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Burns in Children

Burns in Children. Evidence Based Care. Dr Amber Young a nd Miss Julia Sarginson The Healing Foundation Children’s Burns Research Centre at the Royal Bristol Hospital for Children. The Healing Foundation Children’s Burns Research Centre. www.bristol.ac.uk / childrens -burns.

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Burns in Children

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  1. Burns in Children Evidence Based Care Dr Amber Young and Miss Julia Sarginson The Healing Foundation Children’s Burns Research Centre at the Royal Bristol Hospital for Children

  2. The Healing Foundation Children’s Burns Research Centre www.bristol.ac.uk/childrens-burns

  3. The scale of the problem: An estimated 23,000 children present to Emergency Departments in the UK each year with burns and scalds Over 2/3rd are in children under 5 years old 60% scald burns (cup of tea) 30% contact burns (hair straighteners, hobs, BBQs, fires) Children’s Burns Research Centre

  4. Common injury patterns: Hot drink scalds Contact burns: Hair straighteners and irons

  5. Current research focus 99% of injuries are <20% TBSA 97% of injuries are <10% TBSA The majority of the published research is on burns of >30% TBSA

  6. Appearance concerns Small area burn, small problem? slow healing Children’s Burns Research Centre

  7. Burns in Children Focussing future research …

  8. Who should we be focussing on? Common injuries: • Small burns • Young children

  9. What should we be focussing on? • Prevention • Reduction in infection • Improvement in scarring appearance • Improved patient care pathways

  10. Burns in Children What are we already researching?

  11. Three of our studies: • SMART Dressings • The MISTIC Study • The Paediatric Burns Literature Review Project

  12. SMART Dressings Dressings that change colour in the presence of infection

  13. Morbidity In Small Thermal Injury in Children A Prospective Study into the Physiological Response to Small-to-Moderate Burn Injury, and the Diagnosis of Early Post-Burn Morbidity, in Pre-School Children.

  14. Aims: • Understand ‘typical’ physiological and biochemical responses to a small area burn in pre-school children to define the normal pathway. • Identify risk factors and differentiating symptoms, signs and biochemical variables to assist in the diagnosis of post-burn illness – pathway deviation.

  15. Design: Prospective observational cohort Population: >28 days, <5 years old Burn group:<20% TBSA, all mechanisms, all depths Comparison group:Isolated finger-tip crush injury Duration: 18 month run – Jan 2014 to July 2015 Target recruitment: Burn group: 570 participants Comparison group: 120 participants Total: 690. Children’s Burns Research Centre

  16. Birmingham Children’s Hospital Due to start Recruiting September 2014 Bristol Royal Hospital for Children Recruiting from 13th January 2014 Broomfield Hospital, Chelmsford Recruiting from 4th June 2014

  17. Data Collection • Prospective information from medical notes • Parental Questionnaires • Parent recorded temperature diaries • 6 week post-injury follow-up telephone call

  18. Paediatric Burns Literature Review Project • Aims: • To inform evidence-based care • To identify areas where research and evidence is lacking • To compare published research in small area burns in children to other childhood injury and adult burn care • All published articles on burns in children from 1960s • Categorisation: • Topic area / sub-theme • Type of article or research study NB – This is not a Systematic Review

  19. Burns in Children Where next?

  20. Discussion • Very little evidence based care for this common childhood injury • Very little published literature • Different care pathways across the country • Varying practice in the management of small burns and scalds

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