Burns : journal of the International Society for Burn Injuries
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Disaster simulation exercises are important to test service processes, capabilities, and deficiencies; disaster response planning should encompass the entire multidisciplinary team over an extended period. Our service simulated a modest eight burn casualty scenario to test our service capabilities over a 10-week period across medical, nursing, and allied health professions. Requirements due to the mass burns casualty cohort were predicted in terms of theatre requirements, allied health treatment hours required, and nursing hours requirements. ⋯ This simulation clearly demonstrated the high and immediate increase in workload demands across all professions over a prolonged 10-week period and that high business-as-usual demand can greatly affect staff capacity to cope with a mass casualty surge in admissions. It was able to provide evidence, and awareness, for leadership and management on the need for resources and resource re-allocation in a mass burn casualty scenario. It also informed a review of our current triggers for activating our SA Health Multiple Burns Plan.
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In resource-limited environments, it is critical to triage burn patients most likely to benefit from operative intervention. This study sought to identify patients with a more significant treatment effect after operative intervention following burn injury at a tertiary burn center in Lilongwe, Malawi. ⋯ Operative intervention confers a survival advantage for patients with flame burns, and the average treatment effect was more significant compared to patients with scald burns. In general, in resource-limited environments flame burns should be prioritized for surgery over scald burns to improve patient outcomes.
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Randomized Controlled Trial Multicenter Study
Esketamine use for primary intelligent analgesia in adults with severe burns: A double-blind randomized trial with effects on analgesic efficacy, gastrointestinal function and mental state.
Opioid consumption for analgesia in burn patients is enormous. Non-opioid analgesics for burn pain management may result in opioid sparing, reducing opioid-related adverse reactions and drug tolerance or addiction. ⋯ Esketamine use is safe for perioperative primary intelligent analgesia of severe burns, resulting in improved resting pain control and lower opioid requirements.
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Despite the multitude of preventative methods, postburn hand contractures are poorly controlled and often require surgery. However, there is no consensus on which hand reconstruction technique is most efficacious. This systematic review aims to compare the efficacy of available postburn hand contracture reconstruction techniques over the long term and to evaluate the quality of current literature. Effectiveness is assessed with functional improvement, increase of skin surface area, and scar quality/enhanced cosmesis. ⋯ No consensus remains on the superiority of a single reconstruction technique. Meticulous preoperative planning and intensive rehabilitation are vital. A stepwise approach, considering individual patient and contracture characteristics and the limitations of each technique, should be followed. Well-designed and conducted future studies, utilizing reliable and validated contracture description methods and outcome assessment, are now imperative.
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For nurses working in specialized units such as burn units, having adequate levels of job satisfaction and motivation is crucial for enhanced productivity in order to maintain quality nursing care. ⋯ A positive correlation was observed between job satisfaction and job motivation of the nurses. If older nurses cannot get support from their supervisors, their satisfaction will be decreased. In addition, if more experienced nurses in the burn unit do not feel importance on the job, their satisfaction will be decreased.