Burns : journal of the International Society for Burn Injuries
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This report is a review of the literature and the clinical experience of electrical burns of the mouth in the West Midlands Regional Burns Unit at the Birmingham Accident Hospital, UK, over the past 10 years. There were five patients, four were children, 9 months to 5 years of age, and one adult. All patients had electrical conduction injuries involving the lips and perioral structures with involvement of the oral commissure. ⋯ Early intraoral splinting has been suggested in the literature. It was not used in any of the patients in this series and, though it may be beneficial, the patient compliance of a paediatric population may be questionable. The incidence of electrical burns has been on the decline, but those affecting the mouth still continue to be a major problem in management.
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Although the literature on the psychological consequences of burns is fairly extensive, the evidence gathered by the charity 'Changing Faces' over the last 2 years suggests that the resources allocated to psychological rehabilitation are still far from adequate. This article draws on the personal experience of one of the authors who was in a car fire 24 years ago, reviews some of the literature, briefly looks at the work done by Changing Faces and discusses some of the tasks of the 'burns team'. The authors are aware that generalizations about the consequences of burns are fraught with risk because every fire has its own causes and complications, but it is hoped that the themes expressed here do raise important general points.
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Two examples of resuscitation of a scalded child by intraosseous infusion, following failed peripheral venous cannulation, are presented. The technique of intraosseous infusion is reviewed and it is concluded that this technique provides a valuable second-line technique for establishing emergency venous access in children. It is quick, reliable and enables the rapid infusion of intravenous fluids and drugs into the systemic venous system. Complications are rare but can be serious and close observation of the infusion site is advisable.