbite in the Western region (P < 0.001) and a higher percentage of scald burns in the Northeastern and Southern regions (P < 0.001). The majority of patients at all centers were referred to outpatient clinics for ongoing burn care. Utilization of a mobile phone app appears to be a useful tool in the triage of patients, but further studies are warranted to assess the impact on accuracy of triage, patient outcomes, and reduction of costs.
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Pediatric burn patients often have hypertension and tachycardia for several years post-injury. Propranolol has shown to be effective in treating the hypermetabolic state secondary to a major burn injury. This study was conducted to document a safe and effective dosing regimen for three different age groups. ⋯ Propranolol can be safely stopped abruptly with no rebound hypertension. Individuals older than 10 years required a lower dose per kilogram following the burn injury than prepubertal burn survivors. Propranolol proved to be both safe and effective in the management of cardiovascular changes occurring in the hypermetabolic state.
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Social interactions and activities are key components of social recovery following burn injuries. The objective of this study is to determine the predictors of these areas of social recovery. This study provides a secondary analysis of a cross-sectional survey of adult burn survivors. ⋯ Individual item responses reveal that survivors had lower scores on items related to participating in outdoor activities (30.4%) or feeling uncomfortable with their appearance (32.4% report dressing to avoid stares). Social interactions and activities are long-term challenges for burn survivors. It is important for clinicians to identify patients who may struggle with social recovery in order to focus on future community-based interventions.
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This study characterizes adult burn readmissions in the United States using a nationally representative hospital inpatient sample. Readmission rates, diagnoses, and risk factors are discussed. We analyzed the 2013 and 2014 Nationwide Readmission Database for adult burn patients. ⋯ In a nationally representative sample of adult burn patients, 4.1 per cent had unplanned 30-day readmissions for burn-specific reasons; 7.5 per cent were readmitted for any reason. Patient comorbidities and discharge before 1 day per %TBSA from the hospital impact readmission risk. Healthcare providers can use this information to identify at-risk patients, modify their treatment plans, and prevent readmissions.
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Case Reports
Too Hot for Your Pocket! Burns From E-Cigarette Lithium Battery Explosions: A Case Series.
The use of electronic cigarettes (ECs) has been on the rise with increased number of battery explosions causing burns. This study is a retrospective review of patients who presented with burns caused by EC explosions. Here, we present a case series of eight patients sustaining burns from EC explosions, within a year, to elucidate the pattern of such burns and to provide a treatment guideline. ⋯ Several types of injuries can occur, including chemical and thermal burns, inhalation injuries, metal poisoning, etc. There are currently no specific guidelines on the management of burns due to lithium-ion battery exposure. Herein, we recommend the following: Initial assessment of injuries should accompany the Advanced Trauma Life Support guidelines; serum levels of lithium, cobalt, and manganese should be checked and elevated levels should be monitored; patients should be monitored for signs of metal toxicity; wound should be extensively debrided and irrigated to remove any residual materials; and litmus test should be performed to check for alkali pH prior to irrigation with water or other aqueous solutions.