Comfort with burn injury management among healthcare providers in a rural and remote region: a cross-sectional survey

Abstract

Background

Rural and remote communities often rely on primary care providers to complete the initial management and referral of burn injuries. This study aimed to assess frontline providers’ comfort with the initial assessment and management of burn injuries in a rural and remote setting.

Methods

A cross-sectional survey was distributed to primary and wound care providers across 10 healthcare facilities in Northwestern Ontario between August and December 2024. Self-reported comfort levels with 15 aspects of burn care were assessed using a five-point Likert scale. Wilcoxon rank-sum tests were used to compare survey responses across practice characteristics.

Results

Fifty-nine providers participated, including family physicians (44 %), nurse practitioners (20 %), emergency physicians (10 %), and others. While 90 % saw at least one burn injury per year, only 42 % saw more than five. Most respondents reported comfort with tetanus prophylaxis (72 %) and burn first aid (66 %). However, fewer felt comfortable assessing burn size (31 %) or depth (27 %), initiating fluid resuscitation (27 %), or applying the American Burn Association guidelines for burn center transfer (24 %). Providers managing five or more burns annually reported significantly greater comfort across multiple domains (p < 0.05). No significant differences were found between early- and late-career providers.

Conclusion

This study demonstrates that providers working in a rural and remote region reported limited comfort with burn size and depth assessment, initiating fluid resuscitation, and applying burn center referral guidelines – important skills for initial injury management and referral. These findings highlight a need for system-level supports and educational resources for providers in regions remote from specialized burn centers.