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G251(P) An audit analysing presentation and management of paediatric burns in a pre-hosptial and accident and emergency setting
  1. D Matthews1,
  2. N Adams1,
  3. C Davies2,
  4. S Thenabadu3
  1. 1School of Medicine, King’s College London, London, UK
  2. 2Postgraduate Medical & Dental Education Department, King’s College Hospital NHS Foundation Trust, London, UK
  3. 3Adult & Paediatric Emergency Medicine, King’s College Hospital NHS Foundation Trust, London, UK

Abstract

Aims Analysis of paediatric burns, including pre-hospital care, presentation and management to the Urgent Care Centre and Accident and Emergency in a district hospital over the course of twelve months for quality improvement.

Methods The audit was undertaken in partnership with consultant medical staff. A data collection form was produced to collect data on all paediatric burn presentations to emergency care services. Mode of presentation, first aid management and pre-hospital care, patient statistics, description and documentation of the incident, including safeguarding protocols, and management in hospital were documented. 145 cases were recorded, over a twelve month period between 1/11/2014–31/10/2015, with a varied distribution in site and severity of burn.

Results 63% of patients carried out some form of first aid prior to hospital attendance, but of these only 8.7% completed the STOP protocol, as recommended on National Burns Awareness day. 15% of patients had a clear description of the burn, including parameters such as size, severity and percentage documented patient notes, but 9.7% of documentation of severity was incorrect, and 46.9% had no documentation. Only 1.4% of patients and their guardians received written guidance after presentation on burn aftercare and prevention with 37.9% receiving no information, written or verbal.

Conclusions The audit revealed three targets of improvement:

  • Public education detailing pre hospital care using the STOP protocol, and after care management.

  • Education of staff, highlighting correct documentation and grading of burns.

  • A policy of provision of written information to patients post presentation.

Adoption of these suggestions could affect emergency department attendance and long term prognosis of paediatric burns.

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