Epidemiology and outcome analysis of 208 children with burns attending an emergency department

Abstract

Objective: The purpose of this study was to prospectively study all burns attending a single inner city emergency department (ED) to establish epidemiological burn patterns and final outcomes for thermal injuries affecting children.

Design and setting: A 12-month prospective study of all burns involving children (ages, 0-16 years) presenting to a single ED serving approximately 500,000 people.

Results: Two hundred eight children with burns attended the ED. The average patient age was 5 years, with most cases involving infants and young children. Fifty one percent of injuries were scalds, and 36% were contact burns. Burn size varied from 1% body surface area to 23% body surface area. First aid had not been administered in one third of cases before attendance, and 87% of patients had received no analgesia. Final outcomes were as follows: 5% of patients were discharged from the ED with no further follow-up. Twenty three percent of patients were instructed to attend their general practitioner for follow-up, and 58% were instructed to attend the ED clinic for review. Four percent of patients were reviewed in the plastic surgery dressing clinic, 7% were admitted to the plastic surgery ward, and 3% of patients were transferred to a burn center. In total, 3% of patients required burn excision and skin grafting for their burns. There were no deaths.

Conclusions: Many pediatric burns are appropriately managed in the ED without the need for burn center care. Although the mortality from burn injury in children may have fallen in recent decades, problems persist in terms of small burns that can be associated with long-standing morbidity. Education and prevention programs are still required at all levels to help address the problem of childhood burns.