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

An artificial intelligence language model improves readability of burns first aid information

AIMS

This study aimed to assess the potential of using an artificial intelligence (AI) large language model to improve the readability of burns first aid information.

METHODS

An AI language model (ChatGPT-3) was used to rewrite content from the top 50 English-language webpages containing burns first aid information to be understandable by an individual with the literacy level of an 11-year-old, as recommended by the American Medical Association and Health Education England. The assessment of readability was conducted using five validated tools.

RESULTS

In their original form, only 4% of the patient education materials (PEMs) met the target readability level across all tools. The median grade was 6.9 (SD=1.1). One-sample one-tailed t-test revealed that this was not significantly below the target (p = .31). After AI-modification, 18% of PEMs reached the target level using all tools, with a median grade of 6 (SD=0.9), which was significantly below the target level (p < .001). Once rewritten using AI, paired t-test demonstrated that all readability scores improved significantly (p < .001).

CONCLUSION

Utilising an AI language model proved an effective and viable method for enhancing readability of burns first aid information.

Consensus on the treatment of second-degree burn wounds (2024 edition)

Second-degree burns are the most common type of burn in clinical practice and hard to manage. Their treatment requires not only a consideration of the different outcomes that may arise from the dressing changes or surgical therapies themselves but also an evaluation of factors such as the burn site, patient age and burn area. Meanwhile, special attention should be given to the fact that there is no unified standard or specification for the diagnosis, classification, surgical procedure, and infection diagnosis and grading of second-degree burn wounds. This not only poses great challenges to the formulation of clinical treatment plans but also significantly affects the consistency of clinical studies. Moreover, currently, there are relatively few guidelines or expert consensus for the management of second-degree burn wounds, and no comprehensive and systematic guidelines or specifications for the treatment of second-degree burns have been formed. Therefore, we developed the Consensus on the Treatment of Second-Degree Burn Wounds (2024 edition), based on evidence-based medicine and expert opinion. This consensus provides specific recommendations on prehospital first aid, nonsurgical treatment, surgical treatment and infection treatment for second-degree burns. The current consensus generated a total of 58 recommendations, aiming to form a standardized clinical treatment plan.

Readability, accountability, and quality of burns first aid information available online

AIM

To assess the readability, accountability, and quality of burns first aid information available online.

METHODS

The top 50 English language webpages containing burns first aid information were compiled and categorised. Readability was measured using five validated tools. Accountability was assessed using the Journal of the American Medical Association (JAMA) benchmarks. Quality was evaluated using a scale based on previous literature.

RESULTS

Two (4%) webpages were judged to be at the target reading level using all tools. Median grade ranged from 4.6 to 9.6 (M = 6.9, SD = 1.1). One-sample one-tailed t-test determined that median grade was not significantly below the target grade of ≤ 6.9 (p = 0.314). Only seven (14%) webpages satisfied all the JAMA accountability benchmarks. No webpages fulfilled all 15 quality criteria. Mean quality score was 9.8 (SD = 2.4). Only 27 (54%) advised 20 min of cooling. One-way analysis of variance demonstrated that accountability was influenced by source (p = 0.01). Pearson's correlation coefficient revealed that accountability and quality had a positive correlation (r = 0.32, p = 0.02).

CONCLUSION

Much of the burns first aid information available online is written above the recommended reading level and fails to meet standards of accountability or quality.

Duration of cooling with water for thermal burns as a first aid intervention: A systematic review

BACKGROUND

Cooling thermal burns with running water is a recommended first aid intervention. However, guidance on the ideal duration of cooling remains controversial and inconsistent across organisations.

AIM

To perform a systematic review of the evidence for the question; Among adults and children with thermal burn, does active cooling using running water as an immediate first aid intervention for 20 min or more, compared with active cooling using running water for any other duration, change the outcomes of burn size, burn depth, pain, adverse outcome (hypothermia) or complications?

METHOD

We searched Medline, Embase, Cochrane Database of Systematic Reviews and used ROBINS-I to assess for risk of bias. We used Grading of Recommendations, Assessment, Development and Evaluation methodology for determining the certainty of evidence. We included all studies that compared the selected outcomes of the duration of cooling of thermal burns with water in all patient ages. (PROSPERO registration number: CRD42021180665). From 560 screened references, we included four observational studies. In these studies, 48% of burns were cooled for 20 min or more. We found no benefit for a duration of 20 min or more of cooling when compared with less than 20 min of cooling for the outcomes of size and depth of burn, re-epithelialization, or skin grafting. The evidence is of very low certainty owing to limitations in study design, risk of bias and indirectness.

CONCLUSION

The optimal duration of cooling for thermal burns remains unknown and future prospective research is indicated to better define this treatment recommendation.

Common mistakes in the choice of topical agents for emergency care of burns: Experimental study

The aim of the research was a histological study of the tissue structure of experimental animals with burns in dynamics using various topical agents after the injury. Experimental simulation of burn injuries was performed on 40 rats, which were divided into the main and control groups. Depending on the nature of care provided, the animals of the main group were divided into subgroups: in the 1st subgroup a uniform layer of sunflower oil was applied, in the 2nd subgroup dexpanthenol was sprayed, in the 3rd subgroup prompt neutralization of traumatic action was performed with a gauze napkin soaked in water. Animals from the control group were not treated. The examination involved a histological study. The results confirmed the negative impact of applying oil to the burnt area as a means of first aid, which caused more pronounced degenerative changes of the dermis and its structures with the involvement of hypodermis in the pathological process, prolonging the duration of healing. As for the use of dexpanthenol spray for burn injuries, the histological changes of tissues did not differ much from those in animals of the control group, which did not receive any care. At the same time, histological findings of the tissues of animals treated with moistened wipes was characterized by less pronounced pathological changes. Histological analysis of tissue changes of the burnt area in dynamics objectively proved the effectiveness of water as the main pathogenetic element of emergency care in an experiment.