No abstract available.
Burn Units ; Burns ; Humans ; Nurse Clinicians

PURPOSE: This study was conducted to assess the appropriateness of emergency department-based triage for determining whether to transfer of burn patients to a burn care specialty center. METHODS: Eligible subjects were enrolled from the EDbased injury surveillance registry from April 2006 to March 2007 in a regional emergency center, which logs more than 42,000 patients annually. To assess the appropriateness of emergency department-based triage for determining whether to transfer patients to a burn center, we used the transfer guidelines recommended by the American Burn Association as the gold standard. Under-triage (defined as non-transfer of a victim who should have been transferred) and the over-triage (defined as transfer of a victim who should not have been transferred) rates were calculated. RESULTS: The total number of burn injury victims was 144 and the male-female ratio was 1:1.15. The mean age was 25.5+/-20.9 years. The numbers of flame, electrical, chemical, inhalation, and other burn injuries were 133 (92.4%), 2 (1.4%), 6 (4.1%), 1 (0.7%), and 2 (1.4%), respectively. Of these 144 patients, 25 (17.4%) were transferred to the ED of a burn center after triage and primary management. The others were discharged and followed up at local clinics. The numbers of major and moderate burns that were indicated for transfer to the burn center were 33 (22.9%) and 3 (2.1%), respectively. The rates of under- and over-triage were 14.6% and 6.9%. CONCLUSION: The proportion of inappropriate disposition of burn injury in a regional emergency center was high (21.5%). Recommended guidelines for triage of burn injuries should be applied more strictly.
Burn Units ; Burns* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Inhalation ; Triage*

Burn Units ; Burns ; surgery ; Humans ; Personnel Management ; Physicians

PURPOSE: The authors analyzed the survival time of severely burned patients who died and reviewed the time of the death after the burn injury. We aimed to determine any relation to the survival time with most important prognostic factors of the surface area burned and the age. METHODS: Statistical analysis was performed on 275 severely burned victims who died at our burn center of Hangang Sacred Heart Hospital from January 1, 2010 to December 31, 2015 for 6 years. RESULTS: 1. The mean age was 50.12±18.2 years and the average burn size was 61.0±27.1% of total body surface area. 2. Most of the patients (90%) died within 45 days, and 80% died within 30 days. 40% of the patients died within 10 days after burn injury, 20% of the patients died between 10 to 20 days after burn injury, 20% of the patients died between 20 to 30 days after burn injury and the rapid decrease in the number of death was observed after 30 days of burn injury time. 3. The shorter survival time (x-axis) time was observed in the patients with larger area of the burned size (y-axis) and the longer survival time was observed with smaller area of the burned size. The negative correlation was shown as figure 1. 4. There was no correlation shown between the age and the survival time of burn victims after burn injury. CONCLUSION: The mortality rate was significantly decreased at 30 to 40 days after burn injury. Therefore, the burn surgeons need more carefully and diversely plan and perform for the initial treatments since the initial surgical procedures determine the survival of severely burned patients.
Body Surface Area ; Burn Units ; Burns* ; Heart ; Humans ; Mortality ; Surgeons

The development of burn units in our country is now undergoing a trend of geographic centralization and regionalization. To solve the problems like severe burn patients are too far away from burn units, overloaded operation in regional burn centers when mass burn accidents happen, and growing requirement for aeromedical transportation, etc., it is now the top priority to improve national aeromedical transportation system for burn patients. Expert teams from Chinese Burn Association, National Aeromedical Rescue Base, and China Association for Disaster & Emergency Rescue Medicine discussed and reached a consensus on the key points of aeromedical transportation of burn patients, including organizational structure, staff and materials, and three links before, during, and after aeromedical transportation. The consensus aims to provide guidance for a safe, efficient, and standardized operation of aeromedical transportation for burn patients in China.
Accidents ; Air Ambulances ; Burn Units ; Consensus ; Disasters ; Humans

PURPOSE: Burn is an unusual medical situation with limited information open to common people. This study was designed to evaluate the communication gap and different understandings between doctor and patient about burn treatment and to improve quality of the treatment. METHODS: Cross-sectional studies were done with interview and questionnaire. 25 doctors and nurses of burn ward and 50 burn patients in Han-gang Sacred Heart Hospital Burn Center were participated. To understand the communication gap and different perception between doctors' and patients' on 1) burn sequela and recovery, 2) disease course and prognosis, 3) healing environment, cost, hospitalization, 4) nurse-physician collaboration, 5) psychiatric consultation, 6) extra incentive were analyzed. RESULTS: Patients tend to expectation positive answer about their prognosis from their physician but they have recognized chronic and negative prognosis of burn treatment. Patients want to know clear and detailed explanation about their test result or treatment methods. Physicians thought that it is important to consider patients' economic status and provide different treatment principle. Short duration of hospitalization is not related to the anxiety of rehabilitation. Patients thought that nurses could manage superficial or repeated treatment. It is more likely that physicians warn the disadvantages of psychiatric consultation than patients. Both groups thought that extra incentive or gratitude money is not helpful for the doctor patient relationship. CONCLUSION: Given the discrepant views of physicians and patients on the burn treatment, physician should be aware of the discrepancies and attempts to resolve any differences.
Anxiety ; Burn Units ; Burns ; Cooperative Behavior ; Cross-Sectional Studies ; Heart ; Hospitalization ; Humans ; Motivation ; Prognosis ; Surveys and Questionnaires

PURPOSE: Complications and mortality rate of burn injuries are recently decreasing owing to development of systematic and special burn therapy. Whereas we are suffering from the lack of the medical manpower in burn center. In the future we might need more medical assistants to compensate these shortages. In this study we tried to search the path through these difficulties by considering the practical application of medical assistants. METHODS: We compared Korea's current situation of burn treatment with other countries in various references. Also we studied and compared recent situation of medical assistants in Korea and U.S.A. We took special considerations for Korean emergency medical technician, physical therapist and occupational therapist. RESULTS: Our study showed that we are practically using emergency medical technician, physical therapist and occupational therapist as medical assistants in various fields including burn centers. Emergency medical technician, physical therapist and occupational therapist as medical assistants can be excellent medical substitutes for shortage of manpower in our burn centers. Compared with U.S.A's current situation we are quite lacking of certain certified programs for such medical assistants. Burn therapists can be promoted from medical assistants through certain certified educational programs. CONCLUSION: We think that emergency medical technician, physical therapist and occupational therapist, who have certification concerning certain medical experience, should undergo certified educational program for burn therapy and should be used as a actual burn therapists to overcome the shortage of manpower in our burn centers.
Burn Units ; Burns ; Certification ; Emergency Medical Technicians ; Humans ; Korea ; Physical Therapists ; Stress, Psychological

BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.
Burn Units ; Burns* ; Humans ; Inhalation ; Lightning ; Renal Insufficiency ; Resuscitation ; Smoke Inhalation Injury ; Wound Healing

OBJECTIVES: This study was designed to evaluate the quality of life in facial burn patients and its relationship to anxiety. METHODS: The study subjects consisted of 36 patients in a burn center after a burn injury. The assessment of quality of life was performed using a clinical administered SF-36 scale. All participants were instructed to complete the State and Trait Anxiety Inventory of Spielberger, the Beck Depression Inventory. RESULTS: There was no correlation between the trait of anxiety and the degree of the burn. The patients who had a high score in the Trait Anxiety Inventory after the burn injury showed a low quality of life at the one year follow-up. But the patients who had a low score in the Trait Anxiety Inventory showed a better quality of life than patients who had a mild burn injury. CONCLUSION: The results of this study suggest that the patients who had severe facial burns with a high score in the Trait Anxiety Inventory showed the specific properties of a low quality of life. Therefore, they needed intensive care from the beginning of the burn injury. In this process, resilience plays a major role in adapting to acute stress, especially burns, and anxiety is one of the protective factors in resilience.
Anxiety ; Burn Units ; Burns ; Depression ; Follow-Up Studies ; Humans ; Critical Care ; Quality of Life

We analyzed 560 cases of anesthesia for burned patients from January 1986 to December 1983 after establishment of burn center in Hangang Sacred Heart Hospital. The results were as follws; 1) The number of patients was 121 in 1986, 203 in 1987 and 236 in 1988. 2) Among 560 cases, 411 (73.4%) cases were male and the most common age group was under 10-year-old (181 cases, 32.4%). 3) Most frequent surgical procedure was skin graft (453 cases 80.9%) and early escharectomy was increased. 4) Inhalation anesthesia was 496 cases (88.6%) and intravenous anesthesia was decreased (16.5% in 1986 and 0.4%, in 1988). 5) The duration of anesthesia was 2.5+/-1.61 hours in 1986, 2.6+/-1.20 hours and 1.5+/-0.89 hours in 1988. It was shortened respectively. 6) Flame burn was the most common cause of burn (65.9%) and the patient with 30-40% burned surface area were most frequent (22.1%).
Anesthesia* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Burn Units ; Burns* ; Child ; Heart ; Humans ; Male ; Skin ; Transplants