Burns : journal of the International Society for Burn Injuries
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Severe burn is a major public health issue in developing nations. Although burn and smoke inhalation in 2002 were documented as being responsible for over 322,000 deaths worldwide, this figure is most likely a gross underestimate. The burden of suffering from fire is exceedingly distributed among the poor. ⋯ Ignorance of safe usage techniques is also contributory. Industry and government regulations and standards are either nonexistent or not adequately enforced. Solving this substantial problem will depend on improved surveillance by means of formal epidemiologic studies, and the contributions and collaboration of international governmental and nongovernmental organizations.
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The paediatric burn population requiring intensive care in Finland has never been examined before. The aim of this study was firstly to determine the aetiology, incidence and prognosis of paediatric burns requiring intensive care in Finland and secondly to compare the possible differences between the two national burn centres. ⋯ There were some small differences between the two burn centres in treatment policies. Most patients were male and most common aetiology was scald. The prognosis of these patients was excellent with no mortality.
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Multicenter Study
Fluid management in burn patients: results from a European survey-more questions than answers.
Many strategies were proposed for fluid management in burn patients with different composition containing saline solution, colloids, or plasma. The actual clinical use of volume replacement regimen in burn patients in Europe was analysed by an international survey. A total of 187 questionnaires consisting of 20 multiple-choice questions were sent to 187 burn units listed by the European Burn Association. ⋯ It is concluded that the kind of volume therapy differs widely among European burn units. This survey supported that no generally accepted volume replacement strategy in burn patients exists. New results, e.g. importance of goal-directed therapy or data concerning use of albumin in the critically ill, have not yet influenced strategies of volume replacement in the burn patient.
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A large proportion of burns in developing countries are related to the nature of domestic appliances used for cooking, heating, and lighting. Our overview of the problem elucidated the need for better surveillance with epidemiologic studies, which will more accurately assess the true incidence in vulnerable populations. ⋯ We propose an initial strategic outline plan for interventions based on values that are suited to the problem and the setting, are culturally appropriate, and can be employed in a reasonable period of time for a sustained period to ensure success. Recommended action steps include promoting the use of alternative energy sources, encouraging an integrated approach to finding interdisciplinary solutions, devising a better system of kerosene containerization, re-engineering appliance designs, legislating for enforcement of health and safety standards, taking a holistic approach through government inter-departmental collaboration, formally discouraging corruption, encouraging ventilation of cooking or living areas, implementing building codes, educating consumers, and training caregivers and health and emergency workers.
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Early efforts to predict death following severe burns focused on age and burn size; more recent work incorporated inhalation injury and pneumonia. Gender, co-morbid illness, and co-existent trauma have been implicated in burn mortality but have rarely been incorporated into predictive models. ⋯ The results of this study suggest that a comprehensive predictive model of burn mortality incorporating certain variables not previously considered in other models provides superior predictive ability.