Burns : journal of the International Society for Burn Injuries
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Despite known inequalities, little is understood about the burden and healthcare experiences of Aboriginal and Torres Strait Islander children who sustain a burn injury and their families. ⋯ Data from this cohort provide rich new information about risk factors and care received from point of injury through to rehabilitation for Aboriginal and Torres Strait Islander children with burns, providing unique insights into what is needed for appropriate, culturally safe care.
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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent severe manifestations of a potentially life-threatening spectrum defined by a desquamating rash of the skin and mucous membranes. This study was prompted by the observed increase in the off-label use of lamotrigine as a causal agent in SJS/TEN in our regional burn center. ⋯ Off-label use of lamotrigine is emerging as a major driver of SJS/TEN with notable changes in patient demographics. Further research is necessary to understand how changing trends in the patient population will impact clinical course and optimal management.
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Outcome monitoring can identify fluctuations in healthcare. Cumulative sum (CUSUM) analysis can detect when mortality deviates from expected, allowing early intervention through targeted audit. We present a 10-year experience of the prospective use of CUSUM methodology in a regional burn centre. ⋯ The use of CUSUM as an early warning trigger stimulates assessment of practice and critical appraisal of factors contributing to unexpected mortality or survival. The revised Baux score at its foundation needs to be carefully considered but remains a valid model. One benefit is positive reinforcement of team cohesion and morale during periods of care excellence leading to excess survivors.
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Early retrospective data identify that dysphagia is common in older persons with burn injury, suggesting a rate of 47 %, and that it is associated with medical, burn, and nutritional outcomes. ⋯ One in every two patients ≥ 75 years admitted with burn injury will demonstrate dysphagia during their hospital admission. Those with pre-existing cognitive impairment are most at risk.
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Appearance concerns are common following burns. However, there is a lack of research investigating early psychological interventions for appearance concerns. This qualitative study explored the acceptability of early psychological interventions for appearance concerns after burns. ⋯ Early psychological interventions for appearance concerns following burns are likely to be acceptable for some patients. However, ambivalence and potential barriers remain to be addressed. Embedding early psychological interventions for appearance concerns into routine burn care could increase acceptability through normalisation.