Burn care in practice‘Baby-walker’ frames: a preventable factor in infant burns
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Analysis of burns caused by pre-filled gas canisters used for lamps or portable camping stoves
2006, BurnsThe use of pre-filled valveless gas canisters for lamps or camping stoves has caused a number of serious burn incidents. We performed a retrospective analysis of all of the patients who were victims of such incidents admitted to the Marseille Burn Centre between January 1990 and March 2004. There were a total of 21 patients burned in such conditions.
Adult males made up the majority of the victims of this sort. Lesions were often extensive (60% of the patients were burned over more than 10% of their body surface) and systematically deep. In order of frequency, burn locations were: the lower limbs, the upper limbs, the hands and the face. The incidents principally occurred during replacement of the canister near an open flame.
The marketing of a canister with a valve in order to avoid gas leaks did not cause the old canisters to be taken off the market. On the contrary, European Safety Standard EN417, updated in October 2003, validated the use of these valveless canisters.
The severity of the lesions caused and the existence of safe equivalent products requires the passage of a law that forbids valveless canisters.
A retrospective study was performed at the Yorkshire Regional Burns Centre from 1994 to 2004 inclusive to determine the changes in treatment and clinical outcomes of patients admitted with hot beverage burns and the effect of changes in referral patterns over this period. Although children under the age of 3 years accounted for 77.5% of all cases of hot beverage scalds, this injury was represented in all age groups. Children from 1 to 2 years of age had the highest incidence of this injury. Changes in referral patterns over this period resulted in a decrease in the mean total body surface area of injury, an increase in the number of admissions and an increase in the time interval from injury to admission to the Burns Centre for this period. The total body surface area given by referring facilities was oftentimes inaccurate, as reported previously by this Burns Centre. The introduction of Biobrane in 2002 was effective in reducing the length of hospitalisation for patients with superficial partial thickness burns. Hot beverage burns remain a significant public health problem deserving of continuing efforts to maintain public awareness.
Landmarks in burn prevention
2000, BurnsThe objective of this paper is to highlight landmarks in burn prevention. Novel strategies in the areas of law and regulation, environmental and consumer product design, and educational programs are identified and discussed. Notwithstanding marked reductions in burn morbidity and mortality, especially in economically developed countries, burn injuries remain an important public health concern throughout the world. More, and more effective, burn prevention programs coupled with renewed efforts to reduce the social and environmental correlates of burn injuries (poverty, overcrowding, family stress, and educational deficits) are needed to further reduce burn incidence and its long-term sequelae.
Baby walkers have been implicated in many forms of paediatric trauma, ranging from finger tip entrapment to severe head injury. Their relationship to childhood burns has been documented previously. The Department of Trade and Industry published further warnings in 1984 and the British Standards Institution in 1989. We wished to determine if the degree or frequency of thermal injury had been lessened by these recommendations.
All parents of children under 15 months of age admitted to this unit in 1994 were asked if their child was in a baby walker at the time of injury. Eight of the 32 infants, aged between 6 and 12 months, were burned in their walking aid. Half of the burns were contact and half scalds, and the average in-patient stay was 8 days. One patient required formal resuscitation and three were grafted.
The incidence and severity of thermal injury sustained in baby walkers remains at a high level despite increased safety measures. Perhaps it is time to concur with the American Academy of Paediatrics and recommend a ban on these dangerous aids.
This restrospective study of paediatric burns in the Lothian region involved a review of 1114 case notes of children up to the age of 12 years, treated for burns as inpatients and outpatients, during a 3-year period between 1988 and 1990. There were more boys than girls and 79 per cent were below 5 years of age. 71.5 per cent were treated as outpatients only, whereas 28.5 per cent were admitted. The Lothian region had the highest incidence of burns of children in Scotland. There has been a statistically significant downward linear trend in burn rates and admissions in Scotland during the 20 years but in this hospital burns admissions have significantly diminished only since 1987. The number of flame burns has declined and a high proportion of the victims were scalded. Efforts need to be made to reduce the large number of scalds by educational and legislative measures.
Contact burns in children
1989, BurnsForty-seven children under the age of 5 years admitted for contact burns into the Burns Unit of the Birmingham Accident Hospital during the period 1981–1988 were reviewed. Contact burns formed only 3.93 per cent of all the thermal injuries seen in this age group for the same period. Most of the children were between 1 and 2 years of age and the hands and face were more frequently burned. The hot electric iron was the commonest cause of burns in the study. Although the sizes of the burns were generally small, the potential scarring and disability were recognized and this influenced the management. The prevention of contact burns from hot electric irons has been discussed and the need to look out for non-accidental injuries emphasized.