Abstract
Background
The purpose of this study was to characterize emergency pediatric burn care triage
at a tertiary children's hospital to identify targets for quality improvement.
Methods
A retrospective review of patients <18 years with primary burn injuries who presented
to a children's emergency department in 2016 was conducted. Demographic and injury
characteristics were recorded. Low acuity was defined by size (<5% total body surface
area burn), depth (not third degree), and no need for conscious sedation for debridement.
Multiple logistic regression was used for analysis.
Results
A total of 309 pediatric burn patients were triaged in the emergency department. Patients
were typically young (median 3.3 years), male (59%), Hispanic (47%), publically insured
(77%), and transferred in (65%). Scalding was the most common mechanism (59%). Though
most burns were small (median 2% total body surface area), not deep (<third degree:
91%), and debrided without sedation (70%), most patients were admitted (80%). On regression,
larger total body surface area, child protective services involvement, and in-transfer,
but not mechanism, location of injury, or time of day, were associated with observation
admission (<24 hours) versus emergency department discharge.
Conclusion
Though burns were low acuity, most children were admitted. Social factors may play
an important role in triage decisions but there may be an opportunity for improved
resource utilization.
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Article info
Publication history
Published online: August 25, 2018
Accepted:
June 25,
2018
Received in revised form:
May 11,
2018
Received:
January 16,
2018
Footnotes
Presented at the 12th Annual Academic Surgical Congress, Jacksonville, FL, January 30–February 1, 2017.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
