Epidemiology, aetiology and knowledge, attitudes, and practices relating to burn injuries in Palestine: A community‐level research

The aim of this study was to identify the epidemiology, aetiology as well as the knowledge, attitudes, and practices relating to burn injuries in Palestine. A mixed‐method approach was used. A survey was distributed to a total of 1500 households selected by randomised approach. The survey was standardised based on World Health Organisation's guidelines for conducting community surveys on injury. Additionally, there were 12 focus group discussions and 10 key informant interviews to collect rich qualitative data. In the West Bank and Gaza, 1.5% of Palestinians had experienced serious burn injuries in the 12 months. The total sample of 1500 yields a margin of error (plus/minus) = 2.5% at a 95% level of confidence and a response distribution (P = 50%) with 3% non‐response rate. Of the 1500 households approached, 184 reported a total of 196 burn injuries, with 87.2% occurring inside the home: 69.4% were females and 39.3% were children. The main source of reported cause of burn was heat and flame (36%), electric current (31.6%), hot liquid (28.6%), and chemicals (2.7%). The most common first aid for burns was pouring water (74.7%). People in rural, refugee, and Bedouin settings had the highest incidence of burns. This study provides the burn prevalence rate, explanatory factors that contribute to the frequency of burns in Palestine. Making burn prevention a higher priority within the national policy is crucial

Estimating the cost impact of dressing choice in the context of a mass burns casualty event

SUMMARY. Mass casualty burn events (MCBs) require intense and complex management. Silver-infused longer use dressingsmight help optimise management of burns in an MCB setting. We developed a model estimating the impact of dressing choice inthe context of an MCB. The model was developed in Excel in collaboration with experienced emergency response clinicians. Themodel compares use of silver-infused dressings with use of traditional dressings in patients with partial thickness burns covering30% of their body. Costs were estimated from a UK perspective as a proxy for a funded emergency response team and limitedto cost of dressings, bandages, padding, analgesia and staff time. Expected patient costs and resource use were summarised overan acute 2-week intervention period and extrapolated to estimate possible time savings in a hypothetical MCB. Per patient costswere estimated at £2,002 (silver) and £1,124 (traditional) (a daily additional spend of £63). Per patient staff time was estimatedat 864 minutes (silver) and 1,200 minutes (traditional) (a daily time saving of 24 minutes). Multiplying up to a possible MCBpopulation of 20 could result in a saving equivalent to 9 staff shifts over the 2-week intervention period. The model was sensitiveto type of silver dressing, frequency of dressing change and staff costs. We found increased costs through use of silver dressingsbut time savings that might help optimise burns management in an MCB. Exploring the balance between costs and staff timemight help future MCB response preparation.Keywords: mass casualty incident, burns, silver dressing, SSD, cost mode

Justification for a Nuclear Global Health Workforce: multidisciplinary analysis of risk, survivability & preparedness, with emphasis on the triage management of thermal burns

An assessment of the risks of nuclear conflict and the global preparedness to deal with such a catastrophe. Includes a proposal for triage and management of burn injuries based on a model of what would happen if there was a nuclear attack on Washington DC. Summarises the need for a global nuclear workforce to establish guidelines and strategies to address a nuclear event, the risk of which would appear to be increasingly likely given current world geopolitics

Burns in Nepal: a participatory, community survey of burn cases and knowledge, attitudes and practices to burn care and prevention in three rural municipalities

ObjectivesAs part of an ongoing, long-term project to co-create burn prevention strategies in Nepal, we collected baseline data to share and discuss with the local community, use as a basis for a co-created prevention strategy and then monitor changes over time. This paper reports on the method and outcomes of the baseline survey and demonstrates how the data are presented back to the community.DesignA community-based survey.SettingCommunity based in three rural municipalities in Nepal.Participants1305 households were approached: the head of 1279 households participated, giving a response rate of 98%. In 90.3% of cases, the head of the household was male.ResultsWe found that 2.7% (CI 1.8 to 3.7) of 1279 households, from three representative municipalities, reported at least one serious burn in the previous 12 months: a serious burn was defined as one requiring medical attention and/or inability to work or do normal activities for 24 hours. While only 4 paediatric and 10 adult cases in the previous 12 months reached hospital care, the impact on the lives of those involved was profound. Only one patient was referred on from primary to secondary/tertiary care; the average length of hospital stay for those presenting directly to secondary/tertiary care was 21 days. A range of first-aid behaviours were used, many of which are appropriate for the local context while a few may be potentially harmful (eg, the use of dung).ConclusionThe participatory approach used in this study ensured a high response rate. We have demonstrated that infographics can link the pathway for each of the cases observed from initial incident to final location of care

A novel, cost effective escharotomy simulator and trainee assessment

Over the last two decades, virtual reality, haptics, simulators, robotics, and other "advanced technologies" have emerged as important innovations in medical learning and practice. In the 21st century, however, it is important to continue to develop simple teaching aids which are available to large audiences in low and middle-income countries. We present a simple 'escharotomy simulator' which has been well received, resulting in an increase in knowledge, and an increase in confidence to carry out the procedure