Reduced Hospitalisation of burns patients following a multi-media campaign that increased adequacy of first aid treatment
Introduction
Immediate cooling of burns as a first aid measure significantly determines burn outcome, and decreases morbidity and healthcare costs by limiting the degree of tissue damage [1], [2], [3], [4], [5]. Consequently, the need for surgery and subsequent reconstruction is reduced [5]. Immediate, continuous application of cool running water (10–15 °C/50–60 °F) for 10–30 min, if available, is recommended as adequate burn first aid treatment (BFAT), although this may need to be tempered to suit circumstance in preventing hypothermia, particularly in children [6], [7], [8], [9], [10].
Awareness of appropriate burns first aid was unclear to many of the burn-injured population of Auckland, New Zealand, especially Maori and Pacific Island people and parents of children <10 years when studied [1]. Inappropriate and sometimes deleterious first aid was also commonplace. In addressing this problem, a multi-media public education campaign was undertaken.
This study examines the effect of that campaign, and highlights the beneficial effect for burn patients of adequate BFAT.
Section snippets
Methods
All patients, with an acute burn injury, treated at a regional burn centre over two 4-month study intervals (November 1997–March 1998 and November 2001–March 2002) separated by an intervening publicity campaign were considered for enrolment. Those who were unable to be interviewed due to death or mechanical ventilation were excluded. Patients/caregivers were interviewed in the emergency department or subsequently during inpatient care (Box 1). Patients were followed for 6 months post-injury.
Results
One hundred and twenty-one patients (of a total 165) were included pre-campaign, and one hundred twenty three patients (of a total 153) following the campaign. Comparison of patient demographics demonstrated no significant differences between populations studied in the pre- and post-campaign (Table 1).
Seventy-three percent of inpatients resided in areas of lower economic status. In all age groups, hot liquid was the predominant cause of injury (46%). Fire (18%), flash (15%) and other causes
Comment
Adequate first aid for burn injury is application of cool water over the injury for at least 20 min. Whilst this advice may need to be tempered in very large burns or in small children, the publicity campaign did not address these issues. It was considered that by complicating the message with riders and addendum, more burn injuries were likely to be under treated initially. It was for these reasons, now supported by the following study, that no aspect of the campaign highlighted the possibility
Conclusions
We have reported a multi-media publicity campaign directed towards first aid treatment of burn injury that impacted significantly on health behaviour. In addition, the injuries seen by the burn service subsequent to the campaign required significantly less inpatient and operative treatment, implying a reduction in their severity. In view of our success, we would encourage others involved in both burn care and public health to undertake similar campaigns.
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