Burns treatment for children and adults: a study of initial burns first aid and hospital care.

Aim: To assess the adequacy of initial burns first aid treatment in the community and its subsequent impact on treatment outcome.

Methods: Four-month prospective study of consecutive burn patients presenting to Middlemore Hospital. Patients were interviewed to determine initial burns first aid treatment (BFAT) and assessed as "adequate" or "inadequate", then compared with subsequent treatment. Inpatient care was wound debridement with/without dressings (DO/DB) or split skin grafting (SSG).

Results: 40.5% of total 121 patients received adequate BFAT, 59.5% did not, p = <0.001. 50% Caucasians received adequate BFAT, compared with 25% Maori and 33% Pacific Island people, p = 0.084. 15.7% of adequate BFAT patients received DO/DB and 6.6% had SSG, compared with 23.4% and 19.3% respectively for inadequate BFAT, p = 0.03. Scald burns occurred most frequently, 4% adequate BFAT scald patients required SSG compared with 20% of inadequate BFAT scald patients, p = 0.003. Maori and Pacific Island people were over-represented as inpatients (collectively 34.8%) when compared to Caucasian (24.8%) or other ethnic groups, p = 0.25. 38% of all patients were children under 10 with inadequate BFAT tendency compared with adults, p = 0.067. Hospital stay decreased among adequate BFAT paediatric patients, p = 0.016.

Conclusions: A public education strategy is required to improve BFAT, targeting at-risk communities. Following this, the study should be repeated to determine the effectiveness of the campaign and any resultant change in community behaviour.