Elsevier

Burns

Volume 30, Issue 1, February 2004, Pages 82-85
Burns

Reduced Hospitalisation of burns patients following a multi-media campaign that increased adequacy of first aid treatment

https://doi.org/10.1016/j.burns.2003.09.009Get rights and content

Abstract

Context: Concern engendered by a previous study that showed inadequate first aid for burn injuries was prevalent in the community led to a novel multi-media public health campaign ensued to address the issue. Objective: To determine whether this public health campaign influenced behaviour by altering first aid treatment for burn injuries (BFAT). Design, setting and population: Prospective intervention study. Consecutive patients with acute burn injuries over two 4-month intervals, presenting to a regional burn service, Auckland, New Zealand. This research was ethically approved by the Local Research Ethics Committee. Main outcome measures: Demographics, burn size, adequacy of burn first aid, outpatient/inpatient wound care and operative intervention requirement. Results: Adequacy of BFAT improved following the campaign (59% versus 40%, P=0.004). Fewer inpatient admissions (64.4% versus 35.8%, P<0.001) and surgical procedures (25.6% versus 11.4%, P<0.001) were undertaken following the campaign with a corresponding increase in outpatient care. Greatest decreases were observed in Maori and Pacific Islanders, and in children <10 years old. Conclusions: Adequacy of BFAT together with a reduction in the numbers of patients requiring inpatient surgical care was improved by a multi-media public awareness campaign.

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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