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Nassar JY, Al Qurashi AA, Albalawi IA, Nukaly HY, Halawani IR, Abumelha AF, Osama Al Dwehji AM, Alhartani MM, Asaad A, Alnajashi A, Khojah IM. Pediatric Burns: A Systematic Review and Meta-Analysis on Epidemiology, Gender Distribution, Risk Factors, Management, and Outcomes in Emergency Departments. Cureus 2023; 15:e49012. [PMID: 38111412 PMCID: PMC10726077 DOI: 10.7759/cureus.49012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/20/2023] Open
Abstract
Pediatric burns pose a significant public health concern, ranking as the fifth most common nonfatal injury globally. This review consolidates data on the epidemiology, outcomes, and management of pediatric burns presenting to emergency departments. A systematic review was conducted across multiple databases, yielding 22 articles from 1992 to 2020. Utilizing the methodological index for non-randomized studies (MINORS) instrument, non-comparative studies scored from 2 to 11 with an average of 6.87, while comparative studies ranged from 12 to 16, averaging 13.67. The review included a total of 828,538 pediatric patients who were evaluated in the systematic review. Predominantly male victims ranged from 53% to 83%. The youngest victims were aged between 0 to 4 years. Burn etiology was largely attributed to scalds. A majority suffered from second-degree burns, with some studies reporting up to 89%. Limited data on total body surface area (TBSA) were documented, with only 2.5% requiring hospitalization. Common interventions included immediate resuscitation and skin grafting. Essential areas for future research are identified, including household risks, pre-treatment decisions, and the significant role of family dynamics in burn injury recovery. Pediatric burns remain a considerable concern, particularly among males and in household environments. The data underline the imperative for prevention strategies and optimized emergency care to positively influence outcomes for burn victims. Future research areas range from evaluating pre-treatment decisions to assessing community awareness regarding burn first aid.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alanoud Asaad
- Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | - Arwa Alnajashi
- Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | - Imad M Khojah
- Emergency Medicine, King Abdulaziz University, Jeddah, SAU
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AKTAÇ Ş, BAŞOĞLU İA, CEBECİ A, OGUZ E, ÖMEROĞLU B. DETERMINATION OF ENERGY AND NUTRIENT INTAKES IN PEDIATRIC BURNED PATIENTS. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.750048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Using Weather, Lunar Cycles, and Time of Year to Predict Trauma Incidents in an Urban, Level I Pediatric Trauma Center. J Trauma Nurs 2021; 28:84-89. [PMID: 33667202 DOI: 10.1097/jtn.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Trauma patterns in adults are influenced by weather conditions, lunar phases, and time of year. The extent to which these factors contribute to pediatric trauma is unclear. OBJECTIVE The present study aimed to review patients from a single Level I pediatric trauma center to determine the influence of weather, the lunar cycle, and time of year on trauma activity. METHODS A retrospective review of trauma activations (n = 1,932) was conducted from 2015 to 2017. Injury type and general demographics were collected. Weather data and lunar cycles were derived from historical databases. RESULTS Days with no precipitation increased the total number of injuries of all types compared with those with precipitation (p < .001). Blunt and penetrating injuries were more likely to occur during full moons, whereas burn injuries were significantly higher during new moons (p < .001). Blunt trauma was significantly higher in September than all other months, F(11, 1,921) = 4.25, p < .001, whereas January had a significantly higher number of burns than all other months (p < .001). CONCLUSIONS Pediatric trauma trends associated with external factors such as weather, lunar cycles, and time of year can inform hospital staffing decisions in anticipation of likely injuries and help direct injury prevention efforts.
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Piastra M, Picconi E, Morena TC, Brasili L, Pizza A, Luca E, Tortorolo L, De Luca D, Cati G, Conti G, De Bellis A. Weaning of Children With Burn Injury by Noninvasive Ventilation: A Clinical Experience. J Burn Care Res 2020; 40:689-695. [PMID: 31032522 DOI: 10.1093/jbcr/irz068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The aim of this study was to report the respiratory management of a cohort of infants admitted to a Pediatric Intensive Care Unit (PICU) over a 7-year period due to severe burn injury and the potential benefits of noninvasive ventilation (NIV). A retrospective review of all pediatric patients admitted to PICU between 2009 and 2016 was conducted. From 2009 to 2016, 118 infants and children with burn injury were admitted to our institution (median age 16 months [IQR = 12.2-20]); 51.7% of them had face burns, 37.3% underwent tracheal intubation, and 30.5% had a PICU stay greater than 7 days. Ventilated patients had a longer PICU stay (13 days [IQR = 8-26] vs 4.5 days [IQR = 2-13]). Both ventilation requirement and TBSA% correlated with PICU stay (r = .955, p < .0001 and r = .335, p = .002, respectively), while ventilation was best related in those >1 week (r = .964, p < .0001 for ventilation, and r = -.079, p = .680, for TBSA%). NIV was introduced in 10 patients, with the aim of shorten the invasive ventilation requirement. As evidenced in our work, mechanical ventilation is frequently needed in burned children admitted to PICU and it is one of the main factors influencing PICU length of stay. No difference was found in terms of PICU length of stay and invasive mechanical ventilation time between children who underwent NIV and children who did not, despite children who underwent NIV had a larger burn surface. NIV can possibly shorten the total invasive ventilation time and related complications.
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Affiliation(s)
- Marco Piastra
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Enzo Picconi
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tony C Morena
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Brasili
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Pizza
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ersilia Luca
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tortorolo
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals APHP, France
| | - Gabriele Cati
- Plastic Surgery and Pediatric Burn Unit, "S. Eugenio" Hospital RmC, Rome, Italy
| | - Giorgio Conti
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Anesthesiology and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea De Bellis
- Plastic Surgery and Pediatric Burn Unit, "S. Eugenio" Hospital RmC, Rome, Italy
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Zhao R, Zhang Y, Ning F, Cao Y, Zang C, Yin S, Song R, Jiang H, Wang Y. Nationwide web survey of pediatric scalds: Prevalence and the relationship with household vacuum flasks. Burns 2017; 44:318-325. [PMID: 29032981 DOI: 10.1016/j.burns.2017.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/01/2017] [Accepted: 08/08/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To explore the prevalence of pediatric (0-72 months old) scalds, and to clarify its relationship with household vacuum flasks. METHODS A cross sectional online survey based on the largest social media in China. Online questionnaire was pushed twice a day to our target respondents for successive seven days. We were authorized to gain, analyze and publish the information related to this research by the Sina & Weibo data center. RESULTS Prevalence of pediatric scalds was 5.5%. Gender ratio (boy to girl) was 1.96:1. Toddlers (12-36 months old) were the most susceptible age group (54.5%). Non-intentional water spill was the main causation (77.3%). An extremely low percent (7.1%) of the parents performed first-aid as described by the "RRICH" rule: water rinse - clothes remove - water immersion - clean cover - hospital. Scars developed in 52.7% patients and 14.7% of them underwent reconstructive surgery. There were 75.5% Chinese families using vacuum flasks in daily life, but only 6.1% families used the fastening device to avoid burns. CONCLUSION Prevalence of pediatric scalds (0-72 months old) was rather high, which might be related to the extensive insecure usage of household vacuum flasks.
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Affiliation(s)
- Ran Zhao
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Yuehou Zhang
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Fanggang Ning
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing, PR China
| | - Yongqian Cao
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Chengyu Zang
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Siyuan Yin
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Ru Song
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Hang Jiang
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China
| | - Yibing Wang
- Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, PR China.
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Johnson E, Maguire S, Hollén L, Nuttall D, Rea D, Kemp A. Agents, mechanisms and clinical features of non-scald burns in children: A prospective UK study. Burns 2017. [DOI: 10.1016/j.burns.2017.01.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sahu SA, Agrawal K, Patel PK. Scald burn, a preventable injury: Analysis of 4306 patients from a major tertiary care center. Burns 2016; 42:1844-1849. [DOI: 10.1016/j.burns.2016.06.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 06/13/2016] [Accepted: 06/17/2016] [Indexed: 11/30/2022]
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Stewart J, Benford P, Wynn P, Watson MC, Coupland C, Deave T, Hindmarch P, Majsak-Newman G, Kendrick D. Modifiable risk factors for scald injury in children under 5 years of age: A Multi-centre Case-Control Study. Burns 2016; 42:1831-1843. [PMID: 27576925 DOI: 10.1016/j.burns.2016.06.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/18/2016] [Accepted: 06/24/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. METHODS Multicentre matched case-control study in acute hospitals, minor injury units and GP practices in four study centres in England. Cases comprised 338 children under 5 presenting with a scald, and 1438 control participants matched on age, gender, date of event and study centre. Parents/caregivers completed questionnaires on safety practices, safety equipment use, home hazards and potential confounders. Odds ratios were estimated using conditional logistic regression. RESULTS Parents of cases were significantly more likely than parents of controls to have left hot drinks within reach of their child (adjusted odds ratio (AOR) 2.33, 95%CI 1.63 to 3.31; population attributable fraction (PAF) 31%). They were more likely not to have taught children rules about climbing on kitchen objects (AOR 1.66, 95%CI 1.12 to 2.47; PAF 20%); what to do or not do when parents are cooking (AOR 1.95, 95%CI 1.33 to 2.85; PAF 26%); and about hot things in the kitchen (AOR 1.89, 95%CI 1.30 to 2.75; PAF 26%). CONCLUSIONS Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children.
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Affiliation(s)
- Jane Stewart
- Nottinghamshire Healthcare NHS Foundation Trust, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, United Kingdom.
| | - Penny Benford
- Faculty of Medicine and Health Sciences, University of Nottingham, Division of Primary Care, 13(th) Floor, Tower Building, University Park, Nottingham NG72RD, United Kingdom
| | - Persephone Wynn
- Faculty of Medicine and Health Sciences, University of Nottingham, Division of Primary Care, 13(th) Floor, Tower Building, University Park, Nottingham NG72RD, United Kingdom
| | - Michael Craig Watson
- Faculty of Medicine and Health Sciences, University of Nottingham, School of Health Sciences, D1019, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom
| | - Carol Coupland
- Faculty of Medicine and Health Sciences, University of Nottingham, 13(th) Floor, Tower Building, University of Nottingham NG72RD, United Kingdom
| | - Toity Deave
- Centre for Child & Adolescent Health, Faculty of Health & Life Sciences, University of the West of England Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Paul Hindmarch
- Institute of Health & Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, United Kingdom
| | - Gosia Majsak-Newman
- Norfolk and Norwich University Hospitals NHS Foundation Trust, NHS Clinical Research & Trials Unit, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Denise Kendrick
- Faculty of Medicine and Health Sciences, University of Nottingham, 13(th) Floor, Tower Building, University of Nottingham NG72RD, United Kingdom
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Bayramoglu A, Sener MT, Cakir Z, Aslan S, Emet M, Akoz A. Characteristics of Patients Who Admitted to the Emergency Department Because of Burns Due to Dens Liquids Such as Hot Milk/Oil. Eurasian J Med 2015; 48:20-3. [PMID: 27026759 DOI: 10.5152/eurasianjmed.2015.34] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 03/24/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Burn is the tissue damage on body caused due to various reasons. Although all burns caused by hot liquids are investigated as scalding burns, dense liquid burns (DLB) caused by such as milk and oil are different from other burns. The aim of this study was to report the properties of DLB. MATERIALS AND METHODS Patients admitted to the Emergency Service of Atatürk University Hospital, with DLB from June 2003 to December 2008, were examined retrospectively. RESULTS During the study, 28 DLB patients were admitted to the emergency service. The most common admission were found in autumn 28.6% (n=8), and in May and June, 17.9% (n=5). The frequency of burns on the right upper extremity was seen in 50% (n=14) of the patients. The burn degree of all patients was determined as 2(nd) degree. Seventy-five percent (n=21) of the patients were discharged, 14.3% (n=4) were hospitalized. None of the patients died. CONCLUSION Dense liquid burns is a burn type that is commonly seen in women, absolutely causing 2(nd) degree burns, frequently reported in upper extremity and head/neck regions, and in contrast to other studies, in our region it is completely seen in patients living in city centre.
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Affiliation(s)
- Atif Bayramoglu
- Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey
| | - M Talip Sener
- Department of Forensic Medicine, Atatürk University School of Medicine, Erzurum, Turkey
| | - Zeynep Cakir
- Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey
| | - Sahin Aslan
- Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey
| | - Mucahit Emet
- Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey
| | - Ayhan Akoz
- Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey
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Clifton LJ, Chong LW, Stewart K. Identification of factors that predict outpatient utilisation of a Plastic Dressing Clinic. A retrospective review of 287 paediatric burn cases. Burns 2015; 41:469-75. [PMID: 25239847 DOI: 10.1016/j.burns.2014.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 07/29/2014] [Accepted: 08/20/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Laura J Clifton
- Plastic Surgery Department, Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh, Midlothian EH9 1LF, Scotland, United Kingdom.
| | - Lee W Chong
- Plastic Surgery Department, Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh, Midlothian EH9 1LF, Scotland, United Kingdom
| | - Ken Stewart
- Plastic Surgery Department, Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh, Midlothian EH9 1LF, Scotland, United Kingdom
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Chotai N, Edmonds K, Dheansa B. More green tea vicar? Burns 2013; 39:1498. [PMID: 23831169 DOI: 10.1016/j.burns.2013.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 05/19/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Neil Chotai
- McIndoe Burns Centre, Queen Victoria Hospital, East Grinstead RH19 3DZ, UK.
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Koletzko B, Shamir R, Ashwell M. Quality and safety aspects of infant nutrition. ANNALS OF NUTRITION AND METABOLISM 2012; 60:179-84. [PMID: 22699763 DOI: 10.1159/000338803] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health.
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Affiliation(s)
- Berthold Koletzko
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Lindwurmstrasse 4, Munich, Germany.
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The severity of kettle burns and the dangers of the dangling cord. Burns 2012; 38:453-8. [DOI: 10.1016/j.burns.2011.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 09/01/2011] [Accepted: 09/05/2011] [Indexed: 11/20/2022]
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de Ramirez SS, Hyder AA, Herbert HK, Stevens K. Unintentional injuries: magnitude, prevention, and control. Annu Rev Public Health 2012; 33:175-91. [PMID: 22224893 DOI: 10.1146/annurev-publhealth-031811-124558] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The World Health Organization estimates injuries accounted for more than 5 million deaths in 2004, significantly impacting the global burden of disease. Nearly 3.9 million of these deaths were due to unintentional injury, a cause also responsible for more than 138 million disability-adjusted life years (DALYs) lost in the same year. More than 90% of the DALYs lost occur in low- and middle-income countries (LMICs), highlighting the disproportionate burden that injuries place on developing countries. This article examines the health and social impact of injury, injury data availability, and injury prevention interventions. By proposing initiatives to minimize the magnitude of death and disability due to unintentional injuries, particularly in LMICs, this review serves as a call to action for further investment in injury surveillance, prevention interventions, and health systems strengthening.
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Epidemiology and disposition of burn injuries among infants presenting to a tertiary-care pediatric emergency department. Pediatr Emerg Care 2011; 27:1022-6. [PMID: 22068061 DOI: 10.1097/pec.0b013e318235e0e4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of the study was to study the etiology of and factors determining the emergency department disposition of infants sustaining burn injuries. METHODS A retrospective chart review was performed on all patients 12 months or younger with a burn injury presenting to our emergency department over a 5-year period. We collected the chief complaint and diagnosis, patient demographics, and circumstances surrounding the burn injury from the emergency department charts. Univariable statistics, multiple imputation, and multivariable regression were performed to determine differences between races and factors leading to admission. RESULTS During the study period, 344 patients meeting inclusion criteria were treated in our emergency department. Scalds (53.2%) and contact burns (39.8%) were the most common causes of burns among the study group. Significant differences were observed between races for mechanism of burn, interhospital transport, and total body surface area affected (P < 0.05). White patients were more likely to have higher body surface affected and to be transferred from another facility (P < 0.05). Increased severity of burn, burns located on the hand, and concern for abuse resulted in higher likelihood of admission (P < 0.01). No significant differences in disposition or mechanism of burn were present between English-speaking and non-English-speaking patients. CONCLUSIONS Although most infant burns in our emergency department are due to scalds, burn injuries due to contact with household objects are common. Race plays a significant role in mechanism and severity of burn sustained. Increased severity of burn, concern for abuse, and burn to the hand were all associated with increased odds of admission.
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Respiratory failure after pediatric scald injury. J Pediatr Surg 2011; 46:1753-8. [PMID: 21929985 DOI: 10.1016/j.jpedsurg.2011.04.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 04/19/2011] [Accepted: 04/20/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE A subset of children with scald burns develops respiratory failure despite no direct injury to the lungs. We examined these patients in an effort to elucidate the etiology of the respiratory failure. METHODS The charts of pediatric patients with greater than 10% total body surface area (TBSA) scald burns were reviewed. Age, weight, burn distribution, percentage of TBSA burned, resuscitation volumes, Injury Severity Score, evidence of abuse, length of stay, days in the intensive care unit, and time and duration of intubation were recorded. RESULTS Two hundred thirty-two patients met our inclusion criteria. Of these, 220 patients did not require intubation, and 12 of the patients did. No patient older than 3 years or with burns less than 15% TBSA required intubation. Fluid over resuscitation was not directly associated with respiratory failure requiring mechanical ventilation. CONCLUSIONS We report the largest published series of patients with scald burns requiring mechanical ventilation in the absence of direct airway injury. Five percent of pediatric patients required mechanical ventilation after scald injury. We believe that a combination of causes including fluid resuscitation, young patient age, small patient size, and possible activation of the systemic inflammatory immune response may be responsible for the respiratory failure.
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Chandran A, Hyder AA, Peek-Asa C. The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev 2010; 32:110-20. [PMID: 20570956 DOI: 10.1093/epirev/mxq009] [Citation(s) in RCA: 273] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
According to the World Health Organization, unintentional injuries were responsible for over 3.9 million deaths and over 138 million disability-adjusted life-years in 2004, with over 90% of those occurring in low- and middle-income countries (LMIC). This paper utilizes the year 2004 World Health Organization Global Burden of Disease Study estimates to illustrate the global and regional burden of unintentional injuries and injury rates, stratified by cause, region, age, and gender. The worldwide rate of unintentional injuries is 61 per 100,000 population per year. Overall, road traffic injuries make up the largest proportion of unintentional injury deaths (33%). When standardized per 100,000 population, the death rate is nearly double in LMIC versus high-income countries (65 vs. 35 per 100,000), and the rate of disability-adjusted life-years is more than triple in LMIC (2,398 vs. 774 per 100,000). This paper calls for more action around 5 core areas that need research investments and capacity development, particularly in LMIC: 1) improving injury data collection, 2) defining the epidemiology of unintentional injuries, 3) estimating the costs of injuries, 4) understanding public perceptions about injury causation, and 5) engaging with policy makers to improve injury prevention and control.
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Affiliation(s)
- Aruna Chandran
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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