First impressions last… A survey of knowledge of first aid in burn-related injuries amongst hospital workers

Knowledge of prevention and first aid in burn injuries among health care workers and non-health care persons in India

Appropriate and timely first aid reduces morbidity in burns. This study aims to assess the knowledge of first aid in burns among healthcare workers (HCW) and nonhealthcare workers. (NHCW).

METHODS

A survey, distributed in both paper and Google survey formats, presented five sample cases with multiple-choice answers. Participants recorded the most suitable first aid management for each scenario. Correct answers were provided on completion.

RESULTS

Out of the total 753 participants, only 89 (11.8%) got all five answers correct. 16% HCW and 6% NHCW could answer all 5 questions correctly (with a true HCW:NHCW ratio of 2.67:1). Providing care for individuals with burns substantially raised the probability of giving accurate responses (p = 0.0001). While attending the general First Aid Course did not affect the responses (p = 0.08), participation in the Burns First Aid Course demonstrated slightly improved results (p = 0.052). The scenario involving liquid petroleum gas leakage saw a high proportion of correct responses, likely influenced by media coverage.

CONCLUSION

We find a clear need for adequate training in burns first aid due to low awareness among healthcare workers (HCW) and non-healthcare workers (NHCW). Factors such as participation in burn first aid courses and gaining firsthand experience in treating burns were found to be linked to improved knowledge of burns prevention and first aid. Utilizing various media channels could be a valuable strategy to reach a broader audience, especially in remote and inaccessible areas.

Knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran

Optimal management of burns begins with first aid from the first hours of injury. Adequate knowledge of how to perform first aid for burns can reduce the consequences of injury. Therefore, this study aims to determine the knowledge, attitude, and sources of information assessment towards burn First aid among people referred to a burn centre in the north of Iran. A questionnaire-based survey was conducted to assess knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran in 2023. In this survey, a convenience sampling method was adopted. The variables consisted of four items on socio-demographic information, 15 items on knowledge, ten items on attitude, and one item on sources of information related to burn First aid. A total of 371 individuals responded to the survey. The mean age of participants was 31.90 ± 8.49 years old. The mean score of the total knowledge of the participants in the research was 6.04 ± 3.05. There was a statistically significant relationship between the variables of age, sex, marital status, place of residence, level of education, and history of receiving first aid training with the participants' knowledge level. The average score of the total attitude of the participants was 44.08 ± 3.88. Out of 371 participants, 214 people (57.7%) had an average attitude, and 157 people (42.3%) had a good attitude towards burn first aid. There was a statistically significant relationship between place of residence, level of education, and history of receiving first aid training with the participants' attitudes in the research. In addition, the level of knowledge had a statistically significant relationship with the participants' attitude level in the research (p-value <0.001). The majority of participants have limited knowledge of burn first aid. This lack of knowledge could lead to severe consequences. Therefore, healthcare organizations should review and promote consistent guidelines for burn first aid to tackle and minimize the effect of this grave injury.

A systematic review of health care workers' knowledge and related factors towards burn first aid

The present systematic review was conducted to investigate the knowledge of health care workers (HCWs) regarding first aid in burns. A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Knowledge', 'First aid', 'Health personnel' and 'Burns' from the earliest to 1 February 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 3213 HCWs participated in seven cross-sectional studies. Of the HCWs, 44.50% were physicians. The studies included in this systematic review were conducted in Saudi Arabia, Australia, Turkey, the UK, Ukraine, and Vietnam. The knowledge rate of HCWs related to first aid for burns was 64.78 out of 100, which indicates their relatively desirable knowledge. The factors of first aid training experience, age, and experienced burn traumas had a significant positive effect on the knowledge of HCWs related to first aid for burns. Also, factors such as gender, nationality, marital status, and job position had a significant relationship with the knowledge of HCWs about first aid for burns. Therefore, it is suggested that health care managers and policymakers implement training programs and practical workshops related to first aid, especially first aid for burns.

Developing an instrument to assess physician knowledge of initial care for burn patients

INTRODUCTION

Burns are associated with high rates of morbidity and mortality, especially in low- and middle-income countries, such as Brazil, because there are no routine prevention programs, a lack of adequate legislation and supervision, and care quality in the acute phase is precarious. In most cases, initial care for burn patients is provided by emergency services without specialized personnel, which leaves the majority of cases to general practitioners who have no specific training in initial burn care, which can lead to worse prognoses and outcomes.

OBJECTIVE

To develop an instrument to assess physician knowledge of initial care for burn patients.

METHODS

This primary quantitative study used the Delphi technique, which involves consensus from a panel of expert panel, as a methodological reference. The instrument was based on information provided in the Ministry of Health's booklet on emergency burn treatment, and an agreement index of 80% was required for item inclusion.

RESULTS

After 3 Delphi phases, the instrument was approved by the panel with an agreement index of 100%.

CONCLUSION

Although the instrument was finalized, other psychometric properties must still be assessed to further determine its validity and reliability.

Developing and Pilot Testing E-Learning Training for Pediatric Nursing Burn Care

Background Nurses caring for pediatric patients who have burns need to be properly trained to provide optimal care. The aims of this pilot study were to (1) develop a pediatric nursing burn care e-learning training for novice nurses; (2) assess the feasibility and acceptability of this educational intervention; and (3) evaluate the preliminary effects of this intervention on novice nurses' knowledge of pediatric nursing burn care. Method A quasi-experimental, one-group, pre-test-posttest design was used. Results Feasibility was achieved because all of the participants completed the study. A significant difference was observed in the mean knowledge level of the novice nurses from before training to after training (87.7% ± 8.7% vs. 58.6% ± 14.5%; p < .001). The novice nurses' had a mean satisfaction of 95.5% after the intervention. Conclusion This new, evidence-based pediatric nursing burn care e-learning training appeared to be feasible. The novice nurses found it to be satisfactory, and it improved their knowledge regarding pediatric burn care. [J Contin Educ Nurs. 2022;53(5):232-240.].

Knowledge, Attitudes, and Practices toward First Aid Management of Skin Burns in Saudi Arabia

Background: Burns are considered a serious health affection that leads to several consequences affecting a person both physically and emotionally. Herbal and traditional medicine have become popular remedies among patients worldwide. Aim: This study explores common practices followed in burns as first aid management. Methods: A cross-sectional study was conducted in the Eastern province of Saudi Arabia using a designed questionnaire distributed electronically through different social media. The questionnaire consisted of socio-demographic details, history of burns, causative material, and practices followed in response to burns. Results: 461 individuals have participated in this study. The commonest reason for burns was hot water or steam. The majority of the respondents (63%) had a satisfactory response to self-aid alone at home. The most common first aid options for managing burns at home were cold water alone 195 (42%), any sort of cream alone 177 (38%), or both 317 (69%). Overall, the result shows no statistically significant difference between the outcome of burn injury and the most commonly used burn aids. Conclusions: Most people use creams and water as the first-aid management of burns, while a good number of people use traditional medicine. Overall, people who receive hospital treatment after getting first aid at home give a better outcome.

Knowledge and practice of burn first aid among parents of under-age children

The objective of this study is to assess the level of knowledge and practice of burn first aid management among parents. A cross-sectional study was conducted among parents of under-age children in the Taman Desa Darul Naim area of Pasir Tumbuh, in Kelantan, Malaysia, using an adapted survey from Davies et al. Out of 80 respondents, 46.3% showed minimal knowledge of burn first aid, 47.5% had moderate knowledge, and 6.3% extensive knowledge. There was a significant relationship between the demographic data and the knowledge of burn first aid for gender (p=0.02), but no significant relationship between the level of knowledge and level of education (p=0.29) or age (p=0.09). The findings indicate that the level of knowledge of burn first aid is limited. Education for parents of under-age children, including demonstrations of burn first aid, is needed to promote safe action and prevent further injury in the community.

The assessment and management of thermal burn injuries in a UK ambulance service: a clinical audit

Background:

Although burn emergencies are infrequently encountered, the ambulance service is often the first point of contact for patients in these situations. It is therefore important that these potentially devastating injuries are managed in accordance with the evidence base. Appropriate assessment and management of these patients in the pre-hospital phase will have a significant impact upon their long-term outcomes, such as scarring cosmesis and functionality.

Aim and objectives:

This audit was conducted to determine if patients presenting to one UK ambulance service with thermal burn injuries were managed safely, effectively and in a timely manner. Areas highlighted for improvement will assist in directing future pre-hospital research and educational requirements. Epidemiological data will also be provided.

Results:

278 thermal burn incidents occurring from June 2017 to May 2018 (inclusive) were included in this audit. A larger proportion of burn patients were paediatrics who fell into the 0–10 age category, most burn patients were injured at a home address and only nine of the overall sample were major burns. Only 35% of patients received adequate cooling of their burns, an essential first aid intervention. The assessment of pain (87%) and provision of analgesia (75%) showed a higher compliance rate. However, only 54% had pain reassessed after analgesia. There was a near 100% compliance rate for patients being managed without hydrogel dressings and topical medicines.

Conclusion:

The results indicate several areas for improvement within the ambulance trust. Of importance is the application of basic first aid, such as cooling. It is important not only to improve education among staff but also to understand non-compliance. It should be acknowledged that assessment of pain and provision of analgesia demonstrated far higher compliance compared to current pre-hospital evidence. Several points for education and research have been identified.

Adequacy of cool running water first aid by healthcare professionals in the treatment of paediatric burns: A cross-sectional study of 4537 children

Objective

To determine the adequacy of cool running water first aid provided by healthcare professionals in the early management of children with thermal burn injuries.

Methods

A cross‐sectional study was undertaken using a prospectively collected registry of children who presented with a thermal burn to the only major paediatric burns centre in Queensland, Australia, from January 2013 to December 2018. Main outcome measures included the type and duration of first aid administered by paramedics, general practitioners and emergency providers at local general hospitals and a children's hospital. In accordance with current Australian guidelines, adequate cooling was defined as 20 min of cool running water within 3 h of the injury.

Results

Of the 4537 children who presented to the paediatric burns centre, 3261 (71.9%) received adequate first aid, including 1502 (33.1%) at the scene of injury. Paramedics and general practitioners administered adequate cooling to 184 (25.0%) and 52 (24.2%) of their patients, respectively. ED clinicians adhered to guidelines in the treatment of 1019 (56.3%) children at general hospitals and 411 (76.0%) at the children's hospital. Among ED patients who presented with incomplete prior first aid, the risk of inadequate cooling was significantly greater for those transported via ambulance (P < 0.001).

Conclusion

Deficiencies remain in the cooling of paediatric burns patients at all levels of initial management. There is a need in the healthcare community for improved education regarding the parameters and clinical benefits of cool running water first aid.

Knowledge and Practice of Burn First Aid Among Saudi Arabian Medical and Non-Medical University Students

Burns are serious injuries, resulting in high morbidity and healthcare costs. Effective first aid improves outcomes. The aim of this study was to assess the knowledge and practice of first aid for burn injuries among medical and non-medical students in Saudi Arabia. A cross-sectional study (N = 408) was conducted, in which a questionnaire was administered assessing students' experience with burns, as well as their hypothetical responses to vignettes involving patients with burn injuries. Although most students reported having personal experience with burns, and had received some information regarding burn first aid, only about half were able to provide correct responses regarding first aid techniques, and medical students were no more accurate than non-medical students in their responses. Results suggest that members of the Saudi Arabian population may lack appropriate knowledge about burn first aid, and education and public information resources may help to remedy this problem.

Survey on Knowledge of First Aid Management of Burns Amongst Medical and Non-medical Students in Karachi, Pakistan: Need for an Educational Intervention?

Background: Burn related injuries (BRIs) are relatively common, mostly accidental, and highly preventable forms of injury. First aid management of BRIs can have a significant impact on the outcome and morbidity of these injuries, yet there seems to be an inadequacy in the knowledge related to burn management worldwide. Hence, our study aimed to delineate the level of knowledge and awareness of burn first aid treatment (BFAT) amongst undergraduate students, and the impact training courses had on that knowledge.

Methods: A cross-sectional study was conducted by employing undergraduate medical and non-medical students from various universities of Karachi, Pakistan. By means of convenience sampling, 400 students were sent online, structured questionnaires. The analysis was conducted using Statistical Package for Social Sciences (SPSS version 23.0, IBM Corp., Armonk, NY, US), and associations calculated through t-tests. A mean knowledge score was calculated to assess the participant’s adequacy of knowledge regarding BFAT.

Results: Medical students had a better knowledge score than their non-medical counterparts (5.8 ± 1.6 versus 3.6 ± 1.5, P < 0.01), however, overall knowledge of BFAT remained inadequate amongst participants. Students who received formal training scored a higher mean knowledge score than the majority of students with no training (P < 0.01).

Conclusion: The majority of students had insufficient overall knowledge about BFAT, highlighting the need for integrating this topic into the curriculum. In addition, education of the masses via multimedia and conducting formal training courses, are both imperative in raising awareness and reducing the occurrence of BRIs.

First aid is associated with improved outcomes in large body surface area burns

BACKGROUND

Animal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h after burn reduces healing time and scarring. We have previously demonstrated the benefits of first aid in minor burn injuries with respect to a reduction in wound depth, faster healing, and decreased skin grafting utilisation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes in large body surface area burn injuries (≥20%).

METHODS

Data was prospectively collected for patients with ≥20% TBSA burns from 2004- 2018. Multivariate regression analysis was used to determine the association of adequate first aid with 8 outcomes - mortality, total length of stay, total body surface area (TBSA), percentage/proportion of TBSA that was full thickness [PFTI], TBSA grafted, number of re-grafting sessions, intensive care admission, and intensive care length of stay. Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury.

FINDINGS

390 patients were identified. Adequate first aid was received in 35.6% (139) of patients. There was a trend towards a reduction in mortality (OR 0.37; 95% CI 0.12-1.13; P = 0.08). Patients who received adequate first aid had a statistically significant 9.8% reduction in TBSA (95% CI -13.6% to -6.1%; P < 0.0001) as well as a 12% lower PTFI compared to patients who received inadequate first aid (95% CI -19% to -4%; P < 0.01). Whilst there was no significant effect of adequate first aid on the TBSA grafted (P = 0.37), adequate first aid was associated with a significantly less number of re-grafting sessions (95% CI --0.29 to -0.08; P < 0.001).

INTERPRETATION

Adequate first aid with 20 min of running water is associated with improved outcomes in large burn injuries. Significant benefits are seen in a reduction in TBSA, proportion of the burn wound that is full thickness, as well as decreased re-grafting. This has significant patient and health system benefits and adds to the body of evidence supporting 20 min of cooling in burns care.

First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients

BACKGROUND

Animal studies indicate treating burn injuries with running water (first aid) for 20min up to 3h post-burn reduces healing time and scarring. There is a lack of human data to support such a recommendation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes.

METHODS

Data was prospectively collected for patients with <10% total body surface area (TBSA) burns from 2007-2012. Multivariate regression analysis was used to determine the association of adequate first aid with four outcomes - wound depth, requirement for skin grafting, healing time (in non-grafted patients), and TBSA not grafted (in grafted patients). Adequate first aid was defined as the application of 20min of cool, running tap water up to 3h following the burn injury.

FINDINGS

4918 patients were identified. Adequate first aid was received in 58.1% (2859) of patients. It was associated with a statistically significant reduction in burn wound depth (OR 1.39; 95% CI 1.24-1.55; P<0.001) but was not associated with a reduction in TBSA (P=0.86) or requirement for grafting (P=0.47). In patients not requiring grafting, those who received adequate first aid were healed on average 10% (HR 1.10; 95% CI 1.03-1.18; P<0.01) or 1.9 days faster (95% CI -2.9 to -0.9; P<0.001). Adequate first aid in patients requiring grafting was associated with a 15% increase in TBSA that was not grafted (0.27%; 95% CI 0.01-0.52; P=0.04).

INTERPRETATION

Adequate first aid with 20min of running water is associated with improved outcomes. Benefits are seen in a reduction in wound depth, faster healing, and decreased grafting requirements. This has significant patient and health system benefits, and calls for promotion of 20min of running water globally in burns care.

Conhecimento de profissionais de saúde acerca do atendimento inicial intra-hospitalar ao paciente vítima de queimaduras

Resumo OBJETIVO Descrever o conhecimento de profissionais de saúde acerca do atendimento inicial intra-hospitalar ao paciente vítima de queimaduras. MÉTODO Estudo descritivo, de abordagem qualitativa, realizado em três unidades que prestam atendimento de urgência e emergência, localizadas em cidade do interior de Minas Gerais. A coleta e a análise dos dados ocorreram simultaneamente, no período de setembro a outubro de 2017. As entrevistas semiestruturadas, audiogravadas e transcritas na íntegra foram submetidas à análise de conteúdo dedutiva. RESULTADOS Participaram 31 profissionais de saúde, entre médicos, fisioterapeutas e profissionais de enfermagem. Foram elaboradas três categorias: “Experiências com queimaduras”, “Conhecimento sobre as condutas assistenciais” e “Transformação do conhecimento”. Considerações finais A maioria dos profissionais demonstrou conhecimento básico, inadequado ou desconhecimento acerca do atendimento ao paciente vítima de queimaduras, mesmo possuindo experiências profissionais, pessoais ou acadêmicas na temática. Espera-se que as evidências encontradas neste estudo contribuam para embasar ações de capacitação destes profissionais.

Practice of first aid in burn related injuries in a developing country

INTRODUCTION

First aid with cool running water reduces the severity of burn. Low level of knowledge of first aid in burns was shown in previous studies with few patients receiving first aid by water lavage. A study investigating the use of water lavage as first aid in patients presenting to hospital with burn in Lagos, Nigeria was carried out.

METHODS

Patients admitted to a University Teaching Hospital for treatment of burns were recruited for this prospective study. Data detailing demographics, scene and aetiology of burns, material used for first aid, who administered first aid, level of education and relationship of first-aider with patients, length of hospital stay, complications and outcome of treatment were collected and statistical analysis performed.

RESULTS

168 patients; 73 (43.4%) children and 95 (56.6%) adults were seen. Burns were sustained at home in 95 (74.2%) cases and outside in 33 (25.8%). Water lavage was used in 49 (29.2%) cases, raw eggs in 21 (12.5%), pap in 16 (9.5%) and other materials in 48.8%. 40 (23.8%) patients had not received any form of first aid at presentation. Patients that received no water first aid had higher complication rate (35.3% versus 18.4%) compared with those that had water first aid.

CONCLUSION AND RECOMMENDATIONS

The use of water first aid in burns was shown to reduce complication rate in this study. People should be educated on the efficacy of water first aid in pre-hospital care of burns.