Factors Implicated in Safety-related Firefighter Fatalities
Firefighting is wrought with risk, as 80–100 firefighters (FFs) die on the job each year in the United States. Many of the fatalities have been analyzed by the National Institute for Occupational Safety and Health (NIOSH) to determine contributing factors. The purpose of this study is to determine variables that put FFs at risk for potentially preventable workplace mortality such as use of personal protective equipment (PPE), seat belts, and appropriate training/fitness/clearance for duty. The NIOSH FF Fatality Database reports from 2009 to 2014 were analyzed. Data including age, gender, years on the job, weather, other ...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Effect of Fireworks Laws on Pediatric Fireworks-Related Burn Injuries
We examined inpatient admissions for pediatric firework-related burn patients from 2006 to 2012 using the nationwide inpatient sample and examined emergency department admissions using the nationwide emergency department sample. Both data sources are part of the Healthcare Cost and Utilization Project. Trajectories over time were evaluated. A total of 3193 injuries represented an estimated 90,257 firework-related injuries treated in the United States from 2006 to 2012. A majority of injuries were managed in the emergency department (n = 2008, 62.9%). The incidence generally increased over time; increasing from 4.28 per 100...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
An Intervention Bundle to Facilitate Return to Work for Burn-Injured Workers: Report From a Burn Model System Investigation
Rates of return to work (RTW) after burn injury vary. A 2012 systematic review of the burn literature reported that nearly 28% of all adult burn survivors never return to any form of employment. These authors called for interventions designed to assist survivors’ ability to function in an employed capacity. In 2010, our burn center outpatient clinic instituted an intervention aimed to return injured workers to employment within 90 days of their insurance claims. The interventions include patient/family education focused on recovery rather than disability, employer contact and education by the vocational rehabilitation (V...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Profile of Patients Without Burn Scar Contracture Development
This study challenges the rehabilitation personnel to expand the upper limit of burn severity that can result in similar positive outcomes. (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
A Comparative Examination of the Clinical Outcome and Histological Appearance of Cryopreserved and Fresh Split-Thickness Skin Grafts
The clinical use of frozen, human allogeneic skin grafts is considered a suitable alternative to freshly harvested allogeneic skin grafts when the latter are not available. However, limited functional and histological information exists regarding the effects of cryopreservation on allogeneic skin grafts, especially those across mismatched histocompatibility barriers. Thus, we performed a side-by-side comparative study of fresh vs frozen skin grafts, across both minor and major histocompatibility barriers, in a miniature swine model. Since porcine skin shares many physical and immunological properties with human skin, our f...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Sedation and Analgesia for Dressing Change: A Survey of American Burn Association Burn Centers
Pain and sedation management for patients undergoing burn dressing change can be challenging. Variations appear to exist in the selection of medications before and during burn dressing change. To determine if institutional variations exist in pain and sedation management for burn dressing change, an online survey was sent to ABA Burn Center nurses and physicians. Three hundred seventy-eight anonymous responses were received from nurses (72%), nurse practitioners (10%), and physicians (18%). Burn centers had adult (22%), pediatric (12%), or pediatric and adult (66%) patients. Eighty percentage of centers had>200 patients/ye...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
2.5% Mafenide Acetate: A Cost-Effective Alternative to the 5% Solution for Burn Wounds
This study aims to evaluate outcomes and cost associated with the use of 2.5 vs 5% mafenide acetate formulation in the adult burn population. Adult patients (≥18 years) receiving 2.5% mafenide acetate during an 11-month period between 2014 and 2015, corresponding to a policy change in favor of the use of 2.5% mafenide acetate, were queried. Historical controls, patients receiving 5% mafenide acetate, were also reviewed during an 11-month period between 2013 and 2014. A retrospective review was performed comparing wound infection rate, bacteremia, sepsis, pneumonia, duration of mafenide therapy, length of hospital stay, m...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Anesthetic Practices for Laser Rehabilitation of Pediatric Hypertrophic Burn Scars
The objective of this quality improvement study is to determine whether a difference exists in postoperative pain outcomes in pediatric patients who receive intraoperative opioid regimens compared with patients who receive opioid-sparing regimens for laser therapy of hypertrophic burn scars. A retrospective review of patients who received laser therapy at a pediatric burn center from April 2014 to May 2015 was performed. Overall, 88 of the 92 procedures reviewed were included. A statistically significant difference was not found between the likelihood of postoperative pain when intraoperative opioid regimens (n = 63) were ...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Quantitative Analysis of Estimated Burn Size Accuracy for Transfer Patients
The objective of this study was to quantify differences between estimated TBSA from referring hospitals vs calculated TBSA in the burn unit in regards to several variables. We conducted a retrospective review of 735 burn patients admitted over a 17-month period. Three hundred twenty-six patients fit the criteria of transfers with recorded %TBSA estimations from referring hospitals. Referring %TBSA was compared with actual %TBSA, and the difference was expressed as a percentage of actual %TBSA. This was then used to group referring estimations as underestimated (less than −25%), satisfactory (−25 to 25%), or overestimat...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Evaluating Pre Burn Center Intubation Practices: An Update
A significant proportion of patients appeared to arrive at our American Burn Association-verified burn center intubated without clear benefit. The current study aims to evaluate regional prehospital intubation practices and their outcomes. All consecutive admissions from November 2012 to June 2014 were reviewed for data points associated with intubation. Demographics and outcomes for patients who were intubated before arrival or within 24 hours of admission were compared using χ2, Fisher’s exact test, and the Kruskal–Wallis test as appropriate. During this period, 958 patients were admitted. Of these, 120 were intubat...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Transcriptional Analysis Reveals Evidence of Chronically Impeded ECM Turnover and Epithelium-to-Mesenchyme Transition in Scar Tissue Giving Rise to Marjolin’s Ulcer
This study aimed to elucidate transcriptional changes leading to malignancy by investigating differentially expressed genes in squamous cells present in a SCC compared with MU. MU tumor cells were isolated from histologically confirmed biopsy of SCC within an unhealed burn scar. Epithelial cells (ECs) adjacent to the tumor were co-isolated and a SCC cell line was commercially purchased. mRNA from all three samples was isolated and its expression was quantified using RNASeq. A threshold of log2fold change>2-fold in either direction was considered “differentially expressed.” Gene expression analysis revealed distinct dif...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Case Report: 2016 ABA Paper Source Type: research
Low Vitamin D Level on Admission for Burn Injury Is Associated With Increased Length of Stay
Currently, there have been few studies that have evaluated the incidence of vitamin D deficiency in adult burn patients or correlated vitamin D levels with burn-related outcomes. The primary objective of the study was to identify the incidence of vitamin D deficiency and insufficiency in an adult burn population. The secondary objective was to determine the impact of vitamin D deficiency and insufficiency on clinical outcomes in burn care. A single-center, retrospective, and observational cohort analysis of adult patients admitted for initial management of burn injury, who had a 25-hydroxyvitamin D (25D) level measured on ...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: 2016 Clinical Research Award Source Type: research
The Psychological Impact of First Burn Camp in Nicaragua
Asociacion Pro-Ninos Quemados de Nicaragua (APROQUEN) is a comprehensive burn center that provides a holistic and integrated approach to treating burns. APROQUEN has set the standards internationally with acute treatment for burns, intensive care, reconstructive surgeries, nutritional care, rehabilitation, occupational therapy, and psychological treatment. APROQUEN is excelling within Central and South America with life-saving techniques and quality of care. It is imperative that burn centers in Central America recognize that the treatment of a child with a burn injury surpasses physical care to include psychological treat...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: 2016 ABA/Shriners Best Pediatric Burn Paper Award Source Type: research
Time Matters in Severe Frostbite: Assessment of Limb/Digit Salvage on the Individual Patient Level
Severe frostbite is associated with high levels of morbidity through loss of digits or limbs. The aim of this study was to examine the salvage rate following severe frostbite injury. Frostbite patients from 2006 to 2014 were identified in the prospectively maintained database at a single urban burn and trauma center. Patients with imaging demonstrating a lack of blood flow in limbs/digits were included in the analysis (N = 73). The Hennepin Frostbite Score was used to quantify frostbite injury and salvage. This score provides a single value to assess each individual patient’s salvage rate. The majority of patients with p...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
Outcomes Following the Use of Nebulized Heparin for Inhalation Injury (HIHI Study)
Inhalation injury (IHI) causes significant morbidity and mortality in burn victims due to both local and systemic effects. Nebulized heparin promotes improvement in lung function and decreased mortality in IHI by reducing the inflammatory response and fibrin cast formation. The study objective was to determine if nebulized heparin 10,000 units improves lung function and decreases mechanical ventilation duration, mortality, and hospitalization length in IHI with minimal systemic adverse events. This retrospective, case–control study evaluated efficacy and safety of nebulized heparin administered to mechanically ventilated...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles: 2016 ABA Papers Source Type: research
