An assessment of burn prevention knowledge in a high burn-risk environment: restaurants.

PubMed

Piazza-Waggoner, Carrie; Adams, C D; Goldfarb, I W; Slater, H

2002-01-01

Our facility has seen an increase in the number of cases of children burned in restaurants. Fieldwork has revealed many unsafe serving practices in restaurants in our tristate area. The current research targets what appears to be an underexamined burn-risk environment, restaurants, to examine server knowledge about burn prevention and burn care with customers. Participants included 71 local restaurant servers and 53 servers from various restaurants who were recruited from undergraduate courses. All participants completed a brief demographic form as well as a Burn Knowledge Questionnaire. It was found that server knowledge was low (ie, less than 50% accuracy). Yet, most servers reported that they felt customer burn safety was important enough to change the way that they serve. Additionally, it was found that length of time employed as a server was a significant predictor of servers' burn knowledge (ie, more years serving associated with higher knowledge). Finally, individual items were examined to identify potential targets for developing prevention programs.

History, Epidemic Evolution, and Model Burn-In for a Network of Annual Invasion: Soybean Rust.

PubMed

Sanatkar, M R; Scoglio, C; Natarajan, B; Isard, S A; Garrett, K A

2015-07-01

Ecological history may be an important driver of epidemics and disease emergence. We evaluated the role of history and two related concepts, the evolution of epidemics and the burn-in period required for fitting a model to epidemic observations, for the U.S. soybean rust epidemic (caused by Phakopsora pachyrhizi). This disease allows evaluation of replicate epidemics because the pathogen reinvades the United States each year. We used a new maximum likelihood estimation approach for fitting the network model based on observed U.S. epidemics. We evaluated the model burn-in period by comparing model fit based on each combination of other years of observation. When the miss error rates were weighted by 0.9 and false alarm error rates by 0.1, the mean error rate did decline, for most years, as more years were used to construct models. Models based on observations in years closer in time to the season being estimated gave lower miss error rates for later epidemic years. The weighted mean error rate was lower in backcasting than in forecasting, reflecting how the epidemic had evolved. Ongoing epidemic evolution, and potential model failure, can occur because of changes in climate, host resistance and spatial patterns, or pathogen evolution.

Military and Civilian Burn Injuries During Armed Conflicts

PubMed Central

Atiyeh, B.S.; Gunn, S.W.A.; Hayek, S.N.

2007-01-01

Summary Burn injury is a ubiquitous threat in the military environment, and war burns have been described for more than 5,000 years of written history. Fire was probably utilized as a weapon long before that. With the ever-increasing destructive power and efficiency of modern weapons, casualties, both fatal and non-fatal, are reaching new highs, particularly among civilians who are becoming the major wartime targets in recent wars, accounting for most of the killed and wounded. Even though medical personnel usually believe that a knowledge of weaponry has little relevance to their ability to effectively treat injuries and that it may in some way be in conflict with their status, accorded under the Geneva and Hague treaties, it is imperative that they know how weapons are used and understand their effects on the human body. The present review explores various categories of weapons of modern warfare that are unfamiliar to most medical and paramedical personnel responsible for burn treatment. The mechanisms and patterns of injury produced by each class of weapons are examined so that a better understanding of burn management in a warfare situation may be achieved. PMID:21991098

The Birmingham Burn Centre archive: A photographic history of post-war burn care in the United Kingdom.

PubMed

Hardwicke, Joseph; Kohlhardt, Angus; Moiemen, Naiem

2015-06-01

The Medical Research Council Burns and Industrial Injuries Unit at the Birmingham Accident Hospital pioneered civilian burn care and research in the United Kingdom during the post-war years. A photographic archive has been discovered that documents this period from 1945 to 1975. The aim of this project was to sort, digitize and archive the images in a secure format for future reference. The photographs detail the management of burns patients, from injury causation and surgical intervention, to nursing care, rehabilitation and long-term follow-up. A total of 2650 images files were collected from over 600 patients. Many novel surgical, nursing, dressing and rehabilitation strategies are documented and discussed. We have chosen to report part of the archive under the sections of (1) aseptic and antimicrobial burn care; (2) burn excision and wound closure; (3) rehabilitation, reconstruction and long-term outcomes; (4) accident prevention; and (5) response to a major burns incident. The Birmingham collection gives us a valuable insight into the approach to civilian burn care in the post-war years, and we present a case from the archive to the modern day, the longest clinical photographic follow-up to date. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Burns from illegal drug manufacture: case series and management.

PubMed

Porter, C J W; Armstrong, J R

2004-01-01

This case series presents our experience with burns sustained while manufacturing illegal drugs. All adult burn admissions in an 18-month period were retrospectively reviewed. All patients suspected of sustaining burns from illegal drug manufacture were contacted. Information regarding the burn mechanism was sought. Nine of the 64 adult burn admissions were caused by explosions during the manufacture of cannabis oil. Young males with hand and face burns were heavily represented. First-aid treatment was often ignored in favor of hiding incriminating evidence. Only two patients gave honest admission histories. Illegal drug manufacture is becoming more common as synthetic drugs become more consumer desirable. Burns sustained may be thermal and/or chemical. Dishonest patient histories negatively influence burn management. A high level of suspicion is required for diagnosing and treating burns from illegal drug manufacture. Public education is unlikely to be effective as the financial rewards outweigh the perceived risks.

Effect of spatial nonuniformity of heating on compression and burning of a thermonuclear target under direct multibeam irradiation by a megajoule laser pulse

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bel’kov, S. A.; Bondarenko, S. V.; Vergunova, G. A.

Direct-drive fusion targets are considered at present as an alternative to targets of indirect compression at a laser energy level of about 2 MJ. In this approach, the symmetry of compression and ignition of thermonuclear fuel play the major role. We report on the results of theoretical investigation of compression and burning of spherical direct-drive targets in the conditions of spatial nonuniformity of heating associated with a shift of the target from the beam center of focusing and possible laser radiation energy disbalance in the beams. The investigation involves numerous calculations based on a complex of 1D and 2D codesmore » RAPID, SEND (for determining the target illumination and the dynamics of absorption), DIANA, and NUT (1D and multidimensional hydrodynamics of compression and burning of targets). The target under investigation had the form of a two-layer shell (ablator made of inertial material CH and DT ice) filled with DT gas. We have determined the range of admissible variation of compression and combustion parameters of the target depending on the variation of the spatial nonuniformity of its heating by a multibeam laser system. It has been shown that low-mode (long-wavelength) perturbations deteriorate the characteristics of the central region due to less effective conversion of the kinetic energy of the target shell into the internal energy of the center. Local initiation of burning is also observed in off-center regions of the target in the case of substantial asymmetry of irradiation. In this case, burning is not spread over the entire volume of the DT fuel as a rule, which considerably reduces the thermonuclear yield as compared to that in the case of spherical symmetry and central ignition.« less

Orion Burn Management, Nominal and Response to Failures

NASA Technical Reports Server (NTRS)

Odegard, Ryan; Goodman, John L.; Barrett, Charles P.; Pohlkamp, Kara; Robinson, Shane

2016-01-01

An approach for managing Orion on-orbit burn execution is described for nominal and failure response scenarios. The burn management strategy for Orion takes into account per-burn variations in targeting, timing, and execution; crew and ground operator intervention and overrides; defined burn failure triggers and responses; and corresponding on-board software sequencing functionality. Burn-to- burn variations are managed through the identification of specific parameters that may be updated for each progressive burn. Failure triggers and automatic responses during the burn timeframe are defined to provide safety for the crew in the case of vehicle failures, along with override capabilities to ensure operational control of the vehicle. On-board sequencing software provides the timeline coordination for performing the required activities related to targeting, burn execution, and responding to burn failures.

Burns in mobile home fires--descriptive study at a regional burn center.

PubMed

Mullins, Robert F; Alarm, Badrul; Huq Mian, Mohammad Anwarul; Samples, Jancie M; Friedman, Bruce C; Shaver, Joseph R; Brandigi, Claus; Hassan, Zaheed

2009-01-01

Death from fires and burns are the sixth most common cause of unintentional injury death in the United States. More than (3/4) of burn deaths occurring in the United States are in the home. Mobile home fires carry twice the death rate as other dwellings. The aim of the study was to describe the characteristics of deaths and injuries in mobile home fire admitted in a regional Burn Center and to identify possible risk factors. A cross-sectional retrospective study was carried out among all burn patients admitted to a regional Burn Center between January 2002 and December 2004 (3469 patients). The study included patients who suffered a burn injury from a mobile home fire. The demographic characteristics of the patients, location of mobile home, associated inhalation injury, source of fire, comorbidity of the victims, employment status, insurance status, family history of burns, and outcomes of the treatment were incorporated in a data collection record. There were 65 burn patients in mobile home fires admitted to the Burn Center during the studied period. The average age of the patients was 39 years (ranging from 2 to 81 years, SD=16.06), 77% were male, 67% were white, and 79% were the residents in the suburban areas of Georgia, South Carolina, North Carolina, and Florida. The average TBSA of burns was about 21% (ranging from 1 to 63%, SD=17.66), 63% of the patients had associated inhalation, three inhalation injury only, and 69% patients required ventilator support. The average length of stay per TBSA percentage of burn was 1.01 days (P=0.00), controlling for age, preexisting medical comorbidities, and inhalation injury. About 88% of the patients had preexisting medical comorbid conditions, 74% were smokers, 64% reported as alcoholic, and 72% had at least some form of health insurance coverage. In 40% of the cases, the cause of the fire was unknown, 31% were caused by accidental explosions, such as electric, gasoline, or kerosene appliances, and 29% were due to other

Timing of slash burning with the seed crop—a case history.

Treesearch

Roy R. Silen

1952-01-01

Studies by Isaac indicate that regeneration to Douglas-fir following logging often fails because a good seed crop is destroyed in the slash fire. To prevent this loss during a good seed year, early burning before seed fall starts has been recommended. If early burning is too hazardous, only the concentrations of slash should be burned later in the fall. In contrast,...

Pattern and profile of electric burn injury cases at a Burn centre.

PubMed

Cheema, Saeed Ashraf

2016-01-01

Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre. Cases were admitted and resuscitated at the emergency, and further treated at burn unit. Thorough history, examination findings and operative procedures were recorded. Patients were photographed for record as well. Emergency operative procedures, wound management, soft tissue coverage procedures and complications during the hospital stay were recorded and studied. Twenty cases (33%) were in the fifth decade of life. High voltage electric burn injury was seen in 42 (69%) of the cases. Whereas only 9 cases were treated conservatively, other 52 cases had 24 fasciotomies and 71 debridements. Series witnessed 10 expiries, and 22 amputations and all these were result of high voltage electric burns. Twenty eight soft tissue coverage procedures were carried out. Electric burn injuries are altogether different from rest of the burn injuries and must be treated accordingly. These injuries are peculiar for ongoing damage, extensive trauma, complications and prolonged morbidity. Treatment requires a high degree of suspicion, more aggressive management to unfold and minimize the deep seated insult.

The Burn Wound Microenvironment

PubMed Central

Rose, Lloyd F.; Chan, Rodney K.

2016-01-01

Significance: While the survival rate of the severely burned patient has improved significantly, relatively little progress has been made in treatment or prevention of burn-induced long-term sequelae, such as contraction and fibrosis. Recent Advances: Our knowledge of the molecular pathways involved in burn wounds has increased dramatically, and technological advances now allow large-scale genomic studies, providing a global view of wound healing processes. Critical Issues: Translating findings from a large number of in vitro and preclinical animal studies into clinical practice represents a gap in our understanding, and the failures of a number of clinical trials suggest that targeting single pathways or cytokines may not be the best approach. Significant opportunities for improvement exist. Future Directions: Study of the underlying molecular influences of burn wound healing progression will undoubtedly continue as an active research focus. Increasing our knowledge of these processes will identify additional therapeutic targets, supporting informed clinical studies that translate into clinical relevance and practice. PMID:26989577

Fire history reconstruction in grassland ecosystems: amount of charcoal reflects local area burned

NASA Astrophysics Data System (ADS)

Leys, Bérangère; Brewer, Simon C.; McConaghy, Scott; Mueller, Joshua; McLauchlan, Kendra K.

2015-11-01

Fire is one of the most prevalent disturbances in the Earth system, and its past characteristics can be reconstructed using charcoal particles preserved in depositional environments. Although researchers know that fires produce charcoal particles, interpretation of the quantity or composition of charcoal particles in terms of fire source remains poorly understood. In this study, we used a unique four-year dataset of charcoal deposited in traps from a native tallgrass prairie in mid-North America to test which environmental factors were linked to charcoal measurements on three spatial scales. We investigated small and large charcoal particles commonly used as a proxy of fire activity at different spatial scales, and charcoal morphotypes representing different types of fuel. We found that small (125-250 μm) and large (250 μm-1 mm) particles of charcoal are well-correlated (Spearman correlation = 0.88) and likely reflect the same spatial scale of fire activity in a system with both herbaceous and woody fuels. There was no significant relationship between charcoal pieces and fire parameters <500 m from the traps. Moreover, local area burned (<5 km distance radius from traps) explained the total charcoal amount, and regional burning (200 km radius distance from traps) explained the ratio of non arboreal to total charcoal (NA/T ratio). Charcoal variables, including total charcoal count and NA/T ratio, did not correlate with other fire parameters, vegetation cover, landscape, or climate variables. Thus, in long-term studies that involve fire history reconstructions, total charcoal particles, even of a small size (125-250 μm), could be an indicator of local area burned. Further studies may determine relationships among amount of charcoal recorded, fire intensity, vegetation cover, and climatic parameters.

[Electrical burns in children. 3 years of case histories].

PubMed

Caneira, E; Serafim, Z; Duarte, R; Leal, M J

1996-01-01

The Burn Unit of Dona Estefânia Hospital admitted a total of 454 patients from January 1992 to January 1995, 24 of these patients suffered from electric shock. Of these 24 patients 3 suffered burns in the mouth, 15 in one or both hands and 6 multiple burns. In 19 patients the burns were up to 1%. A description is made of 5 cases, male children between the ages of 9 and 13 years, which were deemed severe. The incidents occurred outdoors with different voltages and in activities considered of ludic or experimental nature: two on the roof of a house, two with railway cables and one with an electrical cable in a port zone. The burnt areas vary between 4% and 70%, all of them 2nd and 3rd degree, with hospitalization lasting from 36 to 116 days. In addition to early and coordinated medical and rehabilitative treatment, according to individual needs, a description is also made of the cutaneous sequelae (deforming cicatrices, bridles), neurologic and psychologic sequelae, with emphasis on a patient who underwent amputation of the lower left leg and 4th and 5th ranges of the right foot. It was concluded that measures should be taken in education and legislation to prevent these accidents. Relevance is given to the need for a multidisciplinary team and specialized center for the treatment of these patients.

Burn Injury Alters Epidermal Cholinergic Mediators and Increases HMGB1 and Caspase 3 in Autologous Donor Skin and Burn Margin

PubMed Central

Holmes, Casey J.; Plichta, Jennifer K.; Gamelli, Richard L.; Radek, Katherine A.

2016-01-01

Burn wound healing complications, such as graft failure or infection, are a major source of morbidity and mortality in burn patients. The mechanisms by which local burn injury alters epidermal barrier function in autologous donor skin and surrounding burn margin are largely undefined. We hypothesized that defects in the epidermal cholinergic system may impair epidermal barrier function and innate immune responses. The objective was to identify alterations in the epidermal cholinergic pathway, and their downstream targets, associated with inflammation and cell death. We established that protein levels, but not gene expression, of the α7 nicotinic acetylcholine receptor (CHRNA7) were significantly reduced in both donor and burn margin skin. Furthermore, the gene and protein levels of an endogenous allosteric modulator of CHRNA7, secreted mammalian Ly-6/urokinase-type plasminogen activator receptor-related protein-1 (SLURP1) and acetylcholine were significantly elevated in donor and burn margin skin. As downstream proteins of inflammatory and cell death targets of nAChR activation, we found significant elevations in epidermal High Mobility Group Box Protein 1 (HMGB1) and caspase 3 in donor and burn margin skin. Lastly, we employed a novel in vitro keratinocyte burn model to establish that burn injury influences the gene expression of these cholinergic mediators and their downstream targets. These results indicate that defects in cholinergic mediators and inflammatory/apoptotic molecules in donor and burn margin skin may directly contribute to graft failure or infection in burn patients. PMID:27648692

Planning for burn disasters: lessons learned from one hundred years of history.

PubMed

Barillo, David J; Wolf, Steven

2006-01-01

The terrorist attacks of September 11th have prompted interest in developing plans to manage thousands of burn casualties. There is little actual experience in the United States in managing disasters of this magnitude. As an alternative, lessons may be learned from the historical experiences of previous civilian burn or fire disasters occurring in this country. A review of relevant medical, fire service, and popular literature pertaining to civilian burn or fire disasters occurring in the United States between the years 1900 and 2000 was performed. In the 20th century, 73 major U.S. fire or burn disasters have occurred. With each disaster prompting a strengthening of fire regulations or building codes, the number of fatalities per incident has steadily decreased. Detailed examination of several landmark fires demonstrated that casualty counts were great but that most victims had fatal injuries and died on the scene or within 24 hours. A second large cohort comprised the walking wounded, who required minimal outpatient treatment. Patients requiring inpatient burn care comprise a small percentage of the total casualty figure but consume enormous resources during hospitalization. Burn mass casualty incidents are uncommon. The number of casualties per incident decreased over time. In most fire disasters, the majority of victims either rapidly die or have minimal injuries and can be treated and released. As a result, most disasters produce fewer than 25 to 50 patients requiring inpatient burn care. This would be a rational point to begin burn center preparations for mass casualty incidents. A robust outpatient capability to manage the walking wounded is also desirable.

Cologne burn centre experience with assault burn injuries.

PubMed

Theodorou, P; Spanholtz, T A; Amini, P; Maurer, C A; Phan, T Q V; Perbix, W; Lefering, R; Spilker, G

2009-12-01

To evaluate demographic and socioeconomic factors associated with assault burn injuries. Assault by burning demonstrates a rare but severe public health issue and accounts for unique injury characteristics in the burn intensive care unit (BICU). We conducted a retrospective cohort study involving patients with thermal injuries admitted to the BICU of a university hospital. The patient cohort was divided into two groups (ABI group: patients with assault burns, n=41; population of all other burned patients admitted to the BICU, n=1202). Bivariate and multivariate analyses including demographic and socioeconomic data were used to identify factors associated with assault burns. Forty-one assault-related burn victims were identified in the study period. This represents 3.3% of all significant burns admitted. Comparing battery victims with the control population, assault patients were more likely to be young (mean age 36.2 years vs. 42.2 years) and immigrants (41.5% vs. 15.1%). Furthermore, marital status (65.9% vs. 40.8% singles), employment status (36.6% vs. 9.7% unemployed) and insurance status (41.5% vs. 12.3% social insurance) were significantly different in the bivariate analysis. Logistic regression evaluation identified three variables that were independently associated with assault burns: younger age (< or =25 years) (odds ratio, 2.54 [95% confidence interval, 1.29-5.02]; p=0.007), ethnic minority (odds ratio, 3.71 [95% confidence interval, 1.91-7.20]; p<0.001) and unemployment (odds ratio, 4.02 [95% confidence interval, 2.03-7.97]; p<0.001). The high incidence of youngsters, unemployment and the great proportion of immigrants in victims of assault might provide several opportunities for community-based psychosocial and occupational programs. A multidisciplinary approach targeting issues specific to the violent nature of the injury and the socioeconomic background of the victims may be of benefit to improve their perspectives for rehabilitation.

Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

PubMed

Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

2016-05-01

Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Effect of Prescribed Burns and Wildfire on Vegetation in Bastrop State Park, TX

NASA Astrophysics Data System (ADS)

Justice, C. J.

2014-12-01

In 2011, central Texas had its worst drought since the 1950's. This, in conjunction with the strong winds produced by Tropical Storm Lee created conditions that made possible the Bastrop County Complex Fire in September 2011. These record-breaking wildfires burned over 95% of the 6,565-acre Bastrop State Park (BSP). Since 2003, BSP had been using prescribed burns as a management practice to reduce fuel load and prevent high severity wildfires. Although these prescribed fires did not prevent the 2011 wildfires they may have mitigated their effects. This study considered the effect of prescribed burn history and wildfire burn severity on vegetation recovery in BSP since the 2011 wildfire. The hypotheses of this study are that prescribed burn history and wildfire burn severity separately and jointly have affected post wildfire vegetation. To test these hypotheses, data were collected in 2013 from 46 plots across BSP using the Fire Effects Monitoring and Inventory (FIREMON) protocol to determine herbaceous plant density, shrub density, overstory density, and midstory tree density. Data were analyzed using analyses of variance (ANOVA) to determine the effects of prescribed fire and wildfire severity on these vegetation measurements. It was found that more severely burned plots had more herbaceous plants, fewer midstory trees, and lower shrub densities than less severely burned plots. Contrary to an initial hypotheses, there were few relationships between prescribed burn history and wildfire effects. The only significant effect detected for prescribed burning was the positive effect of prescribed fire on midstory tree density, but only for plots that were not severely burned in the wildfire. In this system, burn severity had a greater effect on post-wildfire vegetation than prescribed burns.

Risk factors for burns at home in Kurdish preschool children: a case-control study.

PubMed

Othman, Nasih; Kendrick, Denise

2013-06-01

It is globally reported that young children are at a higher risk of burns but little is known about the individual risk factors. This study was undertaken in 2008 to investigate factors associated with burn injuries in children aged 0-5 years. This was a case-control study with cases recruited prospectively from children attending hospital for a new burn injury and controls recruited from children admitted for other conditions. A total of 248 cases and 248 controls were recruited. Cases included scalds (79%), contact burns (17%) and flame injuries (4%). Burns were most commonly caused by tea utensils (42%) and kerosene stoves (36%). Multivariable analyses found that a poor living standard (OR 5.4, 95% CI 2.6 to 11.7), having a child with a higher activity score (OR 5.3, 95% CI 3.4 to 8.5), having a history of burns in other family members (OR 2.8, 95% CI 1.5 to 5.2) and a higher number of home hazards (OR for a one unit increase in hazards score 1.32, 95% CI 1.02 to 1.70) were all associated with a significant increase in the odds of a burn injury. The presence of a second carer (OR 0.42, 95% CI 0.2 to 0.7) and having disability (OR 0.14, 95% CI 0.03 to 0.6) were protective factors. This information about risk factors for burn injuries can be used to target preventive interventions towards families at the greatest risk of injury.

Transcriptomic and behavioural characterisation of a mouse model of burn pain identify the cholecystokinin 2 receptor as an analgesic target

PubMed Central

Yin, Kathleen; Deuis, Jennifer R; Lewis, Richard J

2016-01-01

Burn injury is a cause of significant mortality and morbidity worldwide and is frequently associated with severe and long-lasting pain that remains difficult to manage throughout recovery. We characterised a mouse model of burn-induced pain using pharmacological and transcriptomic approaches. Mechanical allodynia elicited by burn injury was partially reversed by meloxicam (5 mg/kg), gabapentin (100 mg/kg) and oxycodone (3 and 10 mg/kg), while thermal allodynia and gait abnormalities were only significantly improved by amitriptyline (3 mg/kg) and oxycodone (10 mg/kg). The need for relatively high opioid doses to elicit analgesia suggested a degree of opioid resistance, similar to that shown clinically in burn patients. We thus assessed the gene expression changes in dorsal root ganglion neurons and pathophysiological mechanisms underpinning burn injury-induced pain using a transcriptomic approach. Burn injury was associated with significantly increased expression of genes associated with axon guidance, neuropeptide signalling, behavioural defence response and extracellular signalling, confirming a mixed neuropathic and inflammatory aetiology. Notably, among the pain-related genes that were upregulated post-injury was the cholecystokinin 2 receptor (Cckbr), a G protein-coupled receptor known as a pain target involved in reducing opioid effectiveness. Indeed, the clinically used cholecystokinin receptor antagonist proglumide (30 mg/kg) was effective at reversing mechanical allodynia, with additional analgesia evident in combination with low-dose oxycodone (1 mg/kg), including significant reversal of thermal allodynia. These findings highlight the complex pathophysiological mechanisms underpinning burn injury-induced pain and suggest that cholecystokinin-2 receptor antagonists may be useful clinically as adjuvants to decrease opioid requirements and improve analgesic management. PMID:27573516

Spatial and temporal corroboration of a fire-scar-based fire history in a frequently burned ponderosa pine forest.

PubMed

Farris, Calvin A; Baisan, Christopher H; Falk, Donald A; Yool, Stephen R; Swetnam, Thomas W

2010-09-01

Fire scars are used widely to reconstruct historical fire regime parameters in forests around the world. Because fire scars provide incomplete records of past fire occurrence at discrete points in space, inferences must be made to reconstruct fire frequency and extent across landscapes using spatial networks of fire-scar samples. Assessing the relative accuracy of fire-scar fire history reconstructions has been hampered due to a lack of empirical comparisons with independent fire history data sources. We carried out such a comparison in a 2780-ha ponderosa pine forest on Mica Mountain in southern Arizona (USA) for the time period 1937-2000. Using documentary records of fire perimeter maps and ignition locations, we compared reconstructions of key spatial and temporal fire regime parameters developed from documentary fire maps and independently collected fire-scar data (n = 60 plots). We found that fire-scar data provided spatially representative and complete inventories of all major fire years (> 100 ha) in the study area but failed to detect most small fires. There was a strong linear relationship between the percentage of samples recording fire scars in a given year (i.e., fire-scar synchrony) and total area burned for that year (y = 0.0003x + 0.0087, r2 = 0.96). There was also strong spatial coherence between cumulative fire frequency maps interpolated from fire-scar data and ground-mapped fire perimeters. Widely reported fire frequency summary statistics varied little between fire history data sets: fire-scar natural fire rotations (NFR) differed by < 3 yr from documentary records (29.6 yr); mean fire return intervals (MFI) for large-fire years (i.e., > or = 25% of study area burned) were identical between data sets (25.5 yr); fire-scar MFIs for all fire years differed by 1.2 yr from documentary records. The known seasonal timing of past fires based on documentary records was furthermore reconstructed accurately by observing intra-annual ring position of fire

Treatment of burn scars in Fitzpatrick phototype III patients with a combination of pulsed dye laser and non-ablative fractional resurfacing 1550 nm erbium:glass/1927 nm thulium laser devices.

PubMed

Tao, Joy; Champlain, Amanda; Weddington, Charles; Moy, Lauren; Tung, Rebecca

2018-01-01

Burn scars cause cosmetic disfigurement and psychosocial distress. We present two Fitzpatrick phototype (FP) III patients with burn scars successfully treated with combination pulsed dye laser (PDL) and non-ablative fractional lasers (NAFL). A 30-year-old, FP III woman with a history of a second-degree burn injury to the bilateral arms and legs affecting 30% body surface area (BSA) presented for cosmetic treatment. The patient received three treatments with 595 nm PDL (7 mm, 8 J, 6 ms), six with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4-8 passes) and five with the 1927 nm thulium laser (10 mJ, 30% density, 4-8 passes). Treated burn scars improved significantly in thickness, texture and colour. A 33-year-old, FP III man with a history of a second-degree burn injury of the left neck and arm affecting 7% BSA presented for cosmetic treatment. The patient received two treatments with 595 nm PDL (5 mm, 7.5 J, 6 ms), four with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4-8 passes) and two with the 1927 nm thulium laser (10 mJ, 30% density, 4-8 passes). The burn scars became thinner, smoother and more normal in pigmentation and appearance. Our patients' burn scars were treated with a combination of PDL and NAFL (two wavelengths). The PDL targets scar hypervascularity, the 1550 nm erbium:glass stimulates collagen remodelling and the 1927 nm thulium targets epidermal processes, particularly hyperpigmentation. This combination addresses scar thickness, texture and colour with a low side effect profile and is particularly advantageous in patients at higher risk of post-procedure hyperpigmentation. Our cases suggest the combination of 595nm PDL plus NAFL 1550 nm erbium:glass/1927 nm thulium device is effective and well-tolerated for burn scar treatment in skin of colour.

Topical Antimicrobials for Burn Wound Infections

PubMed Central

Dai, Tianhong; Huang, Ying-Ying; Sharma, Sulbha K.; Hashmi, Javad T.; Kurup, Divya B.; Hamblin, Michael R.

2010-01-01

Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance. PMID:20429870

Topical Application of Honey for Burn Wound Treatment - an Overview

PubMed Central

Subrahmanyam, M.

2007-01-01

Summary The use of honey in the treatment of burn wounds is discussed and an attempt is made to assess honey's current status as a burn wound dressing. Various kinds of honey are considered, as also the history of its use for this purpose since ancient times. The scientific reasons for honey's appropriateness in burns treatment are reviewed and an account is provided of the main benefits of such treatment. PMID:21991084

Burning mouth syndrome: Evaluation of clinical and laboratory findings.

PubMed

Halac, Gulistan; Tekturk, Pinar; Eroglu, Saliha; Cikrikcioglu, Mehmet Ali; Cimendur, Ozlem; Kilic, Elif; Asil, Talip

2016-07-30

Burning mouth syndrome is a chronic and persistent painful condition characterized by burning sensation in the oral mucosa. We investigated the etiological factors of patients presented with the history of burning in the mouth who admitted our outpatient clinics over the 8-years period and who had no underlying identifiable local factors. We also tried to determine their demographic and clinical characteristics. Our aim was to investigate the association between burning mouth and psychiatric disorders such as depression and anxiety, chronic diseases like diabetes mellitus (DM) and other laboratory studies in patients complaining of solely burning in the mouth. The study included patients with the history of burning in mouth who presented in our outpatient clinic between 2005 and 2012. They were evaluated by a neurologist, a psychiatrist, an internist, and a dentist. Complete blood counts, biochemical analysis and cranial magnetic resonance imaging (MRI) were performed for all patients. A total of 26 (22 (84%) females, 4 (15%) males; mean age 55.9 years) patients were enrolled in this study. Five (19.2%) of the patients had depression, 2 (7.7%) had anxiety disorder, 2 (7.7%) had diabetes mellitus, 8 (30%) had B12 vitamin deficiency, 3 (11.5%) had decreased ferritin levels in blood, and 1 (3.8%) had folic acid deficiency. Cranial MRI of all patients were normal. Nine patients (34.6%) had no etiological causes. A multidisciplinary approach in the management of burning mouth and establishment of common criteria for the diagnosis would provide insight into the underlying pathophysiological mechanism.

Current concepts on burn wound conversion – a review of recent advances in understanding the secondary progressions of burns

PubMed Central

Salibian, Ara A.; Del Rosario, Angelica Tan; De Almeida Moura Severo, Lucio; Nguyen, Long; Banyard, Derek A.; Toranto, Jason D.; Evans, Gregory R.D.; Widgerow, Alan D.

2016-01-01

Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies. PMID:26787127

Management of acid burns: experience from Bangladesh.

PubMed

Das, Kishore Kumar; Olga, Loren; Peck, Michael; Morselli, Paolo G; Salek, A J M

2015-05-01

Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns.

PubMed

Salibian, Ara A; Rosario, Angelica Tan Del; Severo, Lucio De Almeida Moura; Nguyen, Long; Banyard, Derek A; Toranto, Jason D; Evans, Gregory R D; Widgerow, Alan D

2016-08-01

Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Knowledge, attitude, and belief regarding burn first aid among caregivers attending pediatric emergency medicine departments.

PubMed

Alomar, Mohammed; Rouqi, Faisal Al; Eldali, Abdelmoneim

2016-06-01

Emergency departments witness many cases of burns that can be prevented with various first-aid measures. Immediate and effective burn first aid reduces morbidity and determines the outcome. Thus, it is imperative that measures of primary burn prevention and first-aid knowledge be improved. This descriptive study determines the current level of knowledge, attitude, and belief regarding burn first aid among caregivers. Caregivers attending four pediatric emergency departments answered a structured questionnaire for demographic information, knowledge, and the burn first aid they provide including two case scenarios. Applying cold water for 15-20min, smothering burning clothes, and covering the pot of oil on fire with a wet cloth were considered appropriate responses. The main outcome measure was the proportion of caregivers who were aware of burn first aid and did not use inappropriate remedies. Additional questions regarding the best means of educating the public on burn first aid were included. Individual chi-squared tests and univariate logistic regressions were performed to correlate knowledge with demographic features, history of burns, and first-aid training. The 408 interviewed caregivers (55% women) reflected a wide range of age, occupation, and educational level. Sixty percent (60%) of respondents had a large family, with 52% reporting a history of burns. Overall, 41% treated burns with cool or cold water, although 97% had inappropriate or no knowledge of the duration. Further, 32% treated burns with nonscientific remedies alone or in combination, including honey, egg white, toothpaste, white flour, tomato paste, yogurt, tea, sliced potato, butter, or ice. Only 15% had first-aid training. While 65% of caregivers covered a pot of oil on fire with a wet cloth, only 24% reported smothering burning clothes. Participants preferred learning more of first aid for burns via social media (41%), hospital visits (30%), and television (TV) (16%). No significant

A clinico-epidemiological study of rescuer burns.

PubMed

Basra, Baljeet Kumar; Suri, Manav P; Patil, Nilesh; Atha, Ravish; Patel, Natvar; Sachde, Jayesh P; Shaikh, M F

2014-08-01

Rescuer burn is a relatively newer terminology introduced to define the burns sustained by a person attempting to rescue a primary burn victim. Few studies have been published thus far on this peculiar type of burns. Due to the general neglect of the rescuer burns victim and discontinuation of treatment in most cases, once the primary victim dies, the rescuer often ends up in badly infected wounds and has a delayed return to work. A prospective study was conducted at the B J Medical College and Civil Hospital, Ahmedabad from January 2009 to December 2012 on the rescuer burns patients treated in its burns and plastic surgery department. 3074 patients of burns received treatment during the period of study. Of these, 48 patients gave the history of sustaining burns while trying to rescue a burns victim. Male to female ratio of rescuers was approximately 7:1. It was significantly higher as compared to the ratio of 1:0.8 of females to male burn victims observed at our centre (p≤0.01). Average age of the rescuers was higher in males as compared to females but the difference was not significant (p≥0.05). Of the 45 cases of female primary burns victims, male rescuer was husband of the primary victim in 41/45 cases (91.1%), mother was rescuer in three cases (6.6% cases) and sister was rescuer in one case. Though multiple people came to rescue a burns victim, in all cases, it was seen that it was the first rescuer who sustained burns himself or herself. None of the rescuers had any knowledge of the techniques and precautions to be taken while performing a rescue operation irrespective of their education status, indirectly pointing to the lack of any teaching on burns rescue in the school education curriculum. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Traditional Herbal Remedies for Burn Wound Healing in Canon of Avicenna

PubMed Central

Aliasl, Jale; Khoshzaban, Fariba

2013-01-01

Burns are a worldwide problem. The incidence of severe burns has been higher than the combined incidence of tuberculosis and HIV infections. Throughout history there have been many different treatments prescribed for burns. The Canon is the masterpiece of Avicenna’s medical books. The Canon includes a description of 785 simple drugs. Avicenna believed in burn treatment, which follows two goals. The first goal is prevention of blistering and the second goal is treatment of the burn wound after it has created blisters, cold drugs are suitable for the first goal and dry drugs with moderate in cold and hot qualities are better for second goal, this study reviewed remedies for burn wounds in Canon.

Burns induced by cupping therapy in a burn center in northeast china.

PubMed

Jing-Chun, Zhao; Jia-Ao, Yu; Chun-Jing, Xian; Kai, Shi; Lai-Jin, Lu

2014-07-01

Cupping therapy as a curative skill has been developed and applied throughout history. Despite reports of adverse effects, this therapy is considered to be relatively safe with no systemic reviews documenting negative side effects. The aim of this study was to explore methods that avoid the adverse effects sometimes associated with this therapy. Clinical records of 14 outpatients and inpatients that visited the First Hospital of Jilin University (Changchun, China) for management of burn injuries caused by cupping therapy were retrospectively reviewed. Characteristics, history of injury, and treatment of each patient was collected and analyzed. Burn injury induced by cupping therapy was not uncommon. Most of the injuries were mild to moderate and cured by conservative methods without severe complications. The use of wet cupping was more prevalent among injured patients than dry cupping. Cupping therapy as an ancient alternative treatment is still popular with a large number of devoted practitioners. Although there is the potential for injury during the application of this therapy, this is mostly preventable. Standardized training for health care professionals and increased the awareness among the public about the proper methods to administer this therapy to avoid adverse effects is important.

Prescribed burning for oak savanna restoration in central Minnesota.

Treesearch

Alan S. White

1986-01-01

Low intensity, spring prescribed burns have been used since 1964 at the Cedar Creek Natural History Area in Minnesota in an attempt to restore the area to an oak savanna. Burned areas are now more savanna like (having greater grass and forb and lower shrub and lower tree representation) than unburned areas but still have higher overstory densities than apparently...

Enhancing the clinical utility of the burn specific health scale-brief: not just for major burns.

PubMed

Finlay, V; Phillips, M; Wood, F; Hendrie, D; Allison, G T; Edgar, D

2014-03-01

Like many other Western burn services, the proportion of major to minor burns managed at Royal Perth Hospital (RPH) is in the order of 1:10. The Burn Specific Health Scale-Brief (BSHS-B) is an established measure of recovery after major burn, however its performance and validity in a population with a high volume of minor burns is uncertain. Utilizing the tool across burns of all sizes would be useful in service wide clinical practice. This study was designed to examine the reliability and validity of the BSHS-B across a sample of mostly minor burn patients. BSHS-B scores of patients, obtained between January 2006 and February 2013 and stored on a secure hospital database were collated and analyzed Cronbach's alpha, factor analysis, logistic regression and longitudinal regression were used to examine reliability and validity of the BSHS-B. Data from 927 burn patients (2031 surveys) with a mean % total burn surface area (TBSA) of 6.7 (SD 10.0) were available for analysis. The BSHS-B demonstrated excellent reliability with a Cronbach's alpha of 0.95. First and second order factor analyses reduced the 40 item scale to four domains: Work; Affect and Relations; Physical Function; Skin Involvement, as per the established construct. TBSA, length of stay and burn surgery all predicted burn specific health in the first three months of injury (p<0.001, p<0.001, p=0.03). BSHS-B whole scale and domain scores showed significant improvement over 24 months from burn (p<0.001). The results from this study show that the structure and performance of the BSHS-B in a burn population consisting of 90% minor burns is consistent with that demonstrated in major burns. The BSHS-B can be employed to track and predict recovery after burns of all sizes to assist the provision of targeted burn care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Burning transformations: Fire history effects on organic matter processing from hillslopes to streams

NASA Astrophysics Data System (ADS)

Barnes, R. T.; Gilbertson, A.; Maxwell, K.

2017-12-01

Disturbance strongly regulates material and energy flows, changing ecosystem pattern and process. An increase in the size and severity of fire, particularly in the Intermountain West, over the last several decades is expected to continue due to a warming climate. Predicting how fire will alter the net ecosystem carbon balance requires us to understand how carbon is stored, processed, and transferred. Here we present results from paired watersheds focused on five 2002 severe fires in Colorado to examine how organic matter is processed along the hillslope and within the stream. Comparing soil samples and water extractable organic matter (WEOM) between burned and unburned sites illustrates the impact of fire: burned soils have 50% organic matter (OM) content as unburned soils, regardless of geomorphic position. While a smaller pool, soil OM (SOM) in burned sites is more susceptible to microbial degradation (p<0.001 for 4 of 6 sites), especially in systems with slower vegetative recovery. This is explained, in part, to the water extractable organic matter (WEOM) from unburned soils having a higher C:N than burned sites (p<0.02). This shift in SOM quality is likely due to differing OM inputs (e.g. grasses and forbes vs. trees in burned vs. unburned sites). Comparing results from intact soil column experiments to soil extractions and stream samples, suggests that the majority of this soil derived WEOM does not make it to the stream, potentially getting sorbed deeper in the mineral rich, organic poor, portion of the soil. Interestingly, the systematic shifts in OM amounts and quality (as measured by SUVA, E2:E3, and fluorescence) within the terrestrial system in response to fire, are not seen in stream exports. As such, while there are significant relationships (p<0.05) between stream DOM quality, DOM bioavailability, and stream metabolism, burned watersheds are not exporting DOM that is more bioavailable. In addition, despite different terrestrial OM pools, burned and

Low-dose aripiprazole for refractory burning mouth syndrome.

PubMed

Umezaki, Yojiro; Takenoshita, Miho; Toyofuku, Akira

2016-01-01

We report a case of refractory burning mouth syndrome (BMS) ameliorated with low dose of aripiprazole. The patient was a 66-year-old female who had suffered from chronic burning pain in her tongue for 13 months. No abnormality associated with the burning sensation was detected in the laboratory tests and the oral findings. Considering the clinical feature and the history together, we diagnosed the burning sensation as BMS. The BMS pain was decreased by aripiprazole (powder) 1.0 mg/d, though no other antidepressants had satisfying pain relief. It could be supposed that the efficacy of aripiprazole is caused by dopamine stabilization in this case, and BMS might have a subtype that is reactive to aripiprazole. Further studies are needed to confirm the efficacy of aripiprazole for BMS.

Peripheral Neuropathy and Nerve Compression Syndromes in Burns.

PubMed

Strong, Amy L; Agarwal, Shailesh; Cederna, Paul S; Levi, Benjamin

2017-10-01

Peripheral neuropathy and nerve compression syndromes lead to substantial morbidity following burn injury. Patients present with pain, paresthesias, or weakness along a specific nerve distribution or experience generalized peripheral neuropathy. The symptoms manifest at various times from within one week of hospitalization to many months after wound closure. Peripheral neuropathy may be caused by vascular occlusion of vasa nervorum, inflammation, neurotoxin production leading to apoptosis, and direct destruction of nerves from the burn injury. This article discusses the natural history, diagnosis, current treatments, and future directions for potential interventions for peripheral neuropathy and nerve compression syndromes related to burn injury. Copyright © 2017 Elsevier Inc. All rights reserved.

Exposure to Indoor Tanning Without Burning and Melanoma Risk by Sunburn History

PubMed Central

Vogel, Rachel Isaksson; Ahmed, Rehana L.; Nelson, Heather H.; Berwick, Marianne; Weinstock, Martin A.

2014-01-01

Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case–control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning–related burns, stratified by their number of lifetime sunburns (0, 1–2, 3–5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure. PMID:25031276

Exposure to Indoor Tanning Without Burning and Melanoma Risk by Sunburn History

PubMed Central

Vogel, Rachel Isaksson; Ahmed, Rehana L.; Nelson, Heather H.; Berwick, Marianne; Weinstock, Martin A.

2014-01-01

Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case–control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning–related burns, stratified by their number of lifetime sunburns (0, 1–2, 3–5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure. PMID:24872541

Surgical and psychiatric profile of patients who self-harm by burning in a regional burn unit over an 11-year period.

PubMed

Conlin, Samantha; Littlechild, Joseph; Aditya, Hosakere; Bahia, Hilal

2016-02-01

Patients admitted to hospital for deliberate self-harm by burning (DSHB) provide a challenge for medical, surgical and psychological management. We retrospectively reviewed all the patients admitted to a Scottish regional burn unit with DSHB over an 11-year period to assess demographics and outcome. Ward admission data were used to identify DSHB patients admitted to the South East Scotland regional burn unit in Livingston, UK between 2002 and 2012, as well as a control group of accidental burn patients. Data were extracted concerning burn injury, psychiatric history and inpatient management. A total of 53 DSHB patients with 58 attendances over the 11-year period were compared to 49 accidental burns patients. Compared to controls, DSHB patients were more likely to be unemployed, live alone and have a previous psychiatric diagnosis (p < 0.01). DSHB patients had more severe burns, a longer hospital stay and were more likely to undergo surgery (p < 0.01). DSHB patients with previous self-harm, suicide attempts and diagnoses of personality and eating disorder all had significantly less severe burns than DSHB patients without these risk factors (p < 0.05). In our experience, DSHB patients have more severe burn injuries and require longer, resource-intensive hospital stays. Burn units should have an appropriate specialist psychologist/psychiatrist who works within the Burn multi-disciplinary team to help manage this complex group of patients' healthcare needs and reduce their risk of further self-harm. © The Author(s) 2016.

Targeting palmitoyl acyltransferase ZDHHC21 improves gut epithelial barrier dysfunction resulting from burn-induced systemic inflammation.

PubMed

Haines, R J; Wang, C Y; Yang, C G Y; Eitnier, R A; Wang, F; Wu, M H

2017-12-01

Clinical studies in burn patients demonstrate a close association between leaky guts and increased incidence or severity of sepsis and other complications. Severe thermal injury triggers intestinal inflammation that contributes to intestinal epithelial hyperpermeability, which exacerbates systemic response leading to multiple organ failure and sepsis. In this study, we identified a significant function of a particular palmitoyl acyltransferase, zinc finger DHHC domain-containing protein-21 (ZDHHC21), in mediating signaling events required for gut hyperpermeability induced by inflammation. Using quantitative PCR, we show that ZDHHC21 mRNA production was enhanced twofold when intestinal epithelial cells were treated with TNF-α-IFN-γ in vitro. In addition, pharmacological targeting of palmitoyl acyltransferases with 2-bromopalmitate (2-BP) showed significant improvement in TNF-α-IFN-γ-mediated epithelial barrier dysfunction by using electric cell-substrate impedance-sensing assays, as well as FITC-labeled dextran permeability assays. Using acyl-biotin exchange assay and click chemistry, we show that TNF-α-IFN-γ treatment of intestinal epithelial cells results in enhanced detection of total palmitoylated proteins and this response is inhibited by 2-BP. Using ZDHHC21-deficient mice or wild-type mice treated with 2-BP, we showed that mice with impaired ZDHHC21 expression or pharmacological inhibition resulted in attenuated intestinal barrier dysfunction caused by thermal injury. Moreover, hematoxylin and eosin staining of the small intestine, as well as transmission electron microscopy, showed that mice with genetic interruption of ZDHHC21 had attenuated villus structure disorganization associated with thermal injury-induced intestinal barrier damage. Taken together, these results suggest an important role of ZDHHC21 in mediating gut hyperpermeability resulting from thermal injury. NEW & NOTEWORTHY Increased mucosal permeability in the gut is one of the major

Burning a Candle in a Vessel, a Simple Experiment with a Long History

NASA Astrophysics Data System (ADS)

Vera, Francisco; Rivera, Rodrigo; Núñez, César

2011-09-01

The experiment in which a candle is burned inside an inverted vessel partially immersed in water has a history of more than 2,200 years, but even nowadays it is common that students and teachers relate the change in volume of the enclosed air to its oxygen content. Contrary to what many people think, Lavoisier concluded that any change in volume in this experiment is negligible; moreover, the explanation relating oxygen consumption in the air with its change in volume is known to be wrong. In this work we briefly review the history behind the candle experiment and its relationship with some typical erroneous explanations. One of the key factors behind Lavoisier's success was the use of experiments carefully designed to test different hypotheses. Following these steps, we performed several closed volume experiments where the candle wick was replaced by a capillary stainless steel cylinder supported and heated by a nichrome filament connected to an external power supply. Our recorded experiments are displayed as web pages, designed with the purpose that the reader can easily visualize and analyze modern versions of Lavoisier's experiments. These experiments clearly show an initial phase of complete combustion, followed by a phase of incomplete combustion with elemental carbon or soot rising to the top of the vessel, and a final phase where the hot artificial wick only evaporates a white steam of wax that cannot ignite because no oxygen is left in the closed atmosphere. After either a complete or incomplete combustion of the oxygen, our experiments show that the final gas volume is nearly equal to the initial air volume.

In the media: Burns as a method of assault.

PubMed

O'Halloran, E; Duke, J; Rea, S; Wood, F

2013-09-01

The aims of this study were to determine whether a change occurred in the pattern of assault burn injury cases hospitalised to the adult state burns unit, Western Australia, from 2004 to mid-year of 2012, and to compare patient and burn characteristics of adult assault burns with those admitted for unintentional burns. Study data were obtained from the Royal Perth Hospital (RPH) Burns Minimum Dataset (BMDS). Aggregated data of unintentional burn admissions during the same period were provided by the BMDS data manager to enable comparisons with assault burn patients. Assault burn admissions during 2004-2012 accounted for approximately 1% of all adult burn hospitalisations. All assault victims were burned by either thermal or scald agents. A high rate of intubation (24%) and ICU admission (1 in 3 cases) was observed in the fire assault group. The six assault cases undergoing intubation were severe burns, median TBSA 50%, most commonly affecting the face, head and torso, half of these cases had inhalational injuries and also required escharotomies. Comparison of admissions by calendar period showed no statistically significant differences in demographic, burn cause or TBSA%. However, statistically significant differences were found for pre-morbid psychiatric history (15% vs. 58%, p=0.025) and concomitant fractures or dislocations (46% vs. 2%), p=0.011). While the proportion of assault burn admissions per total burn admissions steadily increased from 0.4% in 2009 to 1.5% in mid-2012, this proportion did not exceed that peak level observed of 2.1% for 2004. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Exposure to indoor tanning without burning and melanoma risk by sunburn history.

PubMed

Vogel, Rachel Isaksson; Ahmed, Rehana L; Nelson, Heather H; Berwick, Marianne; Weinstock, Martin A; Lazovich, DeAnn

2014-07-01

Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case-control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning-related burns, stratified by their number of lifetime sunburns (0, 1-2, 3-5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Exposure to indoor tanning without burning and melanoma risk by sunburn history.

PubMed

Vogel, Rachel Isaksson; Ahmed, Rehana L; Nelson, Heather H; Berwick, Marianne; Weinstock, Martin A; Lazovich, DeAnn

2014-06-01

Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case-control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning-related burns, stratified by their number of lifetime sunburns (0, 1-2, 3-5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Toll-Like Receptor Signaling in Burn Wound Healing and Scarring

PubMed Central

D'Arpa, Peter; Leung, Kai P.

2017-01-01

Significance: Damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) emanate from burn-injured tissue and enter systemic circulation. Locally and systemically, they activate pattern-recognition receptors, including toll-like receptors (TLRs), to stimulate cytokine secretion, which in the severest burns typically results in extreme systemic cytokine levels, a dysfunctioning immune system, infection, impaired healing, and excessive scarring. This system-wide disruption of homeostasis can advance to life-threatening, multiorgan dysfunction syndrome. Knowledge of DAMP- and PAMP-TLR signaling may lead to treatments that ameliorate local and systemic inflammation and reduce scarring and other burn injury sequela. Recent Advances: Many PAMPs and DAMPs, the TLRs they activate, and their downstream signaling molecules have been shown to contribute to local and systemic inflammation and tissue damage following burn injury. Critical Issues: Whether TLR-pathway-targeting treatments applied at different times postburn injury might improve scarring remains an open question. The evaluation of this question requires the use of appropriate preclinical and clinical burn models carried out until after mature scar has formed. Future Directions: After TLR-pathway-targeting treatments are evaluated in porcine burn wound models and their safety is demonstrated, they can be tested in proof-of-concept clinical burn wound models. PMID:29062590

Improving burn care and preventing burns by establishing a burn database in Ukraine.

PubMed

Fuzaylov, Gennadiy; Murthy, Sushila; Dunaev, Alexander; Savchyn, Vasyl; Knittel, Justin; Zabolotina, Olga; Dylewski, Maggie L; Driscoll, Daniel N

2014-08-01

Burns are a challenge for trauma care and a contribution to the surgical burden. The former Soviet republic of Ukraine has a foundation for burn care; however data concerning burns in Ukraine has historically been scant. The objective of this paper was to compare a new burn database to identify problems and implement improvements in burn care and prevention in this country. Retrospective analyses of demographic and clinical data of burn patients including Tukey's post hoc test, analysis of variance, and chi square analyses, and Fisher's exact test were used. Data were compared to the American Burn Association (ABA) burn repository. This study included 1752 thermally injured patients treated in 20 hospitals including Specialized Burn Unit in Municipal Hospital #8 Lviv, Lviv province in Ukraine. Scald burns were the primary etiology of burns injuries (70%) and burns were more common among children less than five years of age (34%). Length of stay, mechanical ventilation use, infection rates, and morbidity increased with greater burn size. Mortality was significantly related to burn size, inhalation injury, age, and length of stay. Wound infections were associated with burn size and older age. Compared to ABA data, Ukrainian patients had double the length of stay and a higher rate of wound infections (16% vs. 2.4%). We created one of the first burn databases from a region of the former Soviet Union in an effort to bring attention to burn injury and improve burn care. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Risk factors for childhood burns: a case-control study of Ghanaian children.

PubMed Central

Forjuoh, S N; Guyer, B; Strobino, D M; Keyl, P M; Diener-West, M; Smith, G S

1995-01-01

STUDY OBJECTIVE--To study risk factors for childhood burns in order to identify possible preventive strategies. DESIGN--Case-control design with pair matching of controls to cases in relation to age, sex, and area of residence. The cases and controls were identified by a community based, multisite survey. The effects of host and socioenvironmental variables reported by mothers were investigated in a multivariate analysis using conditional logistic regression. SETTING--A developing country setting the Ashanti Region in Ghana. PARTICIPANTS--These comprised 610 cases aged 0-5 years who had been burned (as evidenced by a visible scar) and 610 controls with no burn history. MAIN RESULTS--The presence of a pre-existing impairment in a child was the strongest risk factor in this population (OR = 6.71; 95% CI 2.78, 16.16). Other significant risk factor included: sibling death from a burn (OR = 4.41; 95% CI 1.16, 16.68); history of burn in a sibling (OR = 1.79; 95% CI 1.24, 2.58); and storage of a flammable substance in the home (OR = 1.51; 95% CI 1.03; 2.21). Maternal education had a protective effect against childhood burns, although this effect was not strong (OR = 0.76; 95% CI 0.55, 1.05). CONCLUSIONS--Community programmes to ensure adequate child supervision and general child wellbeing, particularly for those with impairments, as well as parental education about burns are recommended, to reduce childhood burns in this region of Ghana. The public should bed advised against storing flammable substances in the home. PMID:7798049

Risk factors for childhood burns: a case-control study of Ghanaian children.

PubMed

Forjuoh, S N; Guyer, B; Strobino, D M; Keyl, P M; Diener-West, M; Smith, G S

1995-04-01

To study risk factors for childhood burns in order to identify possible preventive strategies. Case-control design with pair matching of controls to cases in relation to age, sex, and area of residence. The cases and controls were identified by a community based, multisite survey. The effects of host and socioenvironmental variables reported by mothers were investigated in a multivariate analysis using conditional logistic regression. A developing country setting the Ashanti Region in Ghana. These comprised 610 cases aged 0-5 years who had been burned (as evidenced by a visible scar) and 610 controls with no burn history. The presence of a pre-existing impairment in a child was the strongest risk factor in this population (OR = 6.71; 95% CI 2.78, 16.16). Other significant risk factor included: sibling death from a burn (OR = 4.41; 95% CI 1.16, 16.68); history of burn in a sibling (OR = 1.79; 95% CI 1.24, 2.58); and storage of a flammable substance in the home (OR = 1.51; 95% CI 1.03; 2.21). Maternal education had a protective effect against childhood burns, although this effect was not strong (OR = 0.76; 95% CI 0.55, 1.05). Community programmes to ensure adequate child supervision and general child wellbeing, particularly for those with impairments, as well as parental education about burns are recommended, to reduce childhood burns in this region of Ghana. The public should bed advised against storing flammable substances in the home.

Building a balanced scorecard for a burn center.

PubMed

Wachtel, T L; Hartford, C E; Hughes, J A

1999-08-01

The Balanced Scorecard provides a model that can be adapted to the management of any burn center, burn service or burn program. This model enables an organization to translate its mission and vision into specific strategic objectives across the four perspective: (1) the financial perspective; (2) the customer service perspective; (3) the internal business perspective; and (4) the growth and learning perspective. Once the appropriate objectives are identified, the Balanced Scorecard guides the organization to develop reasonable performance measures and establishes targets, initiatives and alternatives to meet programmatic goals and pursue longer-term visionary improvements. We used the burn center at the University of Colorado Health Sciences Center to test whether the Balanced Scorecard methodology was appropriate for the core business plan of a healthcare strategic business unit (i.e. a burn center).

Knowledge of childhood burn risks and burn first aid: Cool Runnings.

PubMed

Burgess, Jacqueline D; Watt, Kerrianne A; Kimble, Roy M; Cameron, Cate M

2018-01-31

The high incidence of hot beverage scalds among young children has not changed in the past 15 years, but preventive campaigns have been scarce. A novel approach was used to engage mothers of young children in an app-based hot beverage scald prevention campaign 'Cool Runnings'. This paper provides baseline data for this randomised controlled trial (RCT). Queensland-based mothers aged 18+ years with at least one child aged 5-12 months were recruited via social media to Cool Runnings, which is a two-group, parallel, single-blinded RCT. In total, 498 participants from across Queensland completed the baseline questionnaire. The most common source of burn first aid information was the internet (79%). One-third (33%) correctly identified hot beverage scalds as the leading cause of childhood burns, 43% knew the age group most at risk. While 94% reported they would cool a burn with water, only 10% reported the recommended 20min duration. After adjusting for all relevant variables, there were two independent predictors of adequate burn first aid knowledge: first aid training in the past year (OR=3.32; 95% CI 1.8 to 6.1) and smoking status (OR=0.17; 95% CI 0.04 to 0.7). In this study, mothers of young children were largely unaware how frequently hot beverage scalds occur and the age group most susceptible to them. Inadequate burn first aid knowledge is prevalent across mothers of young children; there is an urgent and compelling need to improve burn first aid knowledge in this group. Given the high incidence of hot beverages scalds in children aged 6-24 months, it is important to target future burn prevention/first aid campaigns at parents of young children. ACTRN12616000019404; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fine scale vegetation classification and fuel load mapping for prescribed burning

Treesearch

Andrew D. Bailey; Robert Mickler

2007-01-01

Fire managers in the Coastal Plain of the Southeastern United States use prescribed burning as a tool to reduce fuel loads in a variety of vegetation types, many of which have elevated fuel loads due to a history of fire suppression. While standardized fuel models are useful in prescribed burn planning, those models do not quantify site-specific fuel loads that reflect...

Burning Issue: Handling Household Burns

MedlinePlus

... hot objects or liquid, fire, friction, the sun, electricity, or certain chemicals. Each year, about a half- ... infant or elderly. the burn was caused by electricity, which can lead to “invisible” burns. Links Burns ...

Pattern of unintentional burns: A hospital based study from Pakistan.

PubMed

Adil, Syed Omair; Ibran, Ehmer-Al; Nisar, Nighat; Shafique, Kashif

2016-09-01

Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. A cross-sectional questionnaire based survey was conducted in Burns Centre of Civil Hospital Karachi, Pakistan and 324 hospitalized adult patients with unintentional burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile. The source of burn, affected body part and place of injury acquisition in terms of home, outside or work were also noted. Logistic regression model was conducted using SPSS software. Out of 324 patients, 295 (91%) had unintentional burn by self and 29 (9%) had unintentional burn by others. Male gender were 2.37 times and no schooling were 1.75 times more likely to have self-inflicted unintentional burn. Lower limb and head and neck were less likely to involve in unintentional burn by self. The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Incidence and cost of non-fatal burns in Iran: a nationwide population-based study.

PubMed

Abouie, Abolfazl; Salamati, Payman; Hafezi-Nejad, Nima; Rahimi-Movaghar, Afarin; Saadat, Soheil; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Rahimi-Movaghar, Vafa

2018-03-01

To determine the incidence and cost of non-fatal burns in Iran; this cross-sectional household survey of a nationally representative sample of 15-64 years old was conducted. Through face-to-face interviews and telephone calls, the data on the demographics, history and cost of burns were collected. The annual incidence rate of burns was estimated 129.85 per 1000 population. Burns occurred higher in younger age, female gender and urban residency. The most common burn description was as follows: unpaid work (activity during burn), home (place of burn), heat and hot substances (mechanism of burn) and upper limb (site of burn). The average total cost of burn includes victims seeking medical care was US$124 per case. The main findings of this study suggest that burns are a major public health concern in Iran. To stop this important health issue, a national program for burn prevention and education must be developed.

TRPV3 Channel in Keratinocytes in Scars with Post-Burn Pruritus

PubMed Central

Park, Chun Wook; Kim, Hyun Ji; Choi, Yong Won; Chung, Bo Young; Woo, So-Youn; Song, Dong-Keun; Kim, Hye One

2017-01-01

Post-burn pruritus is a common and distressing sequela of burn scars. Empirical antipruritic treatments usually fail to have a satisfactory outcome because of their limited selectivity and possible side effects. Therefore, novel drug targets need to be identified. Here, we aimed to investigate the possible role of protease-activated receptor 2 (PAR2) and transient receptor potential vanniloid 3 (TRPV3), along with the relation of TRPV3 to thymic stromal lymphopoietin (TSLP). Specimens from normal (unscarred) or burn-scarred (with or without pruritus) tissue were obtained from burn patients for this study. In each sample, the keratinocytes were isolated and cultured, and the intracellular Ca2+ level at the time of stimulation of each factor was quantified and the interaction was screened. PAR2 function was reduced by antagonism of TRPV3. Inhibiting protein kinase A (PKA) and protein kinase C (PKC) reduced TRPV3 function. TSLP mRNA and protein, and TSLPR protein expressions, increased in scars with post-burn pruritus, compared to scars without it or to normal tissues. In addition, TRPV1 or TRPV3 activation induced increased TSLP expression. Conclusively, TRPV3 may contribute to pruritus in burn scars through TSLP, and can be considered a potential therapeutic target for post-burn pruritus. PMID:29140280

[Ischemic cholangiopathy induced by extended burns].

PubMed

Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

2013-04-01

Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Epidemiology of Burns in Rural Bangladesh: An Update.

PubMed

He, Siran; Alonge, Olakunle; Agrawal, Priyanka; Sharmin, Shumona; Islam, Irteja; Mashreky, Saidur Rahman; Arifeen, Shams El

2017-04-05

Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries.

Burns due to acid assaults in Bogotá, Colombia.

PubMed

Guerrero, Linda

2013-08-01

Acid burns are not very frequent, occupying between 3% and maximum 14% of all etiologies. They mostly occur at home or at work, however there has been an increase in publications outlining chemical burns where aggression is the cause of this burn. There is a different epidemiological profile between developed countries and developing ones. It seems an ongoing upsurge is occurring in the number of registered attacks within developing countries in recent years. A cross sectional retrospective review of attacks by acid was done in Bogota, Colombia from 1995 to the first trimester 2012. A cumulative number of 35 burn patients were registered during the study period. It is found that the main target, almost the unique target, of this attack are young women belonging to low socioeconomic status with low education degree and high dependence on her partner. The patient's age mean was 22.7 years, ranging from 13 to 41 years. The physical and psychological scars were very severe. Copyright © 2012. Published by Elsevier Ltd.

Suicidal burns in Samarkand burn centers and their consequences.

PubMed

Shakirov, B M; Ahmedov, Y M; Hakimov, E A; Tagaev, K R; Karabaev, B H

2013-12-31

Suicide is a global public health problem, particularly in Asia where few countries with large populations have high suicide rates accounting for the majority of the world's suicides. During a 14-year period, 76 individuals, aged 17 to 66 years, committed suicide from 1995 to 2008 and were included in this report. Data was collected on each patient including, age, sex, place of injury, patient occupation, accommodation, psychiatric illness, suicidal motives, flammable substances used, place of burn, season of the year, and total body surface area (TBSA) burnt. Most suicidal cases (55 out of 76) had a history of depressive episodes and emotional unstable disorders, and 18 of them had a known history of psychiatric illness. In 5 cases alcohol intoxication was present at the moment of suicide, and 3 patients had chronic alcohol dependence together with basic psychiatric disease. It is also evident from this study that the causes of suicide in females are mainly socio-economical and psychological.

Suicidal burns in Samarkand burn centers and their consequences

PubMed Central

Shakirov, B.M.; Ahmedov, Y.M.; Hakimov, E.A.; Tagaev, K.R.; Karabaev, B.H.

2013-01-01

Summary Suicide is a global public health problem, particularly in Asia where few countries with large populations have high suicide rates accounting for the majority of the world’s suicides. During a 14-year period, 76 individuals, aged 17 to 66 years, committed suicide from 1995 to 2008 and were included in this report. Data was collected on each patient including, age, sex, place of injury, patient occupation, accommodation, psychiatric illness, suicidal motives, flammable substances used, place of burn, season of the year, and total body surface area (TBSA) burnt. Most suicidal cases (55 out of 76) had a history of depressive episodes and emotional unstable disorders, and 18 of them had a known history of psychiatric illness. In 5 cases alcohol intoxication was present at the moment of suicide, and 3 patients had chronic alcohol dependence together with basic psychiatric disease. It is also evident from this study that the causes of suicide in females are mainly socio-economical and psychological. PMID:24799853

Initial evaluation and management of the critical burn patient.

PubMed

Vivó, C; Galeiras, R; del Caz, Ma D P

2016-01-01

The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Impact of Work-Related Burn Injury on Social Reintegration Outcomes: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

PubMed

Schneider, Jeffrey C; Shie, Vivian L; Espinoza, Leda F; Shapiro, Gabriel D; Lee, Austin; Acton, Amy; Marino, Molly; Jette, Alan; Kazis, Lewis E; Ryan, Colleen M

2017-11-26

To examine differences in long-term social reintegration outcomes for burn survivors with and without work-related injuries. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Older participants, those who were married, and men were more likely to be burned at work (P<.01). Burn survivors who were injured at work scored significantly lower on the Work and Employment scale score after adjusting for demographic and clinical characteristics (P=.01). All other domain scale scores demonstrated no significant differences between groups. Individuals with work-related injuries scored significantly worse on 6 of the 19 items within the Work and Employment scale (P<.05). These individuals were more likely to report that they were afraid to go to work and felt limited in their ability to perform at work. Burn survivors with work-related injuries report worse work reintegration outcomes than those without work-related injuries. Identification of those at higher risk for work reintegration challenges after burn injury may enable survivors, providers, employers, and insurers to better use appropriate resources to promote and target optimal employment outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Comparison of four measures in reducing length of stay in burns: An Asian centre's evolved multimodal burns protocol.

PubMed

Chong, Si Jack; Kok, Yee Onn; Choke, Abby; Tan, Esther W X; Tan, Kok Chai; Tan, Bien-Keem

2017-09-01

Multidisciplinary burns care is constantly evolving to improve outcomes given the numerous modalities available. We examine the use of Biobrane, micrografting, early renal replacement therapy and a strict target time of surgery within 24h of burns on improving outcomes of length of stay, duration of surgery, mean number of surgeries and number of positive tissue cultures in a tertiary burns centre. A post-implementation prospective cohort of inpatient burns patients from 2014 to 2015 (n=137) was compared against a similar pre-implementation cohort from 2013 to 2014 (n=93) using REDCAP, an electronic database. There was no statistically significant difference for comorbidities, age and percentage (%) TBSA between the new protocol and control groups. The protocol group had shorter mean time to surgery (23.5-38.5h) (p<0.002), 0.63 fewer operative sessions, shorter mean length of stay (11.8-16.8 days) (p<0.04), less positive tissue cultures (0.59-1.28) (p<0.03). The 4 measures of the new burns protocol improved burns care and validated the collective effort of a multi-disciplinary, multipronged burns management supported by surgeons, anesthetists, renal physicians, emergency physicians, nurses, and allied healthcare providers. Biobrane, single stage onlay micrograft/allograft, early CRRT and surgery within 24h were successfully introduced. These are useful adjuncts in the armamentarium to be considered for any burns centre. Copyright © 2017. Published by Elsevier Ltd.

Signaling pathways targeted by curcumin in acute and chronic injury: burns and photo-damaged skin.

PubMed

Heng, Madalene C Y

2013-05-01

Phosphorylase kinase (PhK) is a unique enzyme in which the spatial arrangements of the specificity determinants can be manipulated to allow the enzyme to recognize substrates of different specificities. In this way, PhK is capable of transferring high energy phosphate bonds from ATP to serine/threonine and tyrosine moieties in serine/threonine kinases and tyrosine kinases, thus playing a key role in the activation of multiple signaling pathways. Phosphorylase kinase is released within five minutes following injury and is responsible for activating inflammatory pathways in injury-activated scarring following burns. In photo-damaged skin, PhK plays an important role in promoting photocarcinogenesis through activation of NF-kB-dependent signaling pathways with inhibition of apoptosis of photo-damaged cells, thus promoting the survival of precancerous cells and allowing for subsequent tumor transformation. Curcumin, the active ingredient in the spice, turmeric, is a selective and non-competitive PhK inhibitor. By inhibition of PhK, curcumin targets multiple PhK-dependent pathways, with salutary effects on a number of skin diseases induced by injury. In this paper, we show that curcumin gel produces rapid healing of burns, with little or no residual scarring. Curcumin gel is also beneficial in the repair of photo-damaged skin, including pigmentary changes, solar elastosis, thinning of the skin with telangiectasia (actinic poikiloderma), and premalignant lesions such as actinic keratoses, dysplastic nevi, and advanced solar lentigines, but the repair process takes many months. © 2012 The International Society of Dermatology.

New Onset Migraine Associated With a Civilian Burn Pit.

PubMed

Chalela, Julio A

2017-05-01

Deployed service members exposed to burn pit smoke can experience a multitude of symptoms. Respiratory symptoms after burn pit smoke exposure are well recognized, but neurologic symptoms are less well recognized. There are reports of migraines triggered by odors but no specific reports of new onset migraines triggered by exposure to burn pit smoke. Clinicians encountering patients with new onset migraines in the deployed setting face the dilemma of evacuating the patients to perform neuroimaging or keeping them in theatre. Retrospective case series study and review of the literature. Three patients with new onset headache after exposure to open burn pit smoke are described. The headaches met established criteria to be classified as migraine with aura in two patients and migraine without aura in one patient. The migraines were triggered by exposure to the burn pit smoke and relieved by avoidance of the smoke. The patients did not have history of migraine and had normal neurological examinations. Computed tomography performed in one patient and optic nerve insonation performed in all three patients were normal. The patients responded well to triptans and antiemetic medicines. Nociceptive odors can trigger classic migraines in adults without prior history of migraine. The temporal association between exposure to the odor and the development of the headache, the absence of abnormalities on neurologic examination, and the response to triptans help establish the diagnosis. Activation of the trigeminal system leading to release of pain-related neuropeptides may mediate the migrainous symptoms. Evacuation for advanced neuroimaging or specialized consultation can be avoided if the above-mentioned criteria are met. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Epidemiology of Burns in Rural Bangladesh: An Update

PubMed Central

He, Siran; Alonge, Olakunle; Agrawal, Priyanka; Sharmin, Shumona; Islam, Irteja; Mashreky, Saidur Rahman; Arifeen, Shams El

2017-01-01

Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries. PMID:28379160

Autonomic dysfunction and osteoporosis after electrical burn.

PubMed

Roshanzamir, Sharareh; Dabbaghmanesh, Mohammad Hossein; Dabbaghmanesh, Alireza; Nejati, Solmaz

2016-05-01

Several studies have shown the importance of the sympathetic nervous system in bone metabolism. There is an evidence of sympathetic skin response (SSR) impairment in electrical burn patients up to 2 years after their injuries. The acute phase of burn is accompanied by increased bone resorption. Whether the prolonged dysfunction of sympathetic nervous system may result in bone metabolism derangement even after the acute phase of electrical burn is the inspiring question for this study. And we tried to find correlation between SSR abnormality and areal bone mineral density (BMD) in electrical burn patients 6 months or more after the incidents. 42 electrical burn patients (≥6 months prior to study) who did not have a known joint or bone disease, history of neuropathy (central or peripheral), diabetes mellitus or consumption of any drug affecting the autonomic nervous system or evidence of neuropathy in nerve conduction study were recruited. We also gathered a control group of 50 healthy subjects (without electrical burn or the exclusion criteria). They went under dual energy X-ray absorptiometry and SSR study. Data were analyzed statistically with SPSS 16.0 making use of independent t-test and Pearson correlation coefficient. P<0.05 was considered significant statistically. Areal BMD was significantly lower in electrical burn patients than control group (P<0.001). SSR latency was significantly prolonged and its amplitude was significantly reduced in burn patients compared to control group (P<0.001). In burn patients there was an inverse correlation of areal BMD of lumbar vertebrae, left femur neck and total femur with SSR latency and a direct correlation of areal BMD with SSR amplitude. In control group there was just direct correlation of areal BMD of lumbar vertebrae and left femur neck with SSR amplitude. Electrical burn patients are at risk of reduced areal BMD long after their injuries. Sympathetic derangement and impaired SSR are correlated with reduction in

How forest context influences the acceptability of prescribed burning and mechanical thinning

Treesearch

Alan D. Bright; Peter Newman

2006-01-01

We examined how forest factors influenced public perceptions of three fuels management alternatives: prescribed burns, mechanical thinning, or no artificial fire management. The factors included the forest?s proximity to urban areas, primary use, wildfire history, and current fire conditions. Surveying three study strata with different wildfire histories and...

An algorithm for targeting finite burn maneuvers

NASA Technical Reports Server (NTRS)

Barbieri, R. W.; Wyatt, G. H.

1972-01-01

An algorithm was developed to solve the following problem: given the characteristics of the engine to be used to make a finite burn maneuver and given the desired orbit, when must the engine be ignited and what must be the orientation of the thrust vector so as to obtain the desired orbit? The desired orbit is characterized by classical elements and functions of these elements whereas the control parameters are characterized by the time to initiate the maneuver and three direction cosines which locate the thrust vector. The algorithm was built with a Monte Carlo capability whereby samples are taken from the distribution of errors associated with the estimate of the state and from the distribution of errors associated with the engine to be used to make the maneuver.

Burns - resources

MedlinePlus

Resources - burns ... The following organizations are good resources for information on burns : Burns Recovered -- brsg.org Model Systems Knowledge Translation Center - Burn Model Systems -- www.msktc.org/burn http:// ...

Determination of Optimal Amikacin Dosing Regimens for Pediatric Patients With Burn Wound Sepsis.

PubMed

Yu, Tian; Stockmann, Chris; Healy, Daniel P; Olson, Jared; Wead, Stephanie; Neely, Alice N; Kagan, Richard J; Spigarelli, Michael G; Sherwin, Catherine M T

2015-01-01

This study aimed to develop optimal amikacin dosing regimens for the empirical treatment of Gram-negative bacterial sepsis in pediatric patients with burn injuries. A pharmacodynamic (PD) target in which the peak concentration (Cmax) is ≥8 times the minimum inhibitory concentration (MIC) (Cmax/MIC ≥ 8) is reflective of optimal bactericidal activity and has been used to predict clinical outcomes. Population pharmacokinetic modeling was performed in NONMEM 7.2 for pediatric patients with and without burn injuries. Amikacin pharmacokinetic parameters were compared between the two groups and multiple dosing regimens were simulated using MATLAB to achieve the PD target in ≥90% of patients with burn injuries. The pharmacokinetic analysis included 282 amikacin concentrations from 70 pediatric patients with burn injuries and 99 concentrations from 32 pediatric patients without burns. A one-compartment model with first-order elimination described amikacin pharmacokinetics well for both groups. Clearance (CL) was significantly higher in patients with burn injuries than in patients without (7.22 vs 5.36 L/h, P < .001). The volume of distribution (V) was also significantly increased in patients with burn injuries (22.7 vs 18.7 L, P < .01). Weight significantly influenced amikacin CL (P < .001) and V (P < .001) for both groups. Model-based simulations showed that a higher amikacin dose (≥25 mg/kg) achieved a Cmax/MIC ≥8 in ≥90% of patients with assumed infections of organisms with an MIC = 8 mg/L. Amikacin pharmacokinetics are altered in patients with burn injuries, including a significant increase in CL and V. In simulations, increased doses (≥25 mg/kg) led to improved PD target attainment rates. Further clinical evaluation of this proposed dosing regimen is warranted to assess clinical and microbiological outcomes in pediatric patients with burn wound sepsis.

Pediatric Treadmill Burns: Assessing the effectiveness of prevention strategies.

PubMed

Goltsman, David; Li, Zhe; Connolly, Siobhan; Meyerowitz-Katz, Daniel; Allan, James; Maitz, Peter K M

2016-11-01

Legislative changes in 2008 in Australia mandated that all new treadmills display a warning sticker about the risk of friction burns in children. This was accompanied by a health promotion campaign advising of the risks of treadmills to children. Analyses of pediatric burns data identified all cases of treadmill burns occurring between 2005 and 2014. The incidence of treadmill burns, associations with age and gender, characteristics of the burns and the adequacy of first aid provided immediately after the burn was examined. There were 298 cases of treadmill burns over the 10-year period (3.5% of all pediatric burns). The incidence rose until the introduction of legislation and health promotion in 2008, and then declined over the remaining study period. The majority of treadmill burns in children were inflicted on the upper limbs (91%), and 93% involved the hands. Most burns were full thickness (62%, n=182) and 49% (n=148) required skin grafts. Approximately one-third of treadmill burns (35%, n=105) occurred while someone else was using the treadmill. In the vast majority of treadmill burn injuries (74%, n=223), there was either no first aid or inadequate first aid provided immediately after the injury. A significant number of treadmill burns occur in children, and these often result in serious injuries that are not treated with appropriate first aid. A reduction in the incidence of these burns was associated with the introduction of legislation and health promotion targeted at child safety around treadmills. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Hot ash burns in the children of Western Australia: how and why they happen.

PubMed

Martin, L; Rea, S; McWilliams, T; Wood, F

2014-08-01

Burns from hot ash are common in the paediatric population in Western Australia. Fifty children were admitted to the paediatric burn centre with hot ash contact burns to the feet in 2011 and 2012. It is important to examine the extent of the problem, seasonal variations, and identify those at risk to determine strategies for prevention campaigns. Retrospective review of medical notes for all admissions to the paediatric burns unit was undertaken for 2011 and 2012. Data were collected for patient demographics, time, circumstance of injury, burn severity and treatment. Hot ash burns accounted for 8.6% of admissions but 16.1% of burns sustained in non-metro areas. Median age was just under 3 years, male or female. Median burn TBSA was 2%, and 44% of children required surgery. The burns were less common in summer, more common on non-school days and in children who were on camping trips away from home. Previous work has shown the value of targeted campaigns. The group for targeted prevention campaigns are the carers of very young children who go camping. Information distributed at camping shows and stores about the principles of campfire safety would reach the people at risk. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.10411 Section 49.10411 Protection of... for general open burning, agricultural burning, and forestry and silvicultural burning. (a) Beginning...

[Surgical treatment of burns : Special aspects of pediatric burns].

PubMed

Bührer, G; Beier, J P; Horch, R E; Arkudas, A

2017-05-01

Treatment of pediatric burn patients is very important because of the sheer frequency of burn wounds and the possible long-term ramifications. Extensive burns need special care and are treated in specialized burn centers. The goal of this work is to present current standards in burn therapy and important innovations in the treatment of burns in children so that the common and small area burn wounds and scalds in pediatric patients in day-to-day dermatological practice can be adequately treated. Analysis of current literature, discussion of reviews, incorporation of current guidelines. Burns in pediatric patients are common. Improvement of survival can be achieved by treatment in burn centers. The assessment of burn depth and area is an important factor for proper treatment. We give an overview for outpatient treatment of partial thickness burns. New methods may result in better long-term outcome. Adequate treatment of burn injuries considering current literature and guidelines improves patient outcome. Rational implementation of new methods is recommended.

Cutaneous chemical burns: assessment and early management.

PubMed

Gnaneswaran, Neiraja; Perera, Eshini; Perera, Marlon; Sawhney, Raja

2015-03-01

Chemical burns are common and may cause significant physical, psychological, social and economic burden. Despite a wide variety of potentially harmful chemicals, important general principals may be drawn in the assessment and initial management of such injuries. Early treatment of chemical burns is crucial and may reduce the period of resulting morbidity. This article reviews the assessment and management of cutaneous chemical burns. Assessment of the patient should be rapid and occur in conjunction with early emergency management. Rapid history and pri-mary and secondary survey may be required to exclude systemic side effects of the injury. Depth of wound assessment is difficult given that necrosis caused by various chemicals can continue despite cessation of exposure. Early management should be conducted with consideration of clinician's safety, and appropriate precautions should be taken. Excluding specific situations and chemical exposure, copious irrigation with water remains the mainstay of early management. Referral to a centre of higher acuity may be required for expert evaluation.

Self-inflicted burns in patients with chronic combat-related post-traumatic stress disorder.

PubMed

Bras, Marijana; Loncar, Zoran; Boban, Maja; Gregurek, Rudolf; Brajković, Lovorka; Tomicić, Hrvoje; Muljacić, Ante; Micković, Vlatko; Kalenić, Barbara

2007-12-01

This study examined self-inflicted burns in case series of four patients with chronic combat-related post-traumatic stress disorder (PTSD). Those patients were hospitalized in the Burn Unit of the University Hospital of Traumatology in Zagreb because of severe burns and had a premorbid psychiatric history of PTSD. Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of these patients were collected. The authors have analyzed possible impacts of the sensationalistic way in which media present cases of self-inflicted burning that induce other, new cases of this suicide type, known in the literature as "Werther's syndrome". The importance of multidisciplinary approach in the treatment of burn patients is stressed with emphasis on the important role of liaison psychiatrist in treating these patients. It is necessary to educate media people to avoid sensational reporting on this kind of events. Continuous psychiatric treatment of vulnerable individuals could be useful in prevention of self-inflicted burns.

A review of campfire burns in children: The QLD experience.

PubMed

Okon, O; Zhu, L; Kimble, R M; Stockton, K A

2018-03-27

Campfire burns in children are a significant health issue. It is imperative that the extent of the problem is examined and strategies discussed to inform future prevention campaigns. A retrospective review of data from the Queensland Paediatric Burns Registry for all children presenting with campfire burns between January 2013 and December 2014 (inclusive). Information collected included patient demographics, detail regarding mechanism of injury, first aid, Total Body Surface Area (TBSA), burn depth, and treatment. Seventy-five children with campfire burns were seen in our paediatric burns centre during this 2-year period. The median age of patients was 3 years (range 10 days-14 years). The hands and feet were the areas most commonly affected. Eleven percent of patients suffered flame burns, whilst 89% suffered contact burns from the hot coals or ashes. Of the latter group, approximately half experienced burns from campfires that had been extinguished for at least one night. Thirteen percent of patients underwent split thickness skin grafting. The incidence of burns was increased during school holiday months. We have previously demonstrated the effectiveness of targeted campaigns in reducing the incidence of campfire burns. A significant portion of patients sustained burns from incorrectly extinguished campfires. These injuries are likely to be preventable with ongoing public awareness campaigns. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Burns first aid treatment in remote Northern Australia.

PubMed

Read, David J; Tan, Swee Chin; Ward, Linda; McDermott, Kathleen

2018-03-01

It is well demonstrated that adequate burns first aid treatment (BFAT) improves clinical outcomes for the injured but adequacy remains low in many studies. This study presents a twelve month assessment of the adequacy of burns first aid treatment for patients managed by the Burns Service, Royal Darwin Hospital (RDH). Prospective study design of all patients managed by the Burns Service, Royal Darwin Hospital. Data were collated from two sources; RDH Burns Registry, and the Burns Registry of Australia and New Zealand (BRANZ). Inclusion criterion was all patients managed by the Burns Service, Royal Darwin Hospital for the period 1 January 2014-31 December 2014. Variables collected and analysed include: demographics, burn mechanism, burn wound depth and adequacy of and circumstances around first aid. Overall 310 cases were analysed. Most injuries involved adults (68%), 19% Indigenous persons and 70% of all patients had their burn injury occur in the urban region. Adequate BFAT occurred in 41% of cases. Adults, contact burns and those where the burn injury occurred in the remote regions were less likely to receive adequate BFAT. Indigenous persons were less likely to attempt any BFAT at all and when they did receive BFAT it was more likely applied by an emergency responder or health professional. Overall adequacy of BFAT is low in the Top End of the Northern Territory. Remote dwellers and Indigenous persons are at increased risk of not applying or receiving adequate BFAT. The poor level of adequate BFAT demonstrated in this study suggests that the Top End community particularly remote and Indigenous persons would benefit from targeted BFAT education programs that are delivered in a culturally and linguistically appropriate fashion. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Burns

MedlinePlus

... doing so puts you in danger as well. Chemical and Electrical Burns For chemical and electrical burns, call 911 or your local ... the power source has been turned off. For chemical burns: Dry chemicals should be brushed off the ...

[Qualitative research on pain experiences of adult burn patients].

PubMed

Li, L; Pan, Q; Xu, L; Lin, R Q; Dai, J X; Chen, Z H

2018-03-20

Objective: To explore the pain experiences of adult burn patients so as to lay foundation for practical analgesic measures. Methods: Using phenomenological method in qualitative research, semi-structured interviews were conducted on 12 adult burn patients hospitalized in our burn units from May to November 2015, aiming at pain experiences from immediately after burns to 3 to 7 months after being discharged from hospital. Then the Colaizzi's analysis method was applied to analyze, induce, and refine themes of interview data. Results: After analysis, pain experiences of adult burn patients were generalized into 6 themes: deep pain experiences, heavy psychological burden, limited daily life, poor assessment and treatment of pain, different attributions of pain, and different ways of coping of pain. Conclusions: Burn pain brings harm to the patients' physiology, mentality, and daily life. Nevertheless, pain processing modes of medical staff and patients themselves are the key factors affecting patients' pain experiences. Therefore, according to the deficiency of current situation of pain management, the targeted analgesic intervention measures should be carried out from the perspectives of medical staff and patients.

Chemical burns of the oral mucosa: report of a case.

PubMed

Isenberg, S R; Hier, L A; Chauvin, P J

1996-03-01

Clinical diagnosis of a chemical burn of the oral mucous membranes may be a diagnostic challenge. This article's intent is to illustrate the typical appearance of a chemical mucosal burn and to increase awareness of the various compounds which, when in contact with the mucous membranes, can result in a burn. The authors present a case involving a self-inflicted chemical injury of the oral mucous membranes and illustrate how the submission of an easily-obtained tissue specimen for pathologic examination may aid in the diagnosis. Because these superficial tissues can be obtained and submitted without the need for local anesthetic, pathologic examination is a quick, easy, and valuable diagnostic test when a patient's history is difficult to obtain or intentionally misleading.

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Reservation, Oregon § 49.11021 Permits for general open burning, agricultural burning, and forestry and...

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.10411 Section 49.10411 Protection of... Tribe of Idaho § 49.10411 Permits for general open burning, agricultural burning, and forestry and...

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.10411 Section 49.10411 Protection of... Tribe of Idaho § 49.10411 Permits for general open burning, agricultural burning, and forestry and...

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.10411 Section 49.10411 Protection of... Tribe of Idaho § 49.10411 Permits for general open burning, agricultural burning, and forestry and...

40 CFR 49.10411 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.10411 Section 49.10411 Protection of... Tribe of Idaho § 49.10411 Permits for general open burning, agricultural burning, and forestry and...

Simulated Rainfall experiments on burned areas

NASA Astrophysics Data System (ADS)

Rulli, Maria Cristina

2010-05-01

Simulated Rainfall experiments were carried out in a Mediterranean area located in Italy, immediately after a forest fire occurrence, to evaluate the effects of forest fire on soil hydraulic properties, runoff and erosion. The selected study area was frequently affected by fire in the last years. Two adjacent 30 mq plots were set up with common physiographic features, and the same fire history, except for the last fire, which burned only one of them. Since both plots were previously subject to the passage of fire 6 years before the last one, one compares the hydrologic response and erosion of an area recently burned (B00) with that of an area burnt 6 years before (B06). Several rainfall simulations were carried out considering different pre-event soil moisture conditions where each rainfall simulation consisted of a single 60 minute application of rainfall with constant intensity of about 76 mm/h. The results show runoff ratio, evaluated for different pre-event soil moisture conditions, ranging from 0 to 2% for B06 plot, and from 21 to 41% for B00. Runoff ratio for the recently burned plot was 60 times higher than for the plot burned six years before, under wet conditions, and 20 times higher, under very wet conditions. A large increase in sediment production also was measured in B00 plot, as compared with that in B06 plot. Suspended sediment yield from B00 plot was more than two orders of magnitude higher than that from B06 plot in all the simulated events. The high runoff and soil losses measured immediately after burning indicate that effective post-fire rehabilitation programs must be carried out to reduce flood risk and soil erosion in recently burned areas. However, the results for the plot burned six year prior show that recovery of the hydrological properties of the soil occurs after the transient post fire modification.

Burning mouth syndrome

PubMed Central

Gurvits, Grigoriy E; Tan, Amy

2013-01-01

Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans. Its common features include a burning painful sensation in the mouth, often associated with dysgeusia and xerostomia, despite normal salivation. Classically, symptoms are better in the morning, worsen during the day and typically subside at night. Its etiology is largely multifactorial, and associated medical conditions may include gastrointestinal, urogenital, psychiatric, neurologic and metabolic disorders, as well as drug reactions. BMS has clear predisposition to peri-/post menopausal females. Its pathophysiology has not been fully elucidated and involves peripheral and central neuropathic pathways. Clinical diagnosis relies on careful history taking, physical examination and laboratory analysis. Treatment is often tedious and is aimed at correction of underlying medical conditions, supportive therapy, and behavioral feedback. Drug therapy with alpha lipoic acid, clonazepam, capsaicin, and antidepressants may provide symptom relief. Psychotherapy may be helpful. Short term follow up data is promising, however, long term prognosis with treatment is lacking. BMS remains an important medical condition which often places a recognizable burden on the patient and health care system and requires appropriate recognition and treatment. PMID:23429751

Burning mouth syndrome.

PubMed

Gurvits, Grigoriy E; Tan, Amy

2013-02-07

Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans. Its common features include a burning painful sensation in the mouth, often associated with dysgeusia and xerostomia, despite normal salivation. Classically, symptoms are better in the morning, worsen during the day and typically subside at night. Its etiology is largely multifactorial, and associated medical conditions may include gastrointestinal, urogenital, psychiatric, neurologic and metabolic disorders, as well as drug reactions. BMS has clear predisposition to peri-/post menopausal females. Its pathophysiology has not been fully elucidated and involves peripheral and central neuropathic pathways. Clinical diagnosis relies on careful history taking, physical examination and laboratory analysis. Treatment is often tedious and is aimed at correction of underlying medical conditions, supportive therapy, and behavioral feedback. Drug therapy with alpha lipoic acid, clonazepam, capsaicin, and antidepressants may provide symptom relief. Psychotherapy may be helpful. Short term follow up data is promising, however, long term prognosis with treatment is lacking. BMS remains an important medical condition which often places a recognizable burden on the patient and health care system and requires appropriate recognition and treatment.

HSP27 phosphorylation protects against endothelial barrier dysfunction under burn serum challenge.

PubMed

Sun, Huan-bo; Ren, Xi; Liu, Jie; Guo, Xiao-wei; Jiang, Xu-pin; Zhang, Dong-xia; Huang, Yue-sheng; Zhang, Jia-ping

2015-07-31

F-actin rearrangement is an early event in burn-induced endothelial barrier dysfunction. HSP27, a target of p38 MAPK/MK2 pathway, plays an important role in actin dynamics through phosphorylation. The question of whether HSP27 participates in burn-related endothelial barrier dysfunction has not been identified yet. Here, we showed that burn serum induced a temporal appearance of central F-actin stress fibers followed by a formation of irregular dense peripheral F-actin in pulmonary endothelial monolayer, concomitant with a transient increase of HSP27 phosphorylation that conflicted with the persistent activation of p38 MAPK/MK2 unexpectedly. The appearance of F-actin stress fibers and transient increase of HSP27 phosphorylation occurred prior to the burn serum-induced endothelial hyperpermeability. Overexpressing phospho-mimicking HSP27 (HSP27(Asp)) reversed the burn serum-induced peripheral F-actin rearrangement with the augmentation of central F-actin stress fibers, and more importantly, attenuated the burn serum-induced endothelial hyperpermeability; such effects were not observed by HSP27(Ala), a non-phosphorylated mutant of HSP27. HSP27(Asp) overexpression also rendered the monolayer more resistant to barrier disruption caused by Cytochalasin D, a chemical reagent that depolymerizes F-actin specifically. Further study showed that phosphatases and sumoylation-inhibited MK2 activity contributed to the blunting of HSP27 phosphorylation during the burn serum-induced endothelial hyperpermeability. Our study identifies HSP27 phosphorylation as a protective response against burn serum-induced endothelial barrier dysfunction, and suggests that targeting HSP27 wound be a promising therapeutic strategy in ameliorating burn-induced lung edema and shock development. Copyright © 2015 Elsevier Inc. All rights reserved.

Burning Mouth Syndrome and "Burning Mouth Syndrome".

PubMed

Rifkind, Jacob Bernard

2016-03-01

Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome.

Concurrent Presentation of Burning Mouth Syndrome and Globus Pharyngis in Enugu, Nigeria: A Ten-year Clinical Evaluation.

PubMed

Chukwuneke, Felix; Akpe, James; Okoye, Linda; Ekwueme, Christian; Obiakor, Anthonia; Amobi, Emmanuel; Egbunike, Doris

2014-01-01

To review 22 patients with globus pharyngis among a group of 39 patients who presented with burning mouth syndrome and to highlight the clinical presentation and treatment outcome of these oropharyngeal symptoms, often ignored by practicing oral surgeons. We carried out a retrospective review of 39 patients with burning mouth syndrome seen at oral surgery units of three specialist hospitals in Enugu, Nigeria between 2001 and 2010. The focus was on the 22 of these patients with burning mouth syndrome and globus pharyngis (the persistent sensation of having phlegm, a pill or some other sort of obstruction in the throat when there is none). Relevant information included patients' oral habits and dental status, past medical history, sociodemographic data, onset of symptoms and treatment outcome. Amongst the 22 patients, 8 (36.4%) were males while 14 (63.6%) were females, giving a male to female ratio of 1:1.8. Of the 8 male patients, 3 (37.5%) were retrenched workers, 2 (25%) were drug addicts, 2 (25%) had a history of psychiatric problems and 1 (12.5%) had post-radiation therapy due to diagnosis of adenocystic carcinoma. Amongst the 14 female patients, 6 (42.8%) were divorcees, 3 (21.4%) were unemployed and unmarried, 2 (14.3%) had menopausal problems, 2 (14.3%) had dental prostheses and 1 (7.2%) had a history of mental disorder. Globus pharyngis can present at the same time in some individuals with burning mouth syndrome. The emotional aetiological factor in this unusual ailment calls for proper examinations and a multidisciplinary approach in the management of patients who presented with burning mouth syndrome, especially with a history of depression.

Work-related burns.

PubMed

Pruitt, Valerie M

2006-01-01

Work-related upper extremity burns often occur. The cause directs the course of action. Thermal burns should be assessed for system alterations, and depth of burn should be determined. Deep partial-thickness burns and more severe burns require a specialist evaluation. Chemical burns must be irrigated and the agent identified. Some chemical burns, such as those that involve phenols and metal fragments, require specific topical applications before water lavage. Hydrofluoric acid burns can cause life-threatening electrolyte abnormalities with a small, highly concentrated acid burn. The goal with any extremity burn is to provide the patient with a multidisciplinary team approach to achieve a functional, usable extremity.

The Attack on Psychosomatic Integrity: a Study of the Psychological Sequelae of Burn Trauma

PubMed Central

Cavaleri, V.; Epifanio, M.S.; Benigno, A.; Conte, F.; Di Pasquale, A.

2009-01-01

Summary Burns pathology is characterized not only by insidious damage to the patients' outward appearance but also by the equally painful emotional difficulties they encounter as they reorganize their identity and their personal history. This exploratory survey, combining research work with medical action, considers the cases of 41 outpatients who were hospitalized and subjected to skin grafting. The patients were recruited through the database of the Palermo Civic Hospital Plastic Surgery and Burns Therapy Operative Unit. The questionnaires were compiled 6 and 12 months post-burn (12 months' observation). The main objective of the research was to investigate the quality of life of burn patients in relation to the way they handled their condition on the emotional level, in order to cope with the stress caused by the burn. PMID:21991160

Alpha Heating and Burning Plasmas in Inertial Confinement Fusion.

PubMed

Betti, R; Christopherson, A R; Spears, B K; Nora, R; Bose, A; Howard, J; Woo, K M; Edwards, M J; Sanz, J

2015-06-26

Estimating the level of alpha heating and determining the onset of the burning plasma regime is essential to finding the path towards thermonuclear ignition. In a burning plasma, the alpha heating exceeds the external input energy to the plasma. Using a simple model of the implosion, it is shown that a general relation can be derived, connecting the burning plasma regime to the yield enhancement due to alpha heating and to experimentally measurable parameters such as the Lawson ignition parameter. A general alpha-heating curve is found, independent of the target and suitable to assess the performance of all laser fusion experiments whether direct or indirect drive. The onset of the burning plasma regime inside the hot spot of current implosions on the National Ignition Facility requires a fusion yield of about 50 kJ.

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

A systematic review of the epidemiology of unintentional burn injuries in South Asia.

PubMed

Golshan, Ashkan; Patel, Cyra; Hyder, Adnan A

2013-09-01

Burns are a significant cause of mortality and morbidity in developing countries. We examined the epidemiology of unintentional burns in South Asia to identify trends and gaps in information. A MEDLINE/PUBMED search (1970-2011) was undertaken on empirical studies that focused on burns in India, Pakistan, Bangladesh and Sri Lanka. Data analyzed included demographics, injury details and risk factors. Twenty-seven studies were identified, mostly from India. Burns were more common among males at younger ages (0-12 years) and among females from adolescence onward (>14 years). Flame-related burns and scalds accounted for over 80% of burns in most cases, and were the most common types of injuries observed among children and women with most burns occurring in the home. Electrical burns occurred mostly among men. Important risk factors for burns included low socioeconomic status, being younger, wearing loose, flammable clothing and the use of kerosene. Data on care-seeking and treatment were limited. Preventing burns in the household in South Asia, particularly around kitchen activities, is essential. Children in South Asia are susceptible to burns and are an important target population. Future research should focus on filling the gaps in burn epidemiology found in this review.

Bilateral lower limb amputations in a nigerian child following high-voltage electrical burns injury: a case report.

PubMed

Dim, Em; Amanari, Oc; Nottidge, Te; Inyang, Uc; Nwashindi, A

2013-07-01

The human body conducts electricity very well. Direct contact with electric current can be lethal. The passage of electric current through the body is capable of producing a wide spectrum of injuries, including serious damage to the heart, brain, skin and muscles. Naked high-voltage electric cables negligently abandoned in residential, commercial and industrial areas are a recipe for disaster. This is a case report of a 5-year girl child who had bilateral lower limb gangrene following electrical burns injury. She presented with a fourday history of electrical burns injuries of both lower limbs including both gluteal regions, associated with a three-day history of fever, with full thickness burns and sepsis, ultimately leading to bilateral above knee guillotine amputations. High-voltage electric current, bilateral lower limb gangrene, bilateral above knee amputation.

Effects of normal acceleration on transient burning rate augmentation of an aluminized solid propellant

NASA Technical Reports Server (NTRS)

Northam, G. B.

1972-01-01

Instantaneous burning rate data for a polybutadiene acrylic acid propellant, containing 16 weight percent aluminum, were calculated from the pressure histories of a test motor with 96.77 sq cm of burning area and a 5.08-cm-thick propellant web. Additional acceleration tests were conducted with reduced propellant web thicknesses of 3.81, 2.54, and 1.27 cm. The metallic residue collected from the various web thickness tests was characterized by weight and shape and correlated with the instantaneous burning rate measurements. Rapid depressurization extinction tests were conducted in order that surface pitting characteristics due to localized increased burning rate could be correlated with the residue analysis and the instantaneous burning rate data. The acceleration-induced burning rate augmentation was strongly dependent on propellant distance burned, or burning time, and thus was transient in nature. The results from the extinction tests and the residue analyses indicate that the transient rate augmentation was highly dependent on local enhancement of the combustion zone heat feedback to the surface by the growth of molten residue particles on or just above the burning surface. The size, shape, and number density of molten residue particles, rather than the total residue weight, determined the acceleration-induced burning rate augmentation.

Factors related to child maltreatment in children presenting with burn injuries.

PubMed

Wibbenmeyer, Lucy; Liao, Junlin; Heard, Jason; Kealey, Lyn; Kealey, Gerald; Oral, Resmiye

2014-01-01

The underpinnings of maltreatment in children presenting with burn injuries are necessary to discern as detection and prevention rest on a clear delineation of factors associated with maltreatment. Inaccurate identification of child victims can result in perpetuation of the maltreatment and its attendant neuropsychological sequela. The authors sought to determine factors associated with maltreatment in children presenting with burn injuries, which would guide the burn team in assessing the likelihood of maltreatment. All consenting children admitted with burn injuries were surveyed regarding their injury mechanism and current sociodemographic status. Suspicious injuries were referred by the burn team to the multidisciplinary review team (MRT). The MRT reported injuries with signs of physical abuse, supervision neglect, neglect of other basic needs, or sexual abuse. These children constituted the cases in our study. Variables related to maltreatment were entered into stepwise logistic regression to identify independent predicting variables. P< .05 was considered significant. MRT identified 16 children (24%) admitted with burn injuries with suspicions of maltreatment. Risk factors related to suspicions of maltreatment included: young age, large burns, tap water injury, immersion lines, delay in care, absence of a two-parent family (unconventional family structure), young parents, inconsistent history, and injury pattern. In this single-center prospective study, the authors identified several factors that, when present in injuries with initial suspicion of maltreatment, should trigger a child maltreatment workup. Burn clinicians have an important role as advocates for children and their families. It is important to continue to further the knowledge of maltreatment detection and prevention among children presenting with burn injuries.

Epidemiology of pediatric burns in southwest China from 2011 to 2015.

PubMed

Li, Haisheng; Wang, Song; Tan, Jianglin; Zhou, Junyi; Wu, Jun; Luo, Gaoxing

2017-09-01

Burns are a major form of injury in children worldwide. This study aimed to investigate the epidemiology, outcome, cost and risk factors of pediatric burns in southwest China. This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University from 2011 to 2015. Data, including demographic, injury-related, and clinical data and patient outcome, were collected from medical records. A total of 2478 children with burns (58.03% boys), accounting for 39.2% of total burn patients, were included. The average age of the burn patients was 2.86±2.86years, and most patients (85.55%) were under five years old. The incidence of burns peaked in January, February and May. Scald burns were the most frequent (79.06%), followed by flame burns (14.0%) and electrical burns (3.35%). Limbs were the most common burn sites (69.73%), and the average total body surface area (TBSA) was 11.57±11.61%. The percentage of children who underwent operations and the number of operations were significantly increased in cases of electrical burns, the older-age group, a larger TBSA and full-thickness burns. Six deaths were recorded, yielding a mortality of 0.24%. The median length of stay and cost were 14days and 9541 CNY, respectively, and the major risk factors for length of stay and cost were the TBSA, number of operations, full-thickness burns and outcome. In southwest China, among children under five years old, scald and flame burns should become the key prevention target, and future prevention strategies should be based on related risk factors. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Biomass Burning

Atmospheric Science Data Center

2015-07-27

Projects:  Biomass Burning Definition/Description:  Biomass Burning: This data set represents the geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ...

Effects of burn location and investigator on burn depth in a porcine model.

PubMed

Singer, Adam J; Toussaint, Jimmy; Chung, Won Taek; Thode, Henry C; McClain, Steve; Raut, Vivek

2016-02-01

In order to be useful, animal models should be reproducible and consistent regardless of sampling bias, investigator creating burn, and burn location. We determined the variability in burn depth based on biopsy location, burn location and investigator in a porcine model of partial thickness burns. 24 partial thickness burns (2.5 cm by 2.5 cm each) were created on the backs of 2 anesthetized pigs by 2 investigators (one experienced, one inexperienced) using a previously validated model. In one of the pigs, the necrotic epidermis covering each burn was removed. Five full thickness 4mm punch biopsies were obtained 1h after injury from the four corners and center of the burns and stained with Hematoxylin and Eosin and Masson's trichrome for determination of burn depth by a board certified dermatopathologist blinded to burn location and investigator. Comparisons of burn depth by biopsy location, burn location and investigator were performed with t-tests and ANOVA as appropriate. The mean (SD) depth of injury to blood vessels (the main determinant of burn progression) in debrided and non-debrided pigs pooled together was 1.8 (0.3)mm, which included 75% of the dermal depth. Non-debrided burns were 0.24 mm deeper than debrided burns (P<0.001). Burn depth increased marginally from cephalic to caudal in non-debrided burns, but showed no statistical differences for these locations, in debrided burns. Additionally, there were also no statistical differences in burn depths from midline to lateral in either of these burn types. Burn depth was similar for both investigators and among biopsy locations. Burn depth was greater for caudal locations in non-debrided burns and overall non-debrided burns were deeper than debrided burns. However, burn depth did not differ based on investigator, biopsy site, and medial-lateral location. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Archaeology of fire: Methodological aspects of reconstructing fire history of prehistoric archaeological sites

NASA Astrophysics Data System (ADS)

Alperson-Afil, Nira

2012-07-01

Concepts which are common in the reconstruction of fire histories are employed here for the purpose of interpreting fires identified at archaeological sites. When attempting to evaluate the fire history of ancient occupations we are limited by the amount and quality of the available data. Furthermore, the identification of archaeological burned materials, such as stone, wood, and charcoal, is adequate for the general assumption of a "fire history", but the agent responsible - anthropogenic or natural - cannot be inferred from the mere presence of burned items. The large body of scientific data that has accumulated, primarily through efforts to prevent future fire disasters, enables us to reconstruct scenarios of past natural fires. Adopting this line of thought, this paper attempts to evaluate the circumstances in which a natural fire may have ignited and spread at the 0.79 Ma occupation site of Gesher Benot Ya'aqov (Israel), resulting with burned wood and burned flint within the archaeological layers. At Gesher Benot Ya'aqov, possible remnants of hearths are explored through analyses of the spatial distribution of burned flint-knapping waste products. These occur in dense clusters in each of the archaeological occupations throughout the long stratigraphic sequence. In this study, the combination between the spatial analyses results, paleoenvironmental information, and various factors involved in the complex process of fire ignition, combustion, and behavior, has enabled the firm rejection of recurrent natural fires as the responsible agent for the burned materials. In addition, it suggested that mainly at early sites, where evidence for burning is present yet scarce, data on fire ecology can be particularly useful when it is considered in relation to paleoenvironmental information.

Biomass Burning Observation Project (BBOP) Final Campaign Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kleinman, LI; Sedlacek, A. J.

2016-01-01

The Biomass Burning Observation Project (BBOP) was conducted to obtain a better understanding of how aerosols generated from biomass fires affect the atmosphere and climate. It is estimated that 40% of carbonaceous aerosol produced originates from biomass burning—enough to affect regional and global climate. Several biomass-burning studies have focused on tropical climates; however, few campaigns have been conducted within the United States, where millions of acres are burned each year, trending to higher values and greater climate impacts because of droughts in the West. Using the Atmospheric Radiation Measurement (ARM) Aerial Facility (AAF), the BBOP deployed the Gulfstream-1 (G-1) aircraftmore » over smoke plumes from active wildfire and agricultural burns to help identify the impact of these events and how impacts evolve with time. BBOP was one of very few studies that targeted the near-field time evolution of aerosols and aimed to obtain a process-level understanding of the large changes that occur within a few hours of atmospheric processing.« less

Hypertrophic scarring: the greatest unmet challenge following burn injury

PubMed Central

Finnerty, Celeste C; Jeschke, Marc G; Branski, Ludwik K; Barret, Juan P.; Dziewulski, Peter; Herndon, David N

2017-01-01

Summary Improvements in acute burn care have enabled patients to survive massive burns which would have once been fatal. Now up to 70% of patients develop hypertrophic scars following burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. The current approach is to optimise the healing potential of the burn wound using targeted wound care and surgery in order to minimise the development of hypertrophic scarring. This approach often fails, and modulation of established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventative and therapeutic strategies. PMID:27707499

Using Ken Burns's "The Civil War" in the Classroom

ERIC Educational Resources Information Center

Levin, Kevin M.

2010-01-01

When it aired in 1989, Ken Burns's epic documentary about America's Civil War garnered the largest audience in PBS history. Viewers who had little interest or knowledge of the Civil War were attracted to the powerful images and sounds as well as the narration by David McCullough and commentary by Shelby Foote--the combination of which served to…

Clinical and demographic features of pediatric burns in the eastern provinces of Turkey

PubMed Central

2011-01-01

Background The aim of this study is to perform a retrospective analysis of the causes of burns observed in children in the eastern provinces of Turkey. Method In this study, patients were studied retrospectively with regard to their age, sex, cause of burns, seasonal variations, social and economic factors, length of hospital stay, burned body surface area, medical history, site of injury, and mortality. Results A total of 125 patients undergoing inpatient treatment were male, (53.2%) and 110 were female (46.8%). The most common causes of burns in patients treated on an inpatient basis were scald burns (65.5%) and tandir burns (15.7%). The mean total body surface area of all the patients was 12.17+9.86%. When the patients were grouped according to tandir, cauldron, and others burn causes, a significant difference was seen between the in burn percentages caused by tandir and cauldron burns and other causes (p < 0.001). Higher burn percentages were seen for cauldron burns than for tandir burns (p < 0.05). The average length of hospital stay was 17.67+13.64 days. When the patients were grouped according to burn causes (tandir, cauldron, and others), a significant difference was determined between the hospitalization periods of patients with tandir burns and other burn causes (p = 0.001) The most commonly proliferating microorganism in burned areas was Pseudomonas aeruginosa (20.4%). Of the 235 patients, 61 were treated in operating rooms. During the 24-month period of the study, 2 of the 235 patients died (0.85%). Conclusion Pediatric burns in the eastern part of Turkey are different from those in other parts of Turkey, as well as in other countries. Due to the lifestyle of the region, tandir and cauldron burns, which cause extensive burn areas and high morbidity, are frequently seen in children. Therefore, precautions and educational programs related to the use of tandirs and cauldrons are needed in this region. PMID:21244683

American Burn Association

MedlinePlus

... Quality Care Resources Prevention Prevention Resources Burn Prevention Poster Contest Burn Awareness Week Advocacy Education Annual Meeting ... Quality Care Resources Prevention Prevention Resources Burn Prevention Poster Contest Burn Awareness Week Advocacy Education Annual Meeting ...

Burning mouth syndrome.

PubMed

Crow, Heidi C; Gonzalez, Yoly

2013-02-01

Pain in the tongue or oral tissues described as "burning" has been referred to by many terms including burning mouth syndrome. When a burning sensation in the mouth is caused by local or systemic factors, it is called secondary burning mouth syndrome and when these factors are treated the pain will resolve. When burning mouth syndrome occurs in the absence of identified risk indicators, the term primary burning mouth syndrome is utilized. This article focuses on descriptions, etiologic theories, and management of primary burning mouth syndrome, a condition for which underlying causative agents have been ruled out. Copyright © 2013. Published by Elsevier Inc.

Does nurses'perceived burn prevention knowledge and ability to teach burn prevention correlate with their actual burn prevention knowledge?

PubMed

Lehna, Carlee; Myers, John

2010-01-01

The purpose of this study was to explore the relationship among nurses'perceived burn prevention knowledge, their perceived ability to teach about burn prevention, and their actual burn prevention knowledge and to test if their actual burn knowledge could be predicted by these perceived measures. A two-page, anonymous survey that included a 10-item burn prevention knowledge test and an assessment of nurses'perceived knowledge of burn prevention and their perceived ability to teach burn prevention was administered to 313 nurses. Actual burn prevention knowledge was determined and the correlation among actual burn prevention knowledge, perceived knowledge, and perceived ability to teach was determined. Differences in these outcome variables based on specialty area were tested using analysis of variance techniques. Generalized linear modeling techniques were used to investigate which variables significantly predict a nurse's actual burn prevention knowledge. Test for interaction effects were performed, and significance was set at .05. Responding nurses (N = 265) described practicing in a variety of settings, such as pediatric settings (40.2%, n = 105), emergency departments (25.4%, n = 86), medical/surgical settings (8.4%, n = 22), and one pediatric burn setting (4.1%, n = 14), with all specialty areas as having similar actual burn prevention knowledge (P = .052). Seventy-seven percent of the nurses said they never taught about burn prevention (n = 177). Perceived knowledge and actual knowledge (r = .124, P = .046) as well as perceived knowledge and perceived ability were correlated (r = .799, P < .001). Significant predictors of actual knowledge were years in practice (beta = -0.063, P = .034), years in current area (beta = 0.072, P = .003), perceived knowledge (beta = 0.109, P = .042), and perceived ability (beta = 0.137, P = .019). All nurses, regardless of specialty area, have poor burn prevention knowledge, which is correlated with their perceived lack of

Scald Burns

MedlinePlus

Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

Predictors of Discharge Disposition in Older Adults With Burns: A Study of the Burn Model Systems.

PubMed

Pham, Tam N; Carrougher, Gretchen J; Martinez, Erin; Lezotte, Dennis; Rietschel, Carly; Holavanahalli, Radha; Kowalske, Karen; Esselman, Peter C

2015-01-01

). Comorbidity (P < .01) and history of alcohol abuse (P < 0.01) were also predictive patient factors. Furthermore, clinical practice variations among the three study sites also constituted a significant factor in discharge disposition (both P < .01 when compared with the index study site). Older age remains an important risk factor for discharge to nonindependent living status, even after accounting for inpatient rehabilitation stay. This analysis, however, reveals significant variations in discharge disposition practices among the three participating study sites. We believe that these variations among burn centers need to be elucidated to better understand discharge disposition status in older patients with burns.

30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

Reach and messages of the world's largest ivory burn.

PubMed

Braczkowski, Alexander; Holden, Matthew H; O'Bryan, Christopher; Choi, Chi-Yeung; Gan, Xiaojing; Beesley, Nicholas; Gao, Yufang; Allan, James; Tyrrell, Peter; Stiles, Daniel; Brehony, Peadar; Meney, Revocatus; Brink, Henry; Takashina, Nao; Lin, Ming-Ching; Lin, Hsien-Yung; Rust, Niki; Salmo, Severino G; Watson, James E M; Kahumbu, Paula; Maron, Martine; Possingham, Hugh P; Biggs, Duan

2018-03-01

Recent increases in ivory poaching have depressed African elephant populations. Successful enforcement has led to ivory stockpiling. Stockpile destruction is becoming increasingly popular, and most destruction has occurred in the last 5 years. Ivory destruction is intended to send a strong message against ivory consumption, both in promoting a taboo on ivory use and catalyzing policy change. However, there has been no effort to establish the distribution and extent of media reporting on ivory destruction events globally. We analyzed media coverage of the largest ivory destruction event in history (Kenya, 30 April 2016) across 11 nation states connected to ivory trade. We used an online-media crawling tool to search online media outlets and subjected 5 of the largest print newspapers (by circulation) in 5 nations of interest to content analysis. Most online news on the ivory burn came from the United States (81% of 1944 articles), whereas most of the print news articles came from Kenya (61% of 157 articles). Eighty-six to 97% of all online articles reported the burn as a positive conservation action, whereas 4-50% discussed ivory burning as having a negative impact on elephant conservation. Most articles discussed law enforcement and trade bans as effective for elephant conservation. There was more relative search interest globally in the 2016 Kenyan ivory burn than any other burn in 5 years. Ours is the first attempt to track the reach of media coverage relative to an ivory burn and provides a case study in tracking the effects of a conservation-marketing event. © 2018 Society for Conservation Biology.

Nutrient dynamics across a dissolved organic carbon and burn gradient in central Siberia

NASA Astrophysics Data System (ADS)

Rodriguez-Cardona, B.; Coble, A. A.; Prokishkin, A. S.; Kolosov, R.; Spencer, R. G.; Wymore, A.; McDowell, W. H.

2016-12-01

In stream ecosystems, dissolved organic carbon (DOC) and nitrogen (N) processing are tightly linked. In temperate streams, greater DOC concentrations and higher DOC:NO3- ratios promote the greatest nitrate (NO3-) uptake. However, less is known about this relationship in other biomes including the arctic which is undergoing changes due to climate change contributing to thawing of permafrost and alterations in biogeochemical cycles in soils and streams. Headwater streams draining into the N. Tunguska River in the central Siberian plateau are affected by forest fires but little is known about the aquatic biogeochemical implications in both a thawing and burning landscape. There are clear patterns between carbon concentration and fire history where generally DOC concentration in streams decrease after fires and older burn sites have shown greater DOC concentrations and more bioavailable DOC that could promote greater heterotrophic uptake of NO3-. However, the relationship between nutrient dynamics, organic matter composition, and fire history in streams is not very clear. In order to assess the influence of organic matter composition and DOC concentration on nutrient uptake in arctic streams, we conducted a series of short-term nutrient addition experiments following the tracer addition for spiraling curve characterization (TASCC) method, consisting of NO3- and NH4++PO43- additions, across 4 streams that comprise a fire gradient that spans 3- >100 years since the last burn with DOC concentrations ranging between 12-23 mg C/L. We hypothesized that nutrient uptake would be greatest in older burn sites due to greater DOC concentrations and availability. We will specifically examine how nutrient uptake relates to DOC concentration and OM composition (analyzed via FTICR-MS) across the burn gradient. Across the four sites DOC concentration and DOC:NO3- ratios decreased from old burn sites to recently burned sites. Results presented here can elucidate on the potential impacts

Burn epidemiology and cost of medication in paediatric burn patients.

PubMed

Koç, Zeliha; Sağlam, Zeynep

2012-09-01

Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Burns

MedlinePlus

... occur by direct or indirect contact with heat, electric current, radiation, or chemical agents. Burns can lead ... is. The burn is caused by chemicals or electricity. The person shows signs of shock . The person ...

The trends of burns epidemiology in a tropical regional burns centre.

PubMed

Hwee, Jolie; Song, Christopher; Tan, Kok Chai; Tan, Bien Keem; Chong, Si Jack

2016-05-01

Singapore General Hospital (SGH) is a regional burns centre in Southeast Asia and is the only dedicated burns facility providing specialized burns care in Singapore. A cohort study was performed for burns patients admitted to SGH from 2011 to 2013. We compared our data with earlier studies and observed the trends of burns epidemiology in Singapore. Results were analyzed using the SPSS programme. 655 patients were admitted during this study period, a 35.9% increase from 2003 to 2005. Scalding by water and flame injury remain the top causes of burns and the mean extent of burn is 9.5%. TBSA correlates with the incidence of burn infection, bacteremia and mortality. Patients with ≥20% TBSA are at a higher risk of bacteremia, and ≥ 34% TBSA is a predictor of mortality. 4.9% (n=32) of our patients developed bacteremia. Bacteremia was associated with a surgical duration of ≥80min. Patients with bacteremia incurred longer hospitalization, and had higher mortality rates. Overall mortality rate of our burns patients has decreased from 4.5% to 2.7% (n=18). Key factors of mortality include inhalational injury, bacteremia and ≥20% TBSA. This is a large epidemiology study of a tropical region burns centre. A total of 655 burns cases over a 3-year period were analyzed. We analysed the key factors associated with adverse outcomes including burns infection, bacteremia and mortality, factors associated with mortality, and discussed strategies on the optimization of burns care. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Burning Mouth Syndrome.

PubMed

Klasser, Gary D; Grushka, Miriam; Su, Nan

2016-08-01

Burning mouth syndrome (BMS) is an enigmatic, misunderstood, and under-recognized painful condition. Symptoms associated with BMS can be varied, thereby providing a challenge for practitioners and having a negative impact on oral health-related quality of life for patients. Management also remains a challenge for practitioners because it is currently only targeted for symptom relief without a definitive cure. There is an urgent need for further investigations to determine the efficacy of different therapies because this is the only way viable therapeutic options can be established for patients with this chronic and painful syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Managing a patient with burning mouth syndrome

PubMed Central

Cheung, Danny; Trudgill, Nigel

2015-01-01

A 64-year-old woman presented with an increasing frequency of symptoms of heartburn and retrosternal pain over the last few months, and a constant and intense burning pain affecting her tongue tip, mouth and lips for the past 5 years. She found consuming hot drinks exacerbated the burning oral pain and chewing gum seemed to alleviate some of her symptoms. She thought these oral sensations were caused by frequently licking her finger tips to separate prints in her work in publishing. She had been previously diagnosed with gastro-oesophageal reflux disease (GORD), and her heartburn symptoms had been controlled until recently with lansoprazole 15 mg daily. Her past medical history included irritable bowel syndrome and depression, for which she had been treated with mebeverine and paroxetine for a number of years. She was a non-smoker and did not consume alcohol. Clinical examination was unremarkable with no oral lesions on examination. Her routine laboratory tests, including autoimmune serology, haematinics and thyroid function tests were all within normal limits. She underwent a gastroscopy, which revealed moderate reflux oesophagitis, and following commencing omeprazole 20 mg twice daily, her heartburn resolved. However, her oral burning symptoms were not affected and a diagnosis of burning mouth syndrome (BMS) was made. Following explanation and reassurance concerning the cause of her BMS symptoms, she chose not to receive treatment for this but to access cognitive behavioural therapy in the future if her symptoms worsened. PMID:28839812

Burn Wound Infections

PubMed Central

Church, Deirdre; Elsayed, Sameer; Reid, Owen; Winston, Brent; Lindsay, Robert

2006-01-01

Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices. PMID:16614255

MORBIDITY AND SURVIVAL PROBABILITY IN BURN PATIENTS IN MODERN BURN CARE

PubMed Central

Jeschke, Marc G.; Pinto, Ruxandra; Kraft, Robert; Nathens, Avery B.; Finnerty, Celeste C.; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

2014-01-01

Objective Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn. Design and Patients Burn patients were prospectively enrolled as part of the multicenter prospective cohort study, Inflammation and the Host Response to Injury Glue Grant, with the following inclusion criteria: 0–99 years of age, admission within 96 hours after injury, and >20% total body surface area burns requiring at least one surgical intervention. Setting Six major burn centers in North America. Measurements and Main Results Burn size cutoff values were determined for mortality, burn wound infection (at least two infections), sepsis (as defined by ABA sepsis criteria), pneumonia, acute respiratory distress syndrome, and multiple organ failure (DENVER2 score >3) for both children (<16 years) and adults (16–65 years). Five-hundred seventy-three patients were enrolled, of which 226 patients were children. Twenty-three patients were older than 65 years and were excluded from the cutoff analysis. In children, the cutoff burn size for mortality, sepsis, infection, and multiple organ failure was approximately 60% total body surface area burned. In adults, the cutoff for these outcomes was lower, at approximately 40% total body surface area burned. Conclusions In the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. PMID:25559438

Burns

MedlinePlus

A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot ... and gases are the most common causes of burns. Another kind is an inhalation injury, caused by ...

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

PubMed

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05). The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

Large-area burns with pandrug-resistant Pseudomonas aeruginosa infection and respiratory failure.

PubMed

Ning, Fang-Gang; Zhao, Xiao-Zhuo; Bian, Jing; Zhang, Guo-An

2011-02-01

Infection due to pandrug-resistant Pseudomonas aeruginosa (PDRPA) has become a challenge in clinical practice. The aim of this research was to summarize the treatment of large-area burns (60% - 80%) with PDRPA infection and respiratory failure in our hospital over the last two years, and to explore a feasible treatment protocol for such patients. We retrospectively analyzed the treatment of five patients with large-area burns accompanied by PDRPA infection and respiratory failure transferred to our hospital from burn units in hospitals in other Chinese cities from January 2008 to February 2010. Before PDRPA infection occurred, all five patients had open wounds with large areas of granulation because of the failure of surgery and dissolving of scar tissue; they had also undergone long-term administration of carbapenems. This therapy included ventilatory support, rigorous repair of wounds, and combined antibiotic therapy targeted at drug-resistance mechanisms, including carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors. Four patients recovered from burns and one died after therapy. First, compromised immunity caused by delayed healing of burn wounds in patients with large-area burns and long-term administration of carbapenems may be the important factors in the initiation and progression of PDRPA infection. Second, if targeted at drug-resistance mechanisms, combined antibiotic therapy using carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors could effectively control PDRPA infection. Third, although patients with large-area burns suffered respiratory failure and had high risks from anesthesia and surgery, only aggressive skin grafting with ventilatory support could control the infection and save lives. Patients may not be able to tolerate a long surgical procedure, so the duration of surgery should be minimized, and the frequency of surgery increased.

Epidermal aquaporin-3 is increased in the cutaneous burn wound

PubMed Central

Sebastian, R.; Chau, E.; Fillmore, P.; Matthews, J.; Price, L.A.; Sidhaye, V.; Milner, S.M.

2018-01-01

development of AQP3 targeted therapies may improve burn wound healing. PMID:25603981

Satisfaction with life after burn: A Burn Model System National Database Study.

PubMed

Goverman, J; Mathews, K; Nadler, D; Henderson, E; McMullen, K; Herndon, D; Meyer, W; Fauerbach, J A; Wiechman, S; Carrougher, G; Ryan, C M; Schneider, J C

2016-08-01

While mortality rates after burn are low, physical and psychosocial impairments are common. Clinical research is focusing on reducing morbidity and optimizing quality of life. This study examines self-reported Satisfaction With Life Scale scores in a longitudinal, multicenter cohort of survivors of major burns. Risk factors associated with Satisfaction With Life Scale scores are identified. Data from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Model System (BMS) database for burn survivors greater than 9 years of age, from 1994 to 2014, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures were the individual items and total Satisfaction With Life Scale (SWLS) scores at time of hospital discharge (pre-burn recall period) and 6, 12, and 24 months after burn. The SWLS is a validated 5-item instrument with items rated on a 1-7 Likert scale. The differences in scores over time were determined and scores for burn survivors were also compared to a non-burn, healthy population. Step-wise regression analysis was performed to determine predictors of SWLS scores at different time intervals. The SWLS was completed at time of discharge (1129 patients), 6 months after burn (1231 patients), 12 months after burn (1123 patients), and 24 months after burn (959 patients). There were no statistically significant differences between these groups in terms of medical or injury demographics. The majority of the population was Caucasian (62.9%) and male (72.6%), with a mean TBSA burned of 22.3%. Mean total SWLS scores for burn survivors were unchanged and significantly below that of a non-burn population at all examined time points after burn. Although the mean SWLS score was unchanged over time, a large number of subjects demonstrated improvement or decrement of at least one SWLS category. Gender, TBSA burned, LOS, and school status were associated with SWLS scores at 6 months

Myosin Light Chain Kinase Mediates Intestinal Barrier Disruption following Burn Injury

PubMed Central

Chen, Chuanli; Wang, Pei; Su, Qin; Wang, Shiliang; Wang, Fengjun

2012-01-01

Background Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC) phosphorylation mediated by MLC kinase (MLCK) is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. Methodology/Principal Findings Male balb/c mice were assigned randomly to either sham burn (control) or 30% total body surface area (TBSA) full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg), an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC)-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. Conclusions/Significance The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury. PMID:22529961

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

Impact of managed moorland burning on peat nutrient and base cation status

NASA Astrophysics Data System (ADS)

Palmer, Sheila; Gilpin, Martin; Wearing, Catherine; Johnston, Kerrylyn; Holden, Joseph; Brown, Lee

2013-04-01

Controlled 'patch' burning of moorland vegetation has been used for decades in the UK to stimulate growth of heather (Calluna vulgaris) for game bird habitat and livestock grazing. Typically small patches (300-900 m2) are burned in rotations of 8-25 years. However, our understanding of the short-to-medium term environmental impacts of the practice on these sensitive upland areas has so far been limited by a lack of scientific data. In particular the effect of burning on concentrations of base cations and acid-base status of these highly organic soils has implications both for ecosystem nutrient status and for buffering of acidic waters. As part of the EMBER project peat chemistry data were collected in ten upland blanket peat catchments in the UK. Five catchments were subject to a history of prescribed rotational patch burning. The other five catchments acted as controls which were not subject to burning, nor confounded by other detrimental activities such as drainage or forestry. Soil solution chemistry was also monitored at two intensively studied sites (one regularly burned and one control). Fifty-centimetre soil cores, sectioned into 5-cm intervals, were collected from triplicate patches of four burn ages at each burned site, and from twelve locations at similar hillslope positions at each control site. At the two intensively monitored sites, soil solution chemistry was monitored at four depths in each patch. Across all sites, burned plots had significantly smaller cation exchange capacities, lower concentrations of exchangeable base cations and increased concentrations of exchangeable H+ and Al3+ in near-surface soil. C/N ratios were also lower in burned compared to unburned surface soils. There was no consistent trend between burn age and peat chemistry across all burned sites, possibly reflecting local controls on post-burn recovery rates or external influences on burn management decisions. At the intensively monitored site, plots burned less than two years

Report From the California Burn Registry—The Causes of Major Burns

PubMed Central

Bongard, Frederic S.; Ostrow, Louis B.; Sacks, Susan T.; McGuire, Andrew; Trunkey, Donald D.

1985-01-01

In its first four years of operation, the California Burn Registry recorded 3,332 cases of burns, of which 73.1% were in male and 26.9% were in female patients of all ages. The average total body surface area burned was 15.4±0.3%. Flame burns were the most common (31.4%). Other common sources included scalds (24.5%) and flammable liquids (12.9%). Several other causes were cited with less frequency. Burns taking place at home occurred more commonly than at all other locations combined. In all, 221 deaths (6.6%) were reported, most (66.1%) of which were due to flame burns. PMID:4013280

Children with burn injuries-assessment of trauma, neglect, violence and abuse

PubMed Central

Toon, Michael H.; Maybauer, Dirk M.; Arceneaux, Lisa L.; Fraser, John F.; Meyer, Walter; Runge, Antoinette; Maybauer, Marc O.

2011-01-01

Abstract: Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA) of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child's palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists. PMID:21498973

Trauma mechanisms and injury patterns in pediatric burn patients.

PubMed

Moehrlen, Theres; Szucs, Thomas; Landolt, Markus A; Meuli, Martin; Schiestl, Clemens; Moehrlen, Ueli

2018-03-01

The objective of this study was to evaluate the frequency, severity, exact patterns and mechanisms of burn injuries in children. The patient records of children with acute burns admitted to the University Children's Hospital of Zurich were retrospectively reviewed over an 11year period. The age group with the highest risk, were children under the age of five (69%). Boys were overrepresented in all age groups, but the gender imbalance increased with age. Infants and toddlers were mainly injured by scalds and contact burns. Conversely, almost three quarters of injuries over the age of 9 were caused by flame. The majority of scald injuries was a result of pulling down hot liquids. The typical distribution of this accident scenario involved mainly the face, trunk and arms. More than half of all flame injuries occurred due to fire accelerants. 55% of children were passively involved while other children throwing flammable substances into a fire. Most of these injuries involved the face and arms. This study shows that burn etiology is age dependent. Additionally, our results demonstrate the diversity of burn accidents and their resulting injuries. These findings may help better specify target groups and subjects for prevention. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Dementia: A risk factor for burns in the elderly.

PubMed

Harvey, Lara; Mitchell, Rebecca; Brodaty, Henry; Draper, Brian; Close, Jacqueline

2016-03-01

Older people are disproportionately at risk of burn and have a high risk of dementia; however the impact of dementia on risk of burn is unknown. Linked hospitalisation and death records for individuals aged 65 years and older admitted to a NSW hospital for a burn over the ten year period 2003-2012 were analysed. Demographic and burn characteristics and health outcomes were compared for people with and without dementia. Incidence rates were calculated per 100,000 population and negative binomial regression was used to examine temporal trends. Of the 1535 older people hospitalised for a burn, 11.0% had a record of dementia. The age-standardised incidence rate for people with dementia was 22.7 per 100,000, and for people without dementia was 14.2 per 100,000 population, an incident rate ratio (IRR) of 1.6 (95%CI 1.3-2.0, p<0.0001). There was no significant change in rates over time. People with dementia were more likely to be admitted with burns to the trunk and have greater than 20% total body surface area (TBSA) burn. Mean length of stay (LOS) was more than double (24 vs 12 days) and 30-day mortality three times higher (15.4% vs 5.1%) for people with dementia. Adjusting for differences in age, sex, TBSA, inhalation injury, comorbidities and complications eliminated the increased mortality but not the difference in LOS. People with dementia were more likely to have been burnt by hot tap water (RR 2.3; 95%CI 1.8-2.8, p<0.0001) and ignition of clothing/nightwear (RR 2.6; 95% CI 1.2-5.4, p=0.0149) and to have sustained the burn in residential aged care (20.0%). Burns in people with dementia are significant injuries, which have not decreased over the past ten years despite prevention efforts to reduce burns in older people. Targeted prevention education in the home and residential aged care facilities is warranted. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

The wound/burn guidelines - 6: Guidelines for the management of burns.

PubMed

Yoshino, Yuichiro; Ohtsuka, Mikio; Kawaguchi, Masakazu; Sakai, Keisuke; Hashimoto, Akira; Hayashi, Masahiro; Madokoro, Naoki; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Isei, Taiki; Ito, Takaaki; Inoue, Yuji; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ogawa, Fumihide; Kadono, Takafumi; Kawakami, Tamihiro; Kukino, Ryuichi; Kono, Takeshi; Kodera, Masanari; Takahara, Masakazu; Tanioka, Miki; Nakanishi, Takeshi; Nakamura, Yasuhiro; Hasegawa, Minoru; Fujimoto, Manabu; Fujiwara, Hiroshi; Maekawa, Takeo; Matsuo, Koma; Yamasaki, Osamu; Le Pavoux, Andres; Tachibana, Takao; Ihn, Hironobu

2016-09-01

Burns are a common type of skin injury encountered at all levels of medical facilities from private clinics to core hospitals. Minor burns heal by topical treatment alone, but moderate to severe burns require systemic management, and skin grafting is often necessary also for topical treatment. Inappropriate initial treatment or delay of initial treatment may exert adverse effects on the subsequent treatment and course. Therefore, accurate evaluation of the severity and initiation of appropriate treatment are necessary. The Guidelines for the Management of Burn Injuries were issued in March 2009 from the Japanese Society for Burn Injuries as guidelines concerning burns, but they were focused on the treatment for extensive and severe burns in the acute period. Therefore, we prepared guidelines intended to support the appropriate diagnosis and initial treatment for patients with burns that are commonly encountered including minor as well as moderate and severe cases. Because of this intention of the present guidelines, there is no recommendation of individual surgical procedures. © 2016 Japanese Dermatological Association.

Global Burned Area and Biomass Burning Emissions from Small Fires

NASA Technical Reports Server (NTRS)

Randerson, J. T.; Chen, Y.; vanderWerf, G. R.; Rogers, B. M.; Morton, D. C.

2012-01-01

In several biomes, including croplands, wooded savannas, and tropical forests, many small fires occur each year that are well below the detection limit of the current generation of global burned area products derived from moderate resolution surface reflectance imagery. Although these fires often generate thermal anomalies that can be detected by satellites, their contributions to burned area and carbon fluxes have not been systematically quantified across different regions and continents. Here we developed a preliminary method for combining 1-km thermal anomalies (active fires) and 500 m burned area observations from the Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate the influence of these fires. In our approach, we calculated the number of active fires inside and outside of 500 m burn scars derived from reflectance data. We estimated small fire burned area by computing the difference normalized burn ratio (dNBR) for these two sets of active fires and then combining these observations with other information. In a final step, we used the Global Fire Emissions Database version 3 (GFED3) biogeochemical model to estimate the impact of these fires on biomass burning emissions. We found that the spatial distribution of active fires and 500 m burned areas were in close agreement in ecosystems that experience large fires, including savannas across southern Africa and Australia and boreal forests in North America and Eurasia. In other areas, however, we observed many active fires outside of burned area perimeters. Fire radiative power was lower for this class of active fires. Small fires substantially increased burned area in several continental-scale regions, including Equatorial Asia (157%), Central America (143%), and Southeast Asia (90%) during 2001-2010. Globally, accounting for small fires increased total burned area by approximately by 35%, from 345 Mha/yr to 464 Mha/yr. A formal quantification of uncertainties was not possible, but sensitivity

Frequency and clinical features of patients who attempted suicide by charcoal burning in Japan.

PubMed

Kato, Koji; Akama, Fumiaki; Yamada, Keigo; Maehara, Mizuki; Kimoto, Keitaro; Kimoto, Kousuke; Takahashi, Yuki; Sato, Reiko; Onishi, Yuichi; Matsumoto, Hideo

2013-02-15

To date, the clinical features between patients in Japan who have attempted suicide by charcoal burning and those who have attempted suicide by other methods in the context of a mental disorder diagnosis as assessed by structured interviews have not been reported. We enrolled 647 consecutive patients who attempted suicide and were hospitalized for inpatient treatment. Psychiatric diagnoses, frequency of suicide attempts, and clinical features were compared between charcoal burning and other suicide methods. Twenty of the 647 patients (3.1%) had attempted suicide by charcoal burning. The ratio of men to women was significantly higher by this method compared with that of other methods. The proportion of patients with mood disorders was significantly higher in the charcoal burning group than that in the other methods group. The occurrence of a psychiatric history in patients in the charcoal burning group was significantly lower than that in the other methods group. The study sample was limited to a single hospital. The results demonstrate the clinical characteristics of patients who attempted suicide by charcoal burning. Therefore, it is necessary to identify the clinical features of patients who have attempted suicide by charcoal burning in Japan. Copyright © 2012 Elsevier B.V. All rights reserved.

IL-6 Signal From the Bone Marrow is Required for the Browning of White Adipose Tissue Post Burn Injury.

PubMed

Abdullahi, Abdikarim; Chen, Peter; Stanojcic, Mile; Sadri, Ali-Reza; Coburn, Natalie; Jeschke, Marc G

2017-01-01

The hypermetabolic stress response after burn contributes to multi-organ failure, sepsis, morbidity, and mortality. The cytokine interleukin 6 (IL-6) has been hypothesized to mediate not only white adipose tissue (WAT) browning in burns, but also other hypermetabolic conditions. In addition to its inflammatory effects, IL-6 also acts as a metabolic mediator that affects metabolic tissues. Therefore, we sought to uncover the origin of circulating IL-6 post burn injury that regulates WAT browning. WAT and sera samples were collected from both adult burn patients admitted to the Ross Tilley Burn Centre at Sunnybrook Hospital and mice subjected to a burn injury. Collected tissues were analyzed for browning markers and metabolic state via histology, gene expression, and resting energy expenditure. Increased WAT browning was observed in burn patients as well as mice subjected to burn injury. Circulating IL-6 levels were significantly elevated post burn injury in mice (<0.05) and in burn patients (<0.05), the latter of which was positively correlated with elevated REE. Genetic loss of whole body IL-6 in mice prevented burn-induced WAT browning. Transplanting IL-6 knockout (KO) mice with bone marrow (BM) from wild-type (WT) mice, recovered the browning phenotype in these mice, as evaluated by increased uncoupling protein 1 (UCP1) expression (<0.05). Conversely, transplanting irradiated WT mice with BM from IL-6 KO mice impaired burn induced browning with no significant expression of UCP1. Together, our findings implicate BM derived IL-6 as the source controlling browning of WAT post burn injury. Thus, targeting IL-6 is a promising target for hypermetabolism in burns.

Resuscitation burn card--a useful tool for burn injury assessment.

PubMed

Malic, C C; Karoo, R O S; Austin, O; Phipps, A

2007-03-01

It is well recognised that the initial assessment of body surface area affected by a burn is often over estimated in Accident and Emergency Departments. A useful aide-memoir in the acute setting is Wallace's "rule of nines" or using the patients' palmar surface of the hand, which approximates 1% of the total body surface area, as a method of assessment. Unfortunately, as with every system, limitations apply. Factors such as patient size and the interpretation of what is exactly the 'palmar surface' may significantly influence burn size estimations and subsequently fluid resuscitation. Our aim is to develop a simple, quick and easy reproducible method of calculating burn injuries for medical professionals in the acute setting. Worldwide, the dimensions of a credit card are standardized (8.5 cm x 5.3 cm), thus producing a surface area of 45 cm2. We created a resuscitation burn card (RBC) using these exact same proportions, upon which a modified body surface area (BSA) nomogram was printed. Knowing the patient height and weight, we calculated the surface area of the card as percentage of total body surface area (TBSA). On the opposite site of the RBC, a Lund and Browder chart was printed, as well as the Parkland formula and a formula to calculate paediatric burn fluid requirements. The plastic, flexible RBC conformed well to the body contour and was designed for single use. We used the resuscitation burn card in the initial assessment of simulated burns in a Regional Burn Centre and in an Accident and Emergency Department. The information present on the card was found to be clear and straightforward to use. The evaluation of burn extent was found to be more accurately measured than the estimation obtained without the RBC. The resuscitation burn card can be a valuable tool in the hands of less experienced medical professionals for the early assessment and fluid resuscitation of a burn.

Scald burns in children aged 14 and younger in Australia and New Zealand—an analysis based on the Burn Registry of Australia and New Zealand (BRANZ).

PubMed

Riedlinger, Dorothee I; Jennings, Paul A; Edgar, Dale W; Harvey, John G; Cleland, Ms Heather J; Wood, Fiona M; Cameron, Peter A

2015-05-01

Scalds are a common injury in children and a frequent reason for hospitalisation despite being a preventable injury. This retrospective two year study reports data from 730 children aged 14 years or younger who sustained a scald between 2009 and 2010 and were admitted to a burns centre in Australia or New Zealand. Data were extracted from the Burn Registry of Australia and New Zealand (BRANZ), which included data from 13 burns centres in Australia and New Zealand. Scald injury contributed 56% (95% CI 53-59%) of all pediatric burns. There were two high risk groups; male toddlers age one to two, contributing 34% (95% CI 31-38%) of all scalds, and indigenous children who were over 3 times more likely to experience a scald requiring admission to a burns unit than their non-indigenous peers. First aid cooling by non-professionals was initiated in 89% (95% CI 86-91%) of cases but only 20% (95% CI 16-23%) performed it as recommended. This study highlights that effective burn first aid reduces hospital stay and reinforces the need to encourage, carers and bystanders to deliver effective first aid and the importance of targeted prevention campaigns that reduce the burden of pediatric scald burns in Australia and New Zealand. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

American Burn Association Practice Guidelines: Burn Shock Resuscitation

DTIC Science & Technology

2008-02-01

Ann Surg 1979;189: 546–52. 39. Jelenko C III, Williams JB, Wheeler ML, et al. Studies in shock and resuscitation, I: use of a hypertonic, albumin...SUMMARY ARTICLE American Burn Association Practice Guidelines Burn Shock Resuscitation Tam N. Pham, MD,* Leopoldo C . Cancio, MD,† Nicole S. Gibran...practice guidelines burn shock resuscitation 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Pham T. N., Cancio L. C

Burns inflicted by self or by others--an 11 year snapshot.

PubMed

Malic, C C; Karoo, R O S; Austin, O; Phipps, A

2007-02-01

In the United Kingdom, the incidence of assault by burning and of self inflicted burns increased significantly over the last decade. This has major implications both for service providers and society as a whole. Our aim was to investigate the differences in patients' characteristics, management and outcome following a burn sustained by either an assault or self immolation. Acute admissions to a tertiary Burn Centre were retrospectively reviewed over an 11 year period (1994-2005). Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of the patients were collected. Over an 11 year period, 1745 patients were admitted to the tertiary Burn Centre. Of this total, 41 patients (mean age 29 years+/-16) sustained burns following an assault, a further 86 patients (mean age of 37 years+/-12) had self inflicted burn injuries; males were preponderant in both groups. In this series, a history of alcohol or substance abuse was present in 25% of both cohorts, 63% of the patients with self inflicted injuries having a previously diagnosed psychiatric disorder. Petrol, accelerants and other flammable liquids were the main agents chosen to inflict injury in both the assault and self inflicted groups. The burn depth and surface area distribution was greater in the self inflicted group compared to those assaulted (29% versus 21%). A difference was also noted in the pattern of distribution of burns between the two groups, as well as between genders although this difference was not significant. Two-thirds (67.4%) of the self immolated patients and 56% of the assaulted group required surgery. The length of hospital stay was similar for both groups, averaging 20 days. The crude mortality for the self inflicted group was 29%, whereas in the assaulted patients, the overall mortality was 4.9%. Although the incidence of burns caused either by assault or attempted suicide is low, the affected patients require a

Targetting and guidance program documentation. [a user's manual

NASA Technical Reports Server (NTRS)

Harrold, E. F.; Neyhard, J. F.

1974-01-01

A FORTRAN computer program was developed which automatically targets two and three burn rendezvous missions and performs feedback guidance using the GUIDE algorithm. The program was designed to accept a large class of orbit specifications and to automatically choose a two or three burn mission depending upon the time alignment of the vehicle and target. The orbits may be specified as any combination of circular and elliptical orbits and may be coplanar or inclined, but must be aligned coaxially with their perigees in the same direction. The program accomplishes the required targeting by repeatedly converging successively more complex missions. It solves the coplanar impulsive version of the mission, then the finite burn coplanar mission, and finally, the full plane change mission. The GUIDE algorithm is exercised in a feedback guidance mode by taking the targeted solution and moving the vehicle state step by step ahead in time, adding acceleration and navigational errors, and reconverging from the perturbed states at fixed guidance update intervals. A program overview is presented, along with a user's guide which details input, output, and the various subroutines.

Economics of pediatric burns.

PubMed

Bass, Michael J; Phillips, Linda G

2008-07-01

Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

Comparing the reported burn conditions for different severity burns in porcine models: a systematic review.

PubMed

Andrews, Christine J; Cuttle, Leila

2017-12-01

There are many porcine burn models that create burns using different materials (e.g. metal, water) and different burn conditions (e.g. temperature and duration of exposure). This review aims to determine whether a pooled analysis of these studies can provide insight into the burn materials and conditions required to create burns of a specific severity. A systematic review of 42 porcine burn studies describing the depth of burn injury with histological evaluation is presented. Inclusion criteria included thermal burns, burns created with a novel method or material, histological evaluation within 7 days post-burn and method for depth of injury assessment specified. Conditions causing deep dermal scald burns compared to contact burns of equivalent severity were disparate, with lower temperatures and shorter durations reported for scald burns (83°C for 14 seconds) compared to contact burns (111°C for 23 seconds). A valuable archive of the different mechanisms and materials used for porcine burn models is presented to aid design and optimisation of future models. Significantly, this review demonstrates the effect of the mechanism of injury on burn severity and that caution is recommended when burn conditions established by porcine contact burn models are used by regulators to guide scald burn prevention strategies. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Preparation of Partial-Thickness Burn Wounds in Rodents Using a New Experimental Burning Device.

PubMed

Sakamoto, Michiharu; Morimoto, Naoki; Ogino, Shuichi; Jinno, Chizuru; Kawaguchi, Atsushi; Kawai, Katsuya; Suzuki, Shigehiko

2016-06-01

The manual application of hot water or hot metal to an animal's skin surface is often used to prepare burn wound models. However, manual burn creation is subject to human variability. We developed a new device that can control the temperature, time, and pressure of contact to produce precise and reproducible animal burn wounds and investigated the conditions required to prepare various burn wounds using our new device. We prepared burn wounds on F344 rats using 3 contact times 2, 4, and 10 seconds using a stamp heated to 80°C. We observed the wound-healing process macroscopically and histologically and evaluated the burn depth using a laser speckle contrast-imaging device, which evaluated the blood flow of the wound. The changes in the burned area over time, tissue perfusion of the burn wounds, histological evaluation of the burn depth by hematoxylin-eosin and azocarmine and aniline blue staining, and the epithelialization rate (the ratio of the epithelialized area to the wound length) were evaluated on histological sections. Results indicated that the burn wounds prepared with contact times of 2, 4, and 10 seconds corresponded to superficial dermal burns, deep dermal burns, and full-thickness burns, respectively. We demonstrated that partial- and full-thickness burn wounds can be precisely and reproducibly created with our new automated burning device.

Minimum deltaV Burn Planning for the International Space Station Using a Hybrid Optimization Technique, Level 1

NASA Technical Reports Server (NTRS)

Brown, Aaron J.

2015-01-01

The International Space Station's (ISS) trajectory is coordinated and executed by the Trajectory Operations and Planning (TOPO) group at NASA's Johnson Space Center. TOPO group personnel routinely generate look-ahead trajectories for the ISS that incorporate translation burns needed to maintain its orbit over the next three to twelve months. The burns are modeled as in-plane, horizontal burns, and must meet operational trajectory constraints imposed by both NASA and the Russian Space Agency. In generating these trajectories, TOPO personnel must determine the number of burns to model, each burn's Time of Ignition (TIG), and magnitude (i.e. deltaV) that meet these constraints. The current process for targeting these burns is manually intensive, and does not take advantage of more modern techniques that can reduce the workload needed to find feasible burn solutions, i.e. solutions that simply meet the constraints, or provide optimal burn solutions that minimize the total DeltaV while simultaneously meeting the constraints. A two-level, hybrid optimization technique is proposed to find both feasible and globally optimal burn solutions for ISS trajectory planning. For optimal solutions, the technique breaks the optimization problem into two distinct sub-problems, one for choosing the optimal number of burns and each burn's optimal TIG, and the other for computing the minimum total deltaV burn solution that satisfies the trajectory constraints. Each of the two aforementioned levels uses a different optimization algorithm to solve one of the sub-problems, giving rise to a hybrid technique. Level 2, or the outer level, uses a genetic algorithm to select the number of burns and each burn's TIG. Level 1, or the inner level, uses the burn TIGs from Level 2 in a sequential quadratic programming (SQP) algorithm to compute a minimum total deltaV burn solution subject to the trajectory constraints. The total deltaV from Level 1 is then used as a fitness function by the genetic

Phenolic compounds of Pinus laricio needles: a bioindicator of the effects of prescribed burning in function of season.

PubMed

Cannac, Magali; Pasqualini, Vanina; Barboni, Toussaint; Morandini, Frederic; Ferrat, Lila

2009-07-15

Fire is a dominant ecological factor in Mediterranean-type ecosystems. Forest management includes many preventive tools, in particular for fire prevention, such as mechanical treatments and prescribed burning. Prescribed burning is a commonly used method for treating fuel loads, but fuel reduction targets for reducing wildfire hazards must be balanced against fuel retention targets in order to maintain habitat and other forest functions. This approach was used on Pinus nigra ssp laricio var. Corsicana, a pine endemic to Corsica of great ecological and economic importance. Many studies of plant phenolic compounds have been carried out concerning responses to various stresses. The aim of this study was to understand i) the effects of prescribed burning 1 to 16 months later and ii) the effects of the seasonality of burning, spring or fall, on the production of phenolic compounds in Pinus laricio. After prescribed burning conducted in spring, Pinus laricio increases the synthesis of total phenolic compounds for a period of 7 months. The increase is greater after spring-burning than fall-burning. With regard to simple phenols, only dihydroferulic acid responds about 1 year after both types of prescribed burning. The causes of these increases are discussed in this paper. Total phenolic compounds could be used as a bioindicator for the short-term response of Pinus laricio needles to prescribed burning. Simple phenols may be useful for revealing the medium-term effects of prescribed burning. The results of this study include recommending forest managers to use prescribed burning in the fall rather than spring to reduce fuel loads and have less impact on the trees.

Critical issues in burn care.

PubMed

Holmes, James H

2008-01-01

Burn care, especially for serious burn injuries, represents a considerable challenge for the healthcare system. The American Burn Association has established a number of strategies for the management of burn patients and dedicates its efforts and resources to promoting and supporting burn-related research, education, care, rehabilitation, and prevention, often in collaboration with other organizations. The American Burn Association has recommended that patients with serious burns be referred to a designated burn center, ie, a hospital outfitted with specialized personnel and equipment dedicated to burn care. Burn centers have been operational for over 50 years, but the complexity and costs of providing specialized burn care have given rise to a number of critical administrative and political issues. These include logistical limitations imposed by the uneven national distribution of burn centers and a potential shortage of burn beds, both during everyday conditions and in the event of a mass disaster. Burn surgeon shortages have also been identified, stemming, in part, from a lack of specialized burn care training opportunities. There is currently a lack of quality outcome data to support evidence-based recommendations for burn care, and burn care centers are compromised by problems obtaining reimbursement for the care of uninsured and publicly insured out-of-state burn patients. Initiatives are underway to maintain efficient burn care facilities that are fully funded, easily accessible, and most importantly, provide optimal, evidence-based care on a daily basis, and are well-equipped to handle a surge of patients during a disaster situation.

Initial Neutron Burn Truncation Experiments on OMEGA

NASA Astrophysics Data System (ADS)

McKenty, P. W.; Keck, R. L.; Kremens, R. L.; Kearney, K. J.; Verdon, C. P.; Zuegel, J. D.; Cable, M. D.; Ognibene, T. J.; Lerche, R. A.; Griffith, R. L.

1997-11-01

The recent deployment of the neutron temporal diagnostic (NTD) on OMEGA has enabled us to perform a series of experiments that will serve as a base line in understanding the effects of various levels of irradiation nonuniformities on neutron burn rates. These experiments were performed using doped and undoped plastic microballoons imploded with 30 kJ of 351-nm (UV) light. Precise control of laser focusing on OMEGA allowed for on-target laser perturbations to be varied from 0.1 to 1.0 μ*m rms. The targets were designed for moderate convergence ( ~*10) and spanned a range of growth factor from ~*50 to 500 ( ~*4 to 6 total e-foldings). Results will be presented depicting the experimental Y*ield O*ver C*lean (YOC) one-dimensionally predicted yield as a function of the calculated distortion fraction and an appraisal of the experimental fuel areal density. Both of these will be evaluated using information gained from the examination of the NTD neutron burn curves. This work was supported by the U.S. Department of Energy Office of Inertial Confinement Fusion under Cooperative Agreement No. DE-FC03-92SF19460.

Efficacy of moist exposed burn ointment on burns.

PubMed

Zhang, Hong-Qi; Yip, Tsui-Pik; Hui, Irene; Lai, Vincy; Wong, Ann

2005-01-01

In this study, we sought to test the medical efficacy of a Chinese medical herb product, moist exposed burn ointment (MEBO), on wound healing rate and infection control in burn injury. Standardized deep burn wounds were created on the back skin of rats by applying a hot brass bar for 12 to 18 seconds. MEBO was applied four times per day and compared with petroleum jelly, silver sulfadiazine, and dry exposure therapy. Under such a controlled setting, although MEBO had a better wound healing rate than the dry exposure treatment, it did not show the medical advantage statistically, as has been claimed, over the other two treatments (P > .05), either in terms of wound healing rate or bacterial control. We conclude that the MEBO is not suitable for deep burn wound treatment, particularly when infection is a concern.

Educational Materials - Burn Wise

EPA Pesticide Factsheets

Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

Severe childhood burns in the Czech Republic: risk factors and prevention

PubMed Central

Čelko, Alexander Martin; Dáňová, Jana; Barss, Peter

2009-01-01

Abstract Objective To assess risk factors for paediatric burn injuries in the Czech Republic and to suggest preventive measures. Methods This study included all children aged 0–16 years hospitalized during 1993–2000 at the Prague Burn Centre and data from the Czech Ministry of Health on national paediatric burn hospitalizations during 1996–2006. Personal, equipment and environmental risk factors were identified from hospital records. Findings The incidence of burn admissions among 0–14 year-olds increased from 85 to 96 per 100 000 between 1996 and 2006, mainly due to a 13% increase among 1–4 year-olds. Between 1993–2000 and 2006, the proportion of burn victims in the country hospitalized at the Prague Burn Centre increased from 9% to 21%. Detailed data were available on 1064 children (64% boys). Around 31% of all burn hospitalizations were in 1 year-olds. Some 79% of burns occurred at home: 70% in the kitchen, 14% in the living room or bedroom and 11% in the bathroom. Of the 18% occurring outdoors, 80% involved boys. Scalds from hot liquids accounted for 70% of all burns. The mean hospital stay was 22 days for boys and 18 days for girls. Conclusion Most burns involved scalds from hot liquids at home: beverages in kitchens and water in bathrooms. There is a need for passive preventive measures, such as redesigned domestic cooking and eating areas, safer electrical kettles and temperature control devices for bathrooms. Educational programmes should be developed for parents and caregivers. A national plan for child burn prevention with specific targets would be helpful. PMID:19551256

Work-Related Burn Injuries Hospitalized in US Burn Centers: 2002 to 2011.

PubMed

Huang, Zhenna; Friedman, Lee S

2017-03-01

To develop a comprehensive definition to identify work-related burns in the National Burn Repository (NBR) based on multiple fields and describes injuries by occupation. The NBR, which is an inpatient dataset, was used to compare type and severity of burn injuries by occupation. Using the definition developed for this analysis, 22,969 burn injuries were identified as work-related. In contrast, the single work-related field intended to capture occupational injuries only captured 4696 cases. The highest numbers of burns were observed in construction/extraction, food preparation, and durable goods production occupations. Occupations with a mean total body surface area (TBSA) burned greater than 10% include transportation and material-moving, architecture and engineering, and arts/design/entertainment/sports/media occupations. The NBR dataset should be further utilized for occupational burn injury investigations and multiple fields should be considered for case ascertainment.

Minor burns - aftercare

MedlinePlus

... Larger than 2 inches (5 cm) On the hand, foot, face, groin, buttocks, hip, knee, ankle, shoulder, elbow, or wrist First aid for Minor Burns First, calm and reassure the person who is burned. If clothing is not stuck to the burn, remove it. ...

Evaluation of the FEERv1.0 Global Top-Down Biomass Burning Emissions Inventory over Africa

NASA Astrophysics Data System (ADS)

Ellison, L.; Ichoku, C. M.

2014-12-01

With the advent of the Fire Energetics and Emissions Research (FEER) global top-down biomass burning emissions product from NASA Goddard Space Flight Center, a subsequent effort is going on to analyze and evaluate some of the main (particulate and gaseous) constituents of this emissions inventory against other inventories of biomass burning emissions over the African continent. There is consistent and continual burning during the dry season in NSSA of many small slash-and-burn fires that, though may be relatively small fires individually, collectively contribute 20-25% of the global total carbon emissions from biomass burning. As a top-down method of estimating biomass-burning emissions, FEERv1.0 is able to yield higher and more realistic emissions than previously obtainable using bottom-up methods. Results of such comparisons performed in detail over Africa will be discussed in this presentation. This effort is carried out in conjunction with a NASA-funded interdisciplinary research project investigating the effects of biomass burning on the regional climate system in Northern Sub-Saharan Africa (NSSA). Essentially, that project aims to determine how fires may have affected the severe droughts that plagued the NSSA region in recent history. Therefore, it is imperative that the biomass burning emissions input data over Africa be as accurate as possible in order to obtain a confident understanding of their interactions and feedbacks with the hydrological cycle in NSSA.

The effect of family characteristics on the recovery of burn injuries in children.

PubMed

Sheridan, Robert L; Lee, Austin F; Kazis, Lewis E; Liang, Matthew H; Li, Nien-Chen; Hinson, Michelle I; Bauk, Helena; Meyer, Walter J; Stubbs, Teresa K; Palmieri, Tina L; Tompkins, Ronald G

2012-09-01

Interactions between family members and characteristics of family life and function may affect a child's recovery from burn injury. We prospectively examined the relationship between family characteristics and physical and psychosocial recovery from burns. The families of 399 burned children aged 5 years to 18 years admitted to one of four Shriners Hospitals for Children for management of acute burns completed the Family Environment Scale within 7 days of admission and then the American Burn Association/Shriners Hospitals for Children Burn Outcome Questionnaire (BOQ) at baseline, 3, 6, 12, 18, 24, 36, and 48 months. Generalized estimating equations with random effects for the time since burn were used to track recovery of the BOQ patient-centered domains associated with baseline family characteristics during the course of the study. The children had a mean age of 11 years and burn size of 32% total body surface area burned. Higher Family Environment Scale scores in cohesion, independence, organization, and active recreational orientation were associated with significantly better rates of recovery in multiple BOQ domains of health-related quality of life. Higher scores in conflict and achievement orientation predicted statistically significant impaired recovery. Higher expressiveness predicted greater difficulty with school reentry. Family characteristics affect the recovery of children after serious burns. Some of these may be amenable to focused anticipatory family interventions to help optimize outcomes. In particular, those characteristics that impair school reentry should be targeted.

Acoustic emission strand burning technique for motor burning rate prediction

NASA Technical Reports Server (NTRS)

Christensen, W. N.

1978-01-01

An acoustic emission (AE) method is being used to measure the burning rate of solid propellant strands. This method has a precision of 0.5% and excellent burning rate correlation with both subscale and large rocket motors. The AE procedure burns the sample under water and measures the burning rate from the acoustic output. The acoustic signal provides a continuous readout during testing, which allows complete data analysis rather than the start-stop clockwires used by the conventional method. The AE method helps eliminate such problems as inhibiting the sample, pressure increase and temperature rise, during testing.

Burns - Multiple Languages

MedlinePlus

... Burn Care - العربية (Arabic) Bilingual PDF Health Information Translations Chinese, Simplified (Mandarin dialect) (简体中文) Expand Section Burn ... Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Burn ...

California Burn Scars

Atmospheric Science Data Center

2014-05-15

article title:  Burn Scars Across Southern California     ... California between October 21 and November 18, 2003. Burn scars and vegetation changes wrought by the fires are illustrated in these ... and Nov 18, 2003 Images:  California Burn Scars location:  United States region:  ...

Advances in Orion's On-Orbit Guidance and Targeting System Architecture

NASA Technical Reports Server (NTRS)

Scarritt, Sara K.; Fill, Thomas; Robinson, Shane

2015-01-01

NASA's manned spaceflight programs have a rich history of advancing onboard guidance and targeting technology. In order to support future missions, the guidance and targeting architecture for the Orion Multi-Purpose Crew Vehicle must be able to operate in complete autonomy, without any support from the ground. Orion's guidance and targeting system must be sufficiently flexible to easily adapt to a wide array of undecided future missions, yet also not cause an undue computational burden on the flight computer. This presents a unique design challenge from the perspective of both algorithm development and system architecture construction. The present work shows how Orion's guidance and targeting system addresses these challenges. On the algorithm side, the system advances the state-of-the-art by: (1) steering burns with a simple closed-loop guidance strategy based on Shuttle heritage, and (2) planning maneuvers with a cutting-edge two-level targeting routine. These algorithms are then placed into an architecture designed to leverage the advantages of each and ensure that they function in concert with one another. The resulting system is characterized by modularity and simplicity. As such, it is adaptable to the on-orbit phases of any future mission that Orion may attempt.

Pressure necrosis masquerading as a burn injury in a patient with a cervical epidural abscess producing acute quadriplegia.

PubMed

Thorpe, Eric J; McCallin, John P; Miller, Sidney F

2008-01-01

A case of a patient with acute onset of quadriplegia from a cervical epidural abscess referred to our tertiary burn center is presented. The pattern of the patient's 'burns' suggested pressure necrosis. A literature review was undertaken of this unusual condition, its evaluation and management. Cervical epidural abscesses are rare and present in a variety of ways. Acute onset of quadriplegia without a history of trauma should trigger a workup to make the diagnosis. The management of complicating skin lesions or burns and the patient outcome will primarily be determined by the management of the epidural abscess.

Parent knowledge on paediatric burn prevention related to the home environment.

PubMed

Cox, Sharon G; Burahee, Abdus; Albertyn, Rene; Makahabane, Jahelihle; Rode, Heinz

2016-12-01

people living in environments optimal for burn incidents know relatively little about burn prevention strategies. Future intervention needs to not only target the population's behavior but most importantly needs to promote better education models. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Tweens feel the burn: "salt and ice challenge" burns.

PubMed

Roussel, Lauren O; Bell, Derek E

2016-05-01

To review our institution's experience with frostbite injury secondary to "salt and ice challenge" (SIC) participation. We conducted a retrospective analysis of intentional freezing burns from 2012 to 2014. Demographics, depth and location of burn, total body surface area of burn, treatment, time to wound healing, length of stay, complications, and motives behind participation were analyzed. Five patients were seen in the emergency department for intentional freezing burns that resulted from SIC (all females; mean age: 12.3 years; range age: 10.0-13.2 years). Mean total body surface area was 0.408%. Salt and ice was in contact with skin for >10 min for two patients, >20 min for two patients, and an unknown duration for one patient. Complications included pain and burn scar dyschromia. Four patients cited peer pressure and desire to replicate SIC as seen on the Internet as their motivation in attempting the challenge. SIC has become a popular, self-harming behavior among youths. Increased public education, and provider and parent awareness of SIC are essential to address this public health concern.

Burns and military clothing.

PubMed

McLean, A D

2001-02-01

Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

Lightning burns.

PubMed

Russell, Katie W; Cochran, Amalia L; Mehta, Sagar T; Morris, Stephen E; McDevitt, Marion C

2014-01-01

We present the case of a lightning-strike victim. This case illustrates the importance of in-field care, appropriate referral to a burn center, and the tendency of lightning burns to progress to full-thickness injury.

Self-inflicted Burns: 10 year review and comparison to national guidelines.

PubMed

Caine, P L; Tan, A; Barnes, D; Dziewulski, P

2016-02-01

There is an increasing trend of self-inflicted burns noted in the literature, often seen in patients with complex psychosocial backgrounds. These patients are challenging to manage as the recovery from the acute burn may be compounded by difficult rehabilitation and suboptimal coping strategies. We aimed to review patients presenting to our burns unit with self-inflicted burns, the management strategies and examine the complexities surrounding their management. We assessed patient outcomes with a particular interest in psychosocial support given. A retrospective review of all patients presenting with self-inflicted burns over a 10 year period (2005-2014 inclusive) was conducted. Patients were identified through IBID database coded as either 'self-inflicted' or 'suicidal.' We reviewed patient and burn demographics, the clinical management, psychosocial management and patient outcomes such as wound healing, re-admission rates, and survival. We identified 118 self-inflicted burns in total. 50/118 (42%) were admitted. 64 (54%) were male and the total body surface burn area ranged from <0.5% to 99% with a median of 14%. 60/118 (51%) had TBSA <10% and 58/118 (49%) had TBSA >10%. 24 (48%) underwent admission to the Burn Intensive Care Unit (BITU). All patients admitted to BITU had TBSA >10%. Of those admitted to BITU 6 were palliative, 18 had full resuscitation and surgical management. Of those 18 patients who had active treatment, 10/18 (56%) died. Mean total length of stay was 31 days, range 1-130 days. 9% of patients sustained injuries whilst being a current inpatient at a psychiatric institution. Of all patients reviewed, 16% (n=19) had a previous history of deliberate self-harm through burns. Of those patients admitted, 98% of were reviewed by the mental health team during their admission with time to psychological review varying depending on fitness for assessment. The overall mean length of stay for all admitted patients who were actively treated but who

Development and Implementation of an Innovative Burn Nursing Handbook for Quality Improvement

PubMed Central

Olszewski, Anna; Yanes, Amber; Stafford, Jessica; Greenhalgh, David G.; Palmieri, Tina L.; Sen, Soman; Tran, Nam

2015-01-01

Objective Evidence-based burn nursing literature is extremely limited and often non-existent. As a result, there is a lack of standardization in burn nursing care. Our objective is to evaluate burn nursing knowledge at an academic medical center and implement innovative educational tools to enhance staff competency and improve the quality of care. Methods A collaboration of practicing clinical nurses developed a 24-question knowledge assessment survey (“pre-survey”) to evaluate fundamental burn nursing knowledge (fluid management, burn pathophysiology, burn-related procedures, wound care, infection control). Pre-education knowledge surveys were administered to 59 burn nurses electronically. A writing team of new and experienced nurses was established and developed a 51-page handbook focusing on areas of need identified in the survey. This book was disseminated to staff as required reading. Post-educational surveys were sent to the same nurses who completed the initial survey. Results Forty-six nurses (46/59, 78.0%) completed the survey with a mean (SD) of 55.9 (11.0)% of questions being answered correctly. Post-surveys sent to the same 46 nurses who completed the pre-survey had a response rate of 78.3% (36/46). We observed a significant increase in correctly answered questions (mean [SD]: 69.6 (8.7)%, P<0.001) in the post-survey intervention. Conclusion The handbook improved education and significantly improved overall fundamental burn knowledge of practicing nursing staff. Use of electronic surveys to drive development of targeted educational interventions provides evidence-based tools for establishing burn nursing standards and developing quality improvement metrics. PMID:26284646

The Impact of Legislation on Gas Can- and Mattress-Related Burn Injuries.

PubMed

Kellogg, Levi; Butcher, Brandon; Peek-Asa, Corinne; Wibbenmeyer, Lucy

2018-01-01

Burn prevention program success requires thorough evaluation of intervention outcomes. The impact of 2 engineering-specific burn prevention regulations, the Children's Gasoline Burn Prevention Act and the Standard for the Flammability of Mattress Sets, will be assessed. Records from 1997 to 2015 within the Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS) were reviewed. After identifying gas can- and mattress-involved burn injuries, injury incidence was estimated by utilizing survey sampling weights associated with each record. Logistic regression, incorporating estimated injury incidence and adjusting for gender and age, was performed to test for change in injury risk following these regulations. Within NEISS, there were 493 burns involving gas cans, yielding an estimated 19,339 injuries (95% confidence interval [CI], 15,781-22,896) during the 19-year study period. The odds of a gas can burn injury after legislation decreased by 67% for children younger than 5 years (odds ratio [OR], 0.33; 95% CI, 0.16-0.66; P = 0.0018). There was no significant change in risk for persons 5 years and older (OR, 1.07; 95% CI, 0.80-1.41; P = 0.66). During the same time, there were 219 NEISS burns involving mattresses, yielding an estimated 6864 injuries (95% CI, 5071-8658). The odds of a mattress burn injury following legislation enactment decreased by 31% for all ages (OR, 0.69; 95% CI, 0.51-0.94; P = 0.02). Both regulations decreased the odds of injury in their target populations. This study demonstrates that passive interventions involving engineering standards remain a powerful tool for burn prevention and should be the focus of future efforts to improve burn care.

Prospective evaluation of parent distress following pediatric burns and identification of risk factors for young child and parent posttraumatic stress disorder.

PubMed

De Young, Alexandra C; Hendrikz, Joan; Kenardy, Justin A; Cobham, Vanessa E; Kimble, Roy M

2014-02-01

Early childhood is a high-risk time for exposure to potentially traumatic medical events. We have previously reported that 10% of young children continue to have posttraumatic stress disorder (PTSD) 6 months after burn injury. This study aimed to 1) document the prevalence and prospective change in parental psychological distress over 6 months following their child's burn injury and 2) identify risk factors for posttraumatic stress symptoms (PTSS) in young children and their parents. Participants were 120 parents of 1-6-year-old children with unintentional burn injuries. Data were collected within 2 weeks, 1 month, and 6 months of burn injury using developmentally sensitive diagnostic interviews and questionnaires. Within the first month, ∼ 25% of parents had a probable PTSD diagnosis, and moderate to extremely severe levels of depression, anxiety, and stress. Distress levels decreased significantly over time; however, 5% of parents still had probable PTSD at 6 months. Hierarchical multiple regression and path analyses indicated that parent posttraumatic stress reactions contributed significantly to the development and maintenance of child PTSS. Other risk factors for child PTSS included premorbid emotional and behavioral difficulties and larger burn size. Risk factors identified for parent PTSS included prior trauma history, acute distress, greater number of child invasive procedures, guilt, and child PTSS. The findings from this study suggest that parents' responses to a traumatic event may play a particularly important role in a young child's psychological recovery. However, further research is needed to confirm the direction of the relationship between child and parent distress. This study identified variables that could be incorporated into screening tools or targeted by early intervention protocols to prevent the development of persistent child and parent PTSS following medical trauma.

Perceptions of prescribed burning in a local forest community in Victoria, Australia.

PubMed

Bell, Tina; Oliveras, Immaculada

2006-11-01

The general perceptions of prescribed burning were elicited from forest users for an area that has been subject to this form of land management for at least 20 years. The largest group consisted of local residents living in and around the Wombat State Forest with two smaller groups of students from a nearby university campus and local professional land managers. A questionnaire was given to each participant in order to explore how the forest was used, to determine the level of knowledge of burning in the targeted forest and Victoria and the perception of the appearance, effectiveness of protection, and accessibility to the forest after prescribed burning. Generally all groups had similar responses with community members having stronger views on the effectiveness and practicalities of prescribed burning, whereas students were more neutral in their opinions. All participants claimed knowledge of prescribed burning activities within Victoria, but fewer had experience of planned fires in the Wombat State Forest. All groups agreed that areas that had not been recently burned had a better appearance than those that had, but this result may have included a range of value judgments. Land managers had a greater understanding of the ecological importance of season and timing of burning; however, some students and community members were equally knowledgeable. Prescribed burning did not impede access to the forest, nor did smoke from prescribed burns pose any great problem. The majority of the participants felt that the amount of prescribed burning done in the forest was adequate for engendering a feeling of protection to life and property, yet many were still suspicious of this management practice. These initial findings indicate several areas in which further research would be useful including the efficacy of education programs for community members and improved communication of burn plans by land managers.

Treatment Strategies for Hypopigmentation in the Context of Burn Hypertrophic Scars

PubMed Central

Carney, Bonnie C.; McKesey, Jacqueline P.; Rosenthal, Dean S.

2018-01-01

Dyspigmentation in burn scars can contribute to the development of psychosocial complications after injury and can be detrimental to social reintegration and quality of life for burn survivors. Although treatments for skin lightening to treat hyperpigmentation have been well reviewed in the literature, skin-darkening strategies to treat hypopigmentation have not. The following potential treatment options in the context of burn hypertrophic scar will be discussed: use of the melanocyte-keratinocyte transplantation procedure, use of ectopic synthetic analogues of alpha-melanocyte stimulating hormone to initiate melanogenesis, and use of FK506 to induce melanogenesis. A proposed future direction of research in laser-assisted drug delivery of inducers of local melanin production, with the hope of developing a targeted, effective approach to dyspigmentation in hypertrophic scar is also discussed. PMID:29464168

The inter-rater reliability of estimating the size of burns from various burn area chart drawings.

PubMed

Wachtel, T L; Berry, C C; Wachtel, E E; Frank, H A

2000-03-01

The accuracy and variability of burn size calculations using four Lund and Browder charts currently in clinical use and two Rule of Nine's diagrams were evaluated. The study showed that variability in estimation increased with burn size initially, plateaued in large burns and then decreased slightly in extensive burns. The Rule of Nine's technique often overestimates the burn size and is more variable, but can be performed somewhat faster than the Lund and Browder method. More burn experience leads to less variability in burn area chart drawing estimates. Irregularly shaped burns and burns on the trunk and thighs had greater variability than less irregularly shaped burns or burns on more defined anatomical parts of the body.

Epidemiologic characteristics, knowledge and risk factors of unintentional burns in rural children in Zunyi, Southwest China

PubMed Central

Shi, Shangpeng; Yang, Huajun; Hui, Ya; Zhou, Xiang; Wang, Tao; Luo, Ya; Xiang, Huiyun; Shi, Xiuquan

2016-01-01

We investigated the knowledge level and risk factors for pediatric unintentional burns in rural Southwest China with an aim to provide basic evidence for the prevention strategies. A stratified sampling method was used to recruit 1842 rural children from 9 schools. Self-reported burns during the past 12 months and relevant risk factors were collected by questionnaires. The burn incidence of all surveyed children was 12.7% (95% confidence interval [95% CI] 11.2–14.2%). We found that burn incidence had a trend to increase with the increasing school grade level and a trend to decrease with increasing knowledge scores on burns. The top two causes of burns were hot liquids (36.3%) and hot object (29.5%). More than 30% of children had little knowledge about preventive measures and how to give first-aid after burns. The main risk factors for burns included female gender, left-behind children by parents who were working in cities, and poor mother school education level. As the incidence of pediatric unintentional burns was high in rural southwest China, schools, families, and local public health agencies should put efforts into health education targeting burn prevention and first-aid measures after burns, particularly in “left-behind” children and those with mothers with poor education. PMID:27748426

Results of Propellant Mixing Variable Study Using Precise Pressure-Based Burn Rate Calculations

NASA Technical Reports Server (NTRS)

Stefanski, Philip L.

2014-01-01

A designed experiment was conducted in which three mix processing variables (pre-curative addition mix temperature, pre-curative addition mixing time, and mixer speed) were varied to estimate their effects on within-mix propellant burn rate variability. The chosen discriminator for the experiment was the 2-inch diameter by 4-inch long (2x4) Center-Perforated (CP) ballistic evaluation motor. Motor nozzle throat diameters were sized to produce a common targeted chamber pressure. Initial data analysis did not show a statistically significant effect. Because propellant burn rate must be directly related to chamber pressure, a method was developed that showed statistically significant effects on chamber pressure (either maximum or average) by adjustments to the process settings. Burn rates were calculated from chamber pressures and these were then normalized to a common pressure for comparative purposes. The pressure-based method of burn rate determination showed significant reduction in error when compared to results obtained from the Brooks' modification of the propellant web-bisector burn rate determination method. Analysis of effects using burn rates calculated by the pressure-based method showed a significant correlation of within-mix burn rate dispersion to mixing duration and the quadratic of mixing duration. The findings were confirmed in a series of mixes that examined the effects of mixing time on burn rate variation, which yielded the same results.

Burn Wise

EPA Pesticide Factsheets

Burn Wise is a partnership program of the U.S. Environmental Protection Agency that emphasizes the importance of burning the right wood, the right way, in the right appliance to protect your home, health, and the air we breathe.

Particle agglomeration and fuel decomposition in burning slurry droplets

NASA Astrophysics Data System (ADS)

Choudhury, P. Roy; Gerstein, Melvin

In a burning slurry droplet the particles tend to agglomerate and produce large clusters which are difficult to burn. As a consequence, the combustion efficiency is drastically reduced. For such a droplet the nonlinear D2- t behavior associated with the formation of hard to burn agglomerates can be explained if the fuel decomposes on the surface of the particles. This paper deals with analysis and experiments with JP-10 and Diesel #2 slurries prepared with inert SiC and Al 2O 3 particles. It provides direct evidence of decomposed fuel residue on the surface of the particles heated by flame radiation. These decomposed fuel residues act as bonding agents and appear to be responsible for the observed agglomeration of particles in a slurry. Chemical analysis, scanning electron microscope photographs and finally micro-analysis by electron scattering clearly show the presence of decomposed fuel residue on the surface of the particles. Diesel #2 is decomposed relatively easily and therefore leaves a thicker deposit on SiC and forms larger agglomerates than the more stable JP-10. A surface reaction model with particles heated by flame radiation is able to describe the observed trend of the diameter history of the slurry fuel. Additional experiments with particles of lower emissivity (Al 2O 3) and radiation absorbing dye validate the theoretical model of the role of flame radiation in fuel decomposition and the formation of agglomerates in burning slurry droplets.

Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

PubMed

Wearn, Christopher; Hardwicke, Joseph; Kitsios, Andreas; Siddons, Victoria; Nightingale, Peter; Moiemen, Naiem

2015-09-01

Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Wound management and outcome of 595 electrical burns in a major burn center.

PubMed

Li, Haisheng; Tan, Jianglin; Zhou, Junyi; Yuan, Zhiqiang; Zhang, Jiaping; Peng, Yizhi; Wu, Jun; Luo, Gaoxing

2017-06-15

Electrical burns are important causes of trauma worldwide. This study aims to analyze the clinical characteristics, wound management, and outcome of electric burns. This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University during 2013-2015. Data including the demographics, injury patterns, wound treatment, and outcomes were collected and analyzed. A total of 595 electrical burn patients (93.8% males) were included. The average age was 37.3 ± 14.6 y, and most patients (73.5%) were aged 19∼50 years. Most patients (67.2%) were injured in work-related circumstances. The mean total body surface area was 8.8 ± 11.8% and most wounds (63.5%) were full-thickness burns. Operation times of high-voltage burns and current burns were higher than those of low-voltage burns and arc burns, respectively. Of the 375 operated patients, 83.2% (n = 312) underwent skin autografting and 49.3% (n = 185) required skin flap coverage. Common types of skin flaps were adjacent (50.3%), random (42.2%), and pedicle (35.7%). Amputation was performed in 107 cases (18.0%) and concentrated on the hands (43.9%) and upper limbs (39.3%). The mean length of stay was 42.9 ± 46.3 d and only one death occurred (0.2%). Current burns and higher numbers of operations were major risk factors for amputation and length of stay, respectively. Electrical burns mainly affected adult males with occupational exposures in China. Skin autografts and various skin flaps were commonly used for electric burn wound management. More standardized and effective strategies of treatment and prevention are still needed to decrease amputation rates. Copyright © 2017 Elsevier Inc. All rights reserved.

[Clinical and biological monitoring of nutritional status in severe burns].

PubMed

Bargues, L; Cottez-Gacia, S; Jault, P; Renard, C; Vest, P

2009-01-01

Burn patients are subject to hypermetabolism and catabolic states. Aim was to evaluate our current practice in nutrition. Twenty-one severely burned patients were prospectively included during three months period. Body weight was measured at least two times in a week during all stay in burn ICU. Biological markers of inflammation (C-reactive protein, CRP) and nutrition (prealbumin) were performed weekly. Protocol included early nasogastric feeding, tolerated gastric stasis less than 250 mL at four hours nasogastric aspirations, caloric target value of 40 Kcal/kg per day and measurement of total daily calorie intakes. Patient demographics showed a mean percent total body surface burn of 51.1+/-27 % (range 20-90), age of 38.7+/-13.1 years (range 18-67) and 57.3 % of smoke inhalation. All patients were ventilated and 19 patients survived. Length of stay was 75.7+/-47 days (range 22-184). Patients received only 58.9+/-10 % of calorie intakes recommended by French burn society. Loss of body mass was 15.2+/-9 kg (range 3-31) or 19.1+/-10 % of admission weight (range 5-37). Erosion of body mass was not correlated with burned surface (p=0.08), calorie intakes (p=0.26), smoke inhalation (p=0.46), lengths of stay (p=0.53), lengths of ventilation (p=0.08) or nutrition (p=0.12), days of antibiotic (p=0.72), number of dressing changes (p=0.6) or surgery (p=0.64). Biological parameters showed CRP decreasing and prealbumin improving values. New strategies of nutrition are necessary to improve outcome and reduce body mass loss in burns.

Burning Mouth Syndrome.

PubMed

Kamala, K A; Sankethguddad, S; Sujith, S G; Tantradi, Praveena

2016-01-01

Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS.

Burning Mouth Syndrome

PubMed Central

Kamala, KA; Sankethguddad, S; Sujith, SG; Tantradi, Praveena

2016-01-01

Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS. PMID:26962284

Assessment of burn-specific health-related quality of life and patient scar status following burn.

PubMed

Oh, Hyunjin; Boo, Sunjoo

2017-11-01

This study assessed patient-perceived levels of scar assessment and burn-specific quality of life (QOL) in Korean burn patients admitted to burn care centers and identified differences in scar assessment and QOL based on various patient characteristics. A cross-sectional descriptive study using anonymous paper-based survey methods was conducted with 100 burn patients from three burn centers specializing in burn care in South Korea. Mean subject age was 44.5 years old, and 69% of the subjects were men. The overall mean QOL was 2.91 out of 5. QOL was lowest for the work subdomain (2.25±1.45) followed by the treatment regimen subdomain (2.32±1.16). The subjects' mean total scar assessment score was 35.51 out of 60, and subjects were most unsatisfied with scar color. Subjects with low income, flame-source burns, severe burns, visible scars, and scars on face or hand reported significantly lower QOL. Subjects with severe burn degree and burn range perceived their burn scar condition to be worse than that of others. The results show that burn subjects experience the most difficulties with their work and the treatment regimen. Subjects with severe burn and visible scarring have a reduced QOL and a poor scar status. Scar management intervention may improve QOL of burn patients especially those with severe burn and visible scars. Further studies are warranted to evaluate the relationship between scar assessment and QOL. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Corneal abrasion and alkali burn secondary to automobile air bag inflation

PubMed Central

Scarlett, Angela; Gee, Paul

2007-01-01

A 59‐year‐old woman self presented to the emergency department with a painful right eye following a motor vehicle accident. She had reduced visual acuity and the eye had an alkaline pH with complete corneal uptake of fluorescein. Diagnosis of corneal abrasion and alkali burn to her right eye secondary to inflation of a driver's automobile airbag was made. The eye was irrigated with normal saline. Such injuries, although rare, can easily be identified within the emergency department by the history of exposure, evidence of facial injuries or burns, and an alkaline pH in the inferior cul‐de‐sac of the eye. Early detection and management with ophthalmology review is therefore imperative to prevent irreversible visual impairment. PMID:17901284

Transient downregulation of microRNA-206 protects alkali burn injury in mouse cornea by regulating connexin 43

PubMed Central

Li, Xiaoyan; Zhou, Huanfen; Tang, Weiqiang; Guo, Qing; Zhang, Yan

2015-01-01

Purpose: Chemical burn in cornea may cause permanent visual problem or complete blindness. In the present study, we investigated the role of microRNA 206 (miR-206) in relieving chemical burn in mouse cornea. Method: An alkali burn model was established in C57BL/6 mice to induce chemical corneal injury. Within 72 hours, the transient inflammatory responses in alkali-treated corneas were measured by opacity and corneal neovascularization (CNV) levels, and the gene expression profile of miR-206 was measured by quantitative real-time PCR (qPCR). Inhibitory oligonucleotides of miR-206, miR-206-I, were intrastromally injected into alkali-burned corneas. The possible protective effects of down-regulating miR-206 were assessed by both in vivo measurements of inflammatory responses and in vitro histochemical examinations of corneal epithelium sections. The possible binding of miR-206 on its molecular target, connexin43 (Cx43), was assessed by luciferase reporter (LR) and western blot (WB) assays. Cx43 was silenced by siRNA to examine its effect on regulating miR-206 modulation in alkali-burned cornea. Results: Opacity and CNV levels, along with gene expression of miR-206, were all transiently elevated within 72 hours of alkali-burned mouse cornea. Intrastromal injection of miR-206-I into alkali-burned cornea down-regulated miR-206 and ameliorated inflammatory responses both in vivo and in vitro. LR and WB assays confirmed that Cx43 was directly targeted by miR-206 in mouse cornea. Genetic silencing of Cx43 reversed the protective effect of miR-206 down-regulation in alkali-burned cornea. Conclusion: miR-206, associated with Cx43, is a novel molecular modulator in alkali burn in mouse cornea. PMID:26045777

Safety and efficacy of an intensive insulin protocol in a burn-trauma intensive care unit.

PubMed

Cochran, Amalia; Davis, Lynn; Morris, Stephen E; Saffle, Jeffrey R

2008-01-01

Aggressive glycemic management in critically ill patients with acute burn injury or life-threatening soft-tissue infections has not been thoroughly evaluated. An intensive insulin protocol with target glucose values of less than 120 mg/dl was implemented in October 2005 in our regional Burn-Trauma intensive care unit. We reviewed our initial experience with this protocol to evaluate the safety and efficacy of aggressive glycemic control in these patient groups. Patients were placed on the intensive insulin protocol based upon the need for glycemic management during their hospitalization for burn or soft-tissue disease. Patient information prospectively collected while on protocol included all measured blood glucose values, total daily insulin use, and incidence of hypoglycemic episodes, defined as serum glucose <60 mg/dl. Thirty patients (17 burns, 13 soft-tissue infections) were placed on the intensive insulin protocol during the first 16 months of use. The mean daily blood glucose level for burn patients was 115.9 mg/dl and for soft-tissue disease patients was 119.5 mg/dl. There was a 5% incidence of hypoglycemic episodes per protocol day. All hypoglycemic episodes were treated by holding the insulin infusion, and no episode had known adverse effects. Hyperglycemia in critically ill patients with burns and extensive soft-tissue disease can be effectively managed with an insulin protocol that targets blood glucose values of less than 120 mg/dl with minimal incidence of hypoglycemia. A multicenter prospective randomized trial would provide the ideal forum for evaluating clinical outcome benefits of using an intensive insulin protocol.

Optimal prescribed burn frequency to manage foundation California perennial grass species and enhance native flora

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carlsen, Tina M.; Espeland, Erin K.; Paterson, Lisa E.

Grasslands can be diverse assemblages of grasses and forbs but not much is known how perennial grass species management affects native plant diversity except in a few instances. We studied the use of late-spring prescribed burns over a span of 11 years where the perennial grass Poa secunda was the foundation species, with four additional years of measurements after the final burn. We also evaluated burn effects on P. secunda, the rare native annual forb Amsinckia grandiflora and local native and exotic species. Annual burning maintained P. secunda number, resulted in significant expansion, the lowest thatch and exotic grass cover,more » the highest percentage of bare ground, but also the lowest native forb and highest exotic forb cover. Burning approximately every 3 years maintained a lower number of P. secunda plants, allowed for expansion, and resulted in the highest native forb cover with a low exotic grass cover. Burning approximately every 5 years and the control (burned once from a wildfire) resulted in a decline in P. secunda number, the highest exotic grass and thatch cover and the lowest percentage of bare ground. P. secunda numbers were maintained up to 4 years after the final burn. And while local native forbs benefited from burning approximately every 3 years, planted A. grandiflora performed best in the control treatment. A. grandiflora did not occur naturally at the site; therefore, no seed bank was present to provide across-year protection from the effects of the burns. Thus, perennial grass species management must also consider other native species life history and phenology to enhance native flora diversity.« less

Optimal prescribed burn frequency to manage foundation California perennial grass species and enhance native flora

DOE PAGES

Carlsen, Tina M.; Espeland, Erin K.; Paterson, Lisa E.; ...

2017-06-06

Grasslands can be diverse assemblages of grasses and forbs but not much is known how perennial grass species management affects native plant diversity except in a few instances. We studied the use of late-spring prescribed burns over a span of 11 years where the perennial grass Poa secunda was the foundation species, with four additional years of measurements after the final burn. We also evaluated burn effects on P. secunda, the rare native annual forb Amsinckia grandiflora and local native and exotic species. Annual burning maintained P. secunda number, resulted in significant expansion, the lowest thatch and exotic grass cover,more » the highest percentage of bare ground, but also the lowest native forb and highest exotic forb cover. Burning approximately every 3 years maintained a lower number of P. secunda plants, allowed for expansion, and resulted in the highest native forb cover with a low exotic grass cover. Burning approximately every 5 years and the control (burned once from a wildfire) resulted in a decline in P. secunda number, the highest exotic grass and thatch cover and the lowest percentage of bare ground. P. secunda numbers were maintained up to 4 years after the final burn. And while local native forbs benefited from burning approximately every 3 years, planted A. grandiflora performed best in the control treatment. A. grandiflora did not occur naturally at the site; therefore, no seed bank was present to provide across-year protection from the effects of the burns. Thus, perennial grass species management must also consider other native species life history and phenology to enhance native flora diversity.« less

Pediatric burns: Kids' Inpatient Database vs the National Burn Repository.

PubMed

Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hartman, Brett C; Hadad, Ivan; Tholpady, Sunil S

2016-04-01

Burn injuries are one of the leading causes of morbidity and mortality in young children. The Kids' Inpatient Database (KID) and National Burn Repository (NBR) are two large national databases that can be used to evaluate outcomes and help quality improvement in burn care. Differences in the design of the KID and NBR could lead to differing results affecting resultant conclusions and quality improvement programs. This study was designed to validate the use of KID for burn epidemiologic studies, as an adjunct to the NBR. Using the KID (2003, 2006, and 2009), a total of 17,300 nonelective burn patients younger than 20 y old were identified. Data from 13,828 similar patients were collected from the NBR. Outcome variables were compared between the two databases. Comparisons revealed similar patient distribution by gender, race, and burn size. Inhalation injury was more common among the NBR patients and was associated with increased mortality. The rates of respiratory failure, wound infection, cellulitis, sepsis, and urinary tract infection were higher in the KID. Multiple regression analysis adjusting for potential confounders demonstrated similar mortality rate but significantly longer length of stay for patients in the NBR. Despite differences in the design and sampling of the KID and NBR, the overall demographic and mortality results are similar. The differences in complication rate and length of stay should be explored by further studies to clarify underlying causes. Investigations into these differences should also better inform strategies to improve burn prevention and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Early fire history near Seguin Falls, Ontario

Treesearch

Daniel C. Dey; Richard P. Guyette

1996-01-01

This report is one of a series of site-specfic fire histories being developed for red oak (Quercus rubra L.)-pine ecosystems in central Ontario. Collectively, these studies documents the role of fire in upland oak forests. this information also provides an ecological basis for developing silviculture prescriptions that use prescribed burning to...

Reasons for Distress Among Burn Survivors at 6, 12, and 24 Months Postdischarge: A Burn Injury Model System Investigation.

PubMed

Wiechman, Shelley A; McMullen, Kara; Carrougher, Gretchen J; Fauerbach, Jame A; Ryan, Colleen M; Herndon, David N; Holavanahalli, Radha; Gibran, Nicole S; Roaten, Kimberly

2017-12-16

To identify important sources of distress among burn survivors at discharge and 6, 12, and 24 months postinjury, and to examine if the distress related to these sources changed over time. Exploratory. Outpatient burn clinics in 4 sites across the country. Participants who met preestablished criteria for having a major burn injury (N=1009) were enrolled in this multisite study. Participants were given a previously developed list of 12 sources of distress among burn survivors and asked to rate on a 10-point Likert-type scale (0=no distress to 10=high distress) how much distress each of the 12 issues was causing them at the time of each follow-up. The Medical Outcomes Study 12-Item Short-Form Health Survey was administered at each time point as a measure of health-related quality of life. The Satisfaction With Appearance Scale was used to understand the relation between sources of distress and body image. Finally, whether a person returned to work was used to determine the effect of sources of distress on returning to employment. It was encouraging that no symptoms were worsening at 2 years. However, financial concerns and long recovery time are 2 of the highest means at all time points. Pain and sleep disturbance had the biggest effect on ability to return to work. These findings can be used to inform burn-specific interventions and to give survivors an understanding of the temporal trajectory for various causes of distress. In particular, it appears that interventions targeted at sleep disturbance and high pain levels can potentially effect distress over financial concerns by allowing a person to return to work more quickly. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Burn-associated bloodstream infections in pediatric burn patients: Time distribution of etiologic agents.

PubMed

Devrim, İlker; Kara, Ahu; Düzgöl, Mine; Karkıner, Aytaç; Bayram, Nuri; Temir, Günyüz; Şencan, Arzu; Sorguç, Yelda; Gülfidan, Gamze; Hoşgör, Münevver

2017-02-01

Infections are the leading cause of morbidity and mortality in patients with burns in burn units. Bloodstream infections (BSIs) in patients with burns may result from burn wound infection, use of invasive devices such as central venous catheters, and translocation of the gastrointestinal flora. In this study, we investigated the distribution and antimicrobial drug resistance of causative pathogens in children with burns and the durational changes of microorganisms in the distribution of BSIs in children. This study was conducted at the Pediatric Burn Unit (PBU) of Dr. Behçet Uz Children Research and Training Hospital during the period of November 2008-April 2015. The study subjects were all the patients admitted to the PBU, in whom microorganisms were isolated at least from one of the cultures, including blood and catheter cultures. Gram-positive bacteria were the most common causative agents of BSI in patients with burns (66.4%), followed by gram-negative bacteria (22.1%) and fungi (11.5%). The median duration of development of BSIs caused by gram-positive bacteria from the time of burn was 5 days (ranging from 2 to 54 days of burn), which was significantly shorter than that of BSIs caused by gram-negative bacteria (12 days) and fungal pathogens (13 days). The etiologic agents of BSIs in children may differ from those in adults. Gram-negative drug-resistant bacteria such as multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were important agents of BSI in patients with burns, especially in the long term; however, gram-positive bacteria should also be considered while deciding the antimicrobial therapy, especially in the early periods of burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Photoacoustic diagnosis of burns in rats: two-dimensional photo-acoustic imaging of burned tissue

NASA Astrophysics Data System (ADS)

Yamazaki, Mutsuo; Sato, Shunichi; Saito, Daizo; Okada, Yoshiaki; Kurita, Akira; Kikuchi, Makoto; Ashida, Hiroshi; Obara, Minoru

2003-06-01

We previously reported that for rat burn models, deep dermal burns and deep burns can be well differentiated by measuring the propagation time of the photoacoustic signals originated from the blood in the healthy skin tissue under the damaged tissue layer. However, the diagnosis was based on point measurement in the wound, and therefore site-dependent information on the injuries was not obtained; such information is very important for diagnosis of extended burns. In the present study, we scanned a photoacoustic detector on the wound and constructed two-dimensional (2-D) images of the blood-originated photoacoustic signals for superficial dermal burns (SDB), deep dermal burns (DDB), deep burns (DB), and healthy skins (control) in rats. For each burn model, site-dependent variation of the signal was observed; the variation probably reflects the distribution of blood vessels in the skin tissue. In spite of the variation, clear differentiation was obtained between SDB, DDB, and DB from the 2D images. The images were constructed as a function of post burn time. Temporal signal variation will be also presented.

Effects of past burning frequency on plant species structure and composition in dry dipterocarp forest

NASA Astrophysics Data System (ADS)

Wanthongchai, Dr.; Bauhus, Prof.; Goldammer, Prof.

2009-04-01

not shorter than every 6-7 years, or 1-2 fires per decade, to maintain ecosystem structure and function. Variation in time and space in this way, the biodiversity of the landscape may be maintained for the long-term. Keywords: Prescribed burning, burning history, burning frequency, plant species, vegetation structure, dry dipterocarp forest, Huay Kha Khaeng wildlife Sanctuary

Cost analysis of acute burn patients treated in a burn centre: the Gulhane experience

PubMed Central

Sahin, I.; Ozturk, S.; Alhan, D.; Açikel, C.; Isik, S.

2011-01-01

Summary Even if calculating the exact cost of burn treatment is a very hard task, the study of cost analysis provides financial perspective. We performed a cost analysis study in our burn centre to respond to questions about total patient treatment cost and the length of hospital stay. We reviewed all patients admitted to the Gulhane Military Medical Academy Burn Centre in Ankara, Turkey, between March 2005 and August 2008. Forty-three patients with major burns were identified on the basis of the study criteria. The data regarding total treatment cost and the length of hospital stay for each type of burn (flame, scald, electric) were collected at the end of the study. The average total body surface area burned was 36 ± 7%.. The average duration of hospital stay was 73 ± 33 days. Patients with electrical burns stayed longer in hospital than patients with other types of burn injuries. Each one per cent of burn corresponded to a mean hospital stay of two days. The overall mean total cost was $US 15,250. The mean total cost of electrical burns was the highest, with $US 22,501 ± 24,039. Even if the costs associated with burn injury are higher than some other well-known health-related problems, they have not been much studied. Reports have produced different results, but it should be kept in mind that although the results of cost analysis studies may vary they must be performed in all newly established burn centres in order to form a financial overview. PMID:21991233

Response measurement of single-crystal chemical vapor deposition diamond radiation detector for intense X-rays aiming at neutron bang-time and neutron burn-history measurement on an inertial confinement fusion with fast ignition.

PubMed

Shimaoka, T; Kaneko, J H; Arikawa, Y; Isobe, M; Sato, Y; Tsubota, M; Nagai, T; Kojima, S; Abe, Y; Sakata, S; Fujioka, S; Nakai, M; Shiraga, H; Azechi, H; Chayahara, A; Umezawa, H; Shikata, S

2015-05-01

A neutron bang time and burn history monitor in inertial confinement fusion with fast ignition are necessary for plasma diagnostics. In the FIREX project, however, no detector attained those capabilities because high-intensity X-rays accompanied fast electrons used for plasma heating. To solve this problem, single-crystal CVD diamond was grown and fabricated into a radiation detector. The detector, which had excellent charge transportation property, was tested to obtain a response function for intense X-rays. The applicability for neutron bang time and burn history monitor was verified experimentally. Charge collection efficiency of 99.5% ± 0.8% and 97.1% ± 1.4% for holes and electrons were obtained using 5.486 MeV alpha particles. The drift velocity at electric field which saturates charge collection efficiency was 1.1 ± 0.4 × 10(7) cm/s and 1.0 ± 0.3 × 10(7) cm/s for holes and electrons. Fast response of several ns pulse width for intense X-ray was obtained at the GEKKO XII experiment, which is sufficiently fast for ToF measurements to obtain a neutron signal separately from X-rays. Based on these results, we confirmed that the single-crystal CVD diamond detector obtained neutron signal with good S/N under ion temperature 0.5-1 keV and neutron yield of more than 10(9) neutrons/shot.

Improved Survival of Patients With Extensive Burns: Trends in Patient Characteristics and Mortality Among Burn Patients in a Tertiary Care Burn Facility, 2004-2013.

PubMed

Strassle, Paula D; Williams, Felicia N; Napravnik, Sonia; van Duin, David; Weber, David J; Charles, Anthony; Cairns, Bruce A; Jones, Samuel W

Classic determinants of burn mortality are age, burn size, and the presence of inhalation injury. Our objective was to describe temporal trends in patient and burn characteristics, inpatient mortality, and the relationship between these characteristics and inpatient mortality over time. All patients aged 18 years or older and admitted with burn injury, including inhalation injury only, between 2004 and 2013 were included. Adjusted Cox proportional hazards regression models were used to estimate the relationship between admit year and inpatient mortality. A total of 5540 patients were admitted between 2004 and 2013. Significant differences in sex, race/ethnicity, burn mechanisms, TBSA, inhalation injury, and inpatient mortality were observed across calendar years. Patients admitted between 2011 and 2013 were more likely to be women, non-Hispanic Caucasian, with smaller burn size, and less likely to have an inhalation injury, in comparison with patients admitted from 2004 to 2010. After controlling for patient demographics, burn mechanisms, and differential lengths of stay, no calendar year trends in inpatient mortality were detected. However, a significant decrease in inpatient mortality was observed among patients with extensive burns (≥75% TBSA) in more recent calendar years. This large, tertiary care referral burn center has maintained low inpatient mortality rates among burn patients over the past 10 years. While observed decreases in mortality during this time are largely due to changes in patient and burn characteristics, survival among patients with extensive burns has improved.

Civilian blast-related burn injuries

PubMed Central

Patel, J.N.; Tan, A.; Dziewulski, P.

2016-01-01

Summary There is limited English literature describing the experience of a civilian hospital managing blast-related burn injuries. As the largest regional burn unit, we reviewed our cases with the aim of identifying means to improve current management. A 6-year retrospective analysis of all patients coded as sustaining blast-related burns was conducted through the unit’s burns database. Medical case notes were reviewed for information on burn demographics, management and outcomes. 42 patients were identified. Male to female ratio was 37:5. Age range was 12-84 years, (mean=33 years). Total body surface area (%TBSA) burn ranged from 0.25% to 60%, (median=1%). The most common burn injury was flame (31/42, 73.8%). Gas explosions were the most common mechanism of injury (19 cases; 45.2%). 7/42 cases (16.7%) had full ATLS management pre-transfer to the burns unit. The Injury Severity Score (ISS) ranged from 0-43 (median=2). 17/42 (40.4%) patients required admission. 37/36 (88.1%) patients were managed conservatively of which 1 patient later required surgery due to deeper burns. 5/42 (11.9%) patients required surgical management at presentation and these were noted to be burns with >15% TBSA requiring resuscitation. One case required emergency escharotomies and finger amputations. All patients survived their burn injuries. Blast-related burn injuries are generally uncommon in the civilian setting. Following proper assessment, most of these cases can be deemed as minor injuries and managed conservatively. Improvement in burns management education and training at local emergency departments would provide efficient patient care and avoid unnecessary referrals to a burns unit. PMID:27857651

Developing and implementing a plan for large-scale burn disaster response in New Jersey.

PubMed

Conlon, Kathe M; Ruhren, Chris; Johansen, Sandra; Dimler, Margaret; Frischman, Barbara; Gehringer, Eileen; Houng, Abraham; Marano, Michael; Petrone, Sylvia J; Mansour, E Hani

2014-01-01

For the first time in modern history burn centers must face the reality of having to potentially care for a staggering number of injured patients. Factors such as staffing, patient acuity and bed availability compel medical professionals to regularly examine various aspects of their respective healthcare delivery systems, especially with regards to how these systems should function for mass casualty response. The majority of burn care in New Jersey is provided by one designated burn treatment facility. A planning group was formed to identify additional hospital support systems capable of providing short-term patient care during a disaster. Focus was on three key areas: identifying actual versus potential nonburn center resources, ascertaining the number and level of burn expertise at these facilities, and assessing the capacities of any available resources and personnel. Retrospective review of discharge data highlighted which of the more than seventy New Jersey hospitals besides The Burn Center were treating and releasing burn injures. In a disaster The Burn Center designates these hospitals as Tier Facilities to serve as additional resources until patients may be transferred to other recognized regional and national burn centers. Triage is conducted in accordance with the American Burn Association Benefit-to-Ratio Triage grid, matching patient acuity with each hospital's tier designation. A secondary triage, conducted 24 hours after the initial incident, identifies which patients require transport for more specialized burn care. Twenty-seven burn centers from Maine through Maryland and the District of Columbia, who have joined together as a Consortium, agree to support one another for optimal patient distribution and management in accordance with accepted national standards of care. State Medical Coordination Centers equipped to coordinate and track transport of large numbers of injured personnel are able to facilitate this collaborative, multiagency response

Emissions from small-scale burns of simulated deployed U.S. military waste.

PubMed

Woodall, Brian D; Yamamoto, Dirk P; Gullett, Brian K; Touati, Abderrahmane

2012-10-16

U.S. military forces have historically relied on open burning as an expedient method of volume reduction and treatment of solid waste during the conflicts in Afghanistan and Iraq. This study is the first effort to characterize a broad range of pollutants and their emission factors during the burning of military waste and the effects that recycling efforts, namely removing plastics, might have on emissions. Piles of simulated military waste were constructed, burned, and emissions sampled at the U.S. Environmental Protection Agency (EPA) Open Burn Testing Facility (OBTF), Research Triangle Park, NC. Three tests contained polyethylene terephthalate (PET #1 or PET) plastic water bottles and four did not. Emission factors for polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), particulate matter (PM(10), PM(2.5)), polychlorinated and polybrominated dioxins/furans (PCDD/F and PBDD/F), and criteria pollutants were determined and are contained within. The average PCDD/F emission factors were 270 ng-toxic equivalency (TEQ) per kg carbon burned (ng-TEQ/kg Cb), ranging from 35 to 780 ng-TEQ/kg Cb. Limited testing suggests that targeted removal of plastic water bottles has no apparent effect on reducing pollutants and may even promote increased emissions.

[Combined burn trauma in the array of modern civilian and combat burns].

PubMed

Ivchenko, E V; Borisov, D N; Golota, A S; Krassiĭ, A B; Rusev, I T

2015-02-01

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

Paediatric electrical burn injuries: experience from a tertiary care burns unit in North India

PubMed Central

Srivastava, S.; Patil, A.N.; Bedi, M.; Tawar, R.S.

2017-01-01

Summary Electrical burn injuries in the paediatric age group constitute a small proportion of all burn cases and cause significant morbidity and long-term psychosocial impact. The objective of this study was to evaluate various aspects of electrical burn injuries in the paediatric age group in our region. A retrospective review was done of all paediatric electrical burns admitted to a tertiary care burns unit over a period of 12 months (January 2016 to December 2016). There were 77 cases of electrical burns under the age of 16 years. High voltage burns predominated and older age groups were more frequently affected. Male:female ratio was 4.1:1. Amputations were required in 18 (23%), skin grafting in 52 (67%) and flap cover in 29 (37%) patients. There were unfavourable outcomes in 32% patients with a mortality rate of 7.8%. Significant association was found between unfavourable outcomes and high voltage burn injuries and length of hospital stay. The impact of electrical burn injuries is substantial and can be reduced by simple preventive measures such as educating parents, improving health infrastructure and adherence to safety regulations.

Skeletal Muscle Satellite Cell Activation Following Cutaneous Burn in Rats

DTIC Science & Technology

2013-12-01

satellite cell activation and survival during oxidative stress. J Muscle Res Cell Motil 2011;32(2):99–109. [33] Rathbone CR, Booth FW, Lees SJ. Sirt1 ...Skeletal muscle satellite cell activation following cutaneous burn in rats Xiaowu Wu*, Thomas J. Walters, Christopher R. Rathbone Extremity Trauma...f o Article history: Accepted 15 October 2012 Keywords: Muscle precursor cell Thermal injury Atrophy Skeletal muscle Activation a b s t r a c t

Burn Safety Awareness on Playgrounds: Thermal Burns from Playground Equipment

MedlinePlus

... Safety Awareness on Playgrounds Thermal Burns from Playground Equipment The U.S. Consumer Product Safety Commission CPSC wants ... of the risk of thermal burns from playground equipment. You may remember the metal slides of your ...

Survival after burn in a sub-Saharan burn unit: challenges and opportunities.

PubMed

Tyson, Anna F; Boschini, Laura P; Kiser, Michelle M; Samuel, Jonathan C; Mjuweni, Steven N; Cairns, Bruce A; Charles, Anthony G

2013-12-01

Burns are among the most devastating of all injuries and a major global public health crisis, particularly in sub-Saharan Africa. In developed countries, aggressive management of burns continues to lower overall mortality and increase lethal total body surface area (TBSA) at which 50% of patients die (LA50). However, lack of resources and inadequate infrastructure significantly impede such improvements in developing countries. This study is a retrospective analysis of patients admitted to the burn center at Kamuzu Central Hospital in Lilongwe, Malawi between June 2011 and December 2012. We collected information including patient age, gender, date of admission, mechanism of injury, time to presentation to hospital, total body surface area (TBSA) burn, comorbidities, date and type of operative procedures, date of discharge, length of hospital stay, and survival. We then performed bivariate analysis and logistic regression to identify characteristics associated with increased mortality. A total of 454 patients were admitted during the study period with a median age of 4 years (range 0.5 months to 79 years). Of these patients, 53% were male. The overall mean TBSA was 18.5%, and average TBSA increased with age--17% for 0-18 year olds, 24% for 19-60 year olds, and 41% for patients over 60 years old. Scald and flame burns were the commonest mechanisms, 52% and 41% respectively, and flame burns were associated with higher mortality. Overall survival in this population was 82%; however survival reduced with increasing age categories (84% in patients 0-18 years old, 79% in patients 19-60 years old, and 36% in patients older than 60 years). TBSA remained the strongest predictor of mortality after adjusting for age and mechanism of burn. The LA50 for this population was 39% TBSA. Our data reiterate that burn in Malawi is largely a pediatric disease and that the high burn mortality and relatively low LA50 have modestly improved over the past two decades. The lack of financial

Survival after burn in a sub-Saharan burn unit: Challenges and opportunities

PubMed Central

Tyson, Anna F.; Boschini, Laura P.; Kiser, Michelle M.; Samuel, Jonathan C.; Mjuweni, Steven N.; Cairns, Bruce A.; Charles, Anthony G.

2013-01-01

Background Burns are among the most devastating of all injuries and a major global public health crisis, particularly in sub-Saharan Africa. In developed countries, aggressive management of burns continues to lower overall mortality and increase lethal total body surface area (TBSA) at which 50% of patients die (LA50). However, lack of resources and inadequate infrastructure significantly impede such improvements in developing countries. Methods This study is a retrospective analysis of patients admitted to the burn center at Kamuzu Central Hospital in Lilongwe, Malawi between June 2011 and December 2012. We collected information including patient age, gender, date of admission, mechanism of injury, time to presentation to hospital, total body surface area (TBSA) burn, comorbidities, date and type of operative procedures, date of discharge, length of hospital stay, and survival. We then performed bivariate analysis and logistic regression to identify characteristics associated with increased mortality. Results A total of 454 patients were admitted during the study period with a median age of 4 years (range 0.5 months to 79 years). Of these patients, 53% were male. The overall mean TBSA was 18.5%, and average TBSA increased with age—17% for 0–18 year olds, 24% for 19–60 year olds, and 41% for patients over 60 years old. Scald and flame burns were the commonest mechanisms, 52% and 41% respectively, and flame burns were associated with higher mortality. Overall survival in this population was 82%; however survival reduced with increasing age categories (84% in patients 0–18 years old, 79% in patients 19–60 years old, and 36% in patients older than 60 years). TBSA remained the strongest predictor of mortality after adjusting for age and mechanism of burn. The LA50 for this population was 39% TBSA. Discussion Our data reiterate that burn in Malawi is largely a pediatric disease and that the high burn mortality and relatively low LA50 have modestly improved

Minor burn management: potions and lotions

PubMed Central

Hyland, Ela J; Connolly, Siobhan M; Fox, Jade A; Harvey, John G

2015-01-01

Summary The first aid for burns is to run cold water over the burn for 20 minutes. This is effective for up to three hours after the injury. Assess the affected body surface area using the rule of nines. Consult a burn unit if more than 5% of the total body surface area is burnt in a child or if more than 10% in an adult. Extensive or deep burns and burns to special areas, such as the hands, should be referred. Chemical or electrical burns should also be assessed by a burn unit. For minor burns, antimicrobial dressings are recommended, but oral antibiotics should be avoided unless there are signs of infection. As burns are tetanus prone, check the patient’s immunisation status. Burns that become infected or are slow to heal should be discussed with a burn unit. The burn unit can also provide advice if there are uncertainties about how to manage a patient. PMID:26648640

Epidemiology and screening of intentional burns in children in a Dutch burn centre.

PubMed

Bousema, Sara; Stas, Helene G; van de Merwe, Marjolijn H; Oen, Irma M M H; Baartmans, Martin G A; van Baar, Margriet E

2016-09-01

International estimates of the incidence of non-accidental burns (NAB) in children admitted to burn centres vary from 1% to 25%. Hardly any data about Dutch figures exist. The aim of this study was to evaluate the incidence, treatment and outcome of burns due to suspected child abuse in paediatric burns. We described the process of care and outcome, including the accuracy of the SPUTOVAMO screening tool and examined child, burn and treatment characteristics related to suspicions of child abuse or neglect. A retrospective study was conducted in children aged 0-17 years with a primary admission after burn injuries to the burn centre Rotterdam in the period 2009-2013. Data on patient, injury and treatment characteristics were collected, using the Dutch Burn Repository R3. In addition, medical records were reviewed. In 498 paediatric admissions, suspected child abuse or neglect was present in 43 children (9%). 442 screening questionnaires (89%) were completed. In 52 out of 442 questionnaires (12%) the completed SPUTOVAMO had one or more positive signs. Significant independent predictors for suspected child abuse were burns in the genital area or buttocks (OR=3.29; CI: 143-7.55) and a low socio-economic status (OR=2.52; 95%CI: 1.30-4.90). The incidence of suspected child abuse indicating generation of additional support in our population is comparable to studies with a similar design in other countries. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Teenager male with burning pain in extremities--suspect Fabry disease, 2 case reports.

PubMed

Patil, Rajesh B; Joglekar, V K

2014-01-01

We present 2 cases of teenager males presented with burning pain in extremities and turned out to be cases of Fabry disease.The purpose of presenting this case is to highlight the fact that suspicion of Fabry disease in patients presenting with these symptoms will lead to early diagnosis and treatment of this condition before occurrences of complications. A 14-year-old male presented with severe burning pain in both hands and feet since last 4 yrs which persisted despite consumption of painkillers and becoming more disabling and without having any family history for such condition. On general examination patient had small reddish coloured lesions around the umbilicus, appearing like angiokeratomas. Skin biopsy confirmed the lesion. On enzyme assay his alpha galactosidase activity found to be '0' nmol/hr/mg of protein, confirming his diagnosis. Patient's creatinine and 2 D ECHO were normal and urine had 1+ proteinuria. Patient started on carbamazepine tablets for pain and referred to higher centre for genetic diagnosis and enzyme replacement therapy. CASE REPORT 2: An 18-year-old male referred to our hospital by general practitioner for fatigue and pedal oedema with deranged renal function tests. On history taking patient gave history of severe burning pain in both hands and feet since age of 9 yrs. Patient's general examination revealed hypertension with pallor, pedal oedema along with angiokeratomas in bathing suit distribution. Patient's ultrasonography of kidney revealed bilaterally normal sized kidneys with altered echotexture and urine examination showed fine granular foamy cells with sub nephrotic range proteinuria. 2 D ECHO revealed concentric left ventricular hypertrophy. Skin biopsy report supported the diagnosis of Fabry disease. Patient advised to undergo renal biopsy to confirm Fabry nephropathy but patient denied any further diagnostic workup for nephropathy or Fabry disease. Patient started on conservative treatment and carbamazepine in renal dose

Burns and Fire Safety

MedlinePlus

Number of Deaths Death Rate Burns and Fire Safety Fact Sheet (2015) Fatalities • 334 children ages 19 and under died from fires or burns ... burns were ages 4 and under. 1 The death rate for children this age (0.73 per 100, ...

Disaster planning: the basics of creating a burn mass casualty disaster plan for a burn center.

PubMed

Kearns, Randy D; Conlon, Kathe M; Valenta, Andrea L; Lord, Graydon C; Cairns, Charles B; Holmes, James H; Johnson, Daryhl D; Matherly, Annette F; Sawyer, Dalton; Skarote, Mary Beth; Siler, Sean M; Helminiak, Radm Clare; Cairns, Bruce A

2014-01-01

In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.

The burn surgeon: an endangered species. Can exposure in medical school increase interest in burn surgery?

PubMed

Kahn, Steven Alexander; Goldman, Matthew; Daul, Matthew; Lentz, Christopher W

2011-01-01

The nation is faced with a shortage of subspecialty physicians, including burn surgeons. Exposure to a specialty in medical school has been shown to influence students' career choices. The authors postulate that exposure to burn surgery increases their interest in the field. Students from a medical school with an American Burn Association-verified burn center and from a school without a burn center were anonymously surveyed and asked to report their interest and knowledge regarding burn surgery using a 5-point Likert scale. They were asked about their current year in school, gender, overall interest in surgery, and any prior exposure to burn surgery (eg, preceptorship or rotation). Students were asked whether exposure to burn surgery or to a strong mentor might increase their interest in the field. Finally, they were asked to pick the most important factor in a list of deterrents to pursuing a career in burn surgery. Predictors of interest in burn surgery were determined with regression analyses. A total of 380 of 662 students responded to the survey (57.4%). Significant predictors of interest in burn surgery were an interest in surgery (P < .001, odds ratio [OR] = 56.3), prior exposure to burn surgery (P = .02, OR = 5.7), and year in school (P = .006, OR = 1.7). First- and second-year students were more likely to report interest in burn surgery (P < .001). Gender and medical school attended were not significant predictors. Prior exposure to burn surgery became a stronger predictor in subgroup analysis of the fourth-year students (P < .001, OR = 24.5). The majority of students reported that exposure to burn surgery (76%) and a strong mentor (87%) would make them more likely to consider burn surgery as a career. "Not interested in surgery" was the most important deterrent to pursuing a career in burn surgery, which was selected by 33% of students. However, 25% of students chose "I don't know anything about burn surgery" as the most important deterrent. Factors

Evaluation and Parameter Analysis of Burn up Calculations for the Assessment of Radioactive Waste - 13187

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fast, Ivan; Aksyutina, Yuliya; Tietze-Jaensch, Holger

2013-07-01

Burn up calculations facilitate a determination of the composition and nuclear inventory of spent nuclear fuel, if operational history is known. In case this information is not available, the total nuclear inventory can be determined by means of destructive or, even on industrial scale, nondestructive measurement methods. For non-destructive measurements however only a few easy-to-measure, so-called key nuclides, are determined due to their characteristic gamma lines or neutron emission. From these measured activities the fuel burn up and cooling time are derived to facilitate the numerical inventory determination of spent fuel elements. Most regulatory bodies require an independent assessment ofmore » nuclear waste properties and their documentation. Prominent part of this assessment is a consistency check of inventory declaration. The waste packages often contain wastes from different types of spent fuels of different history and information about the secondary reactor parameters may not be available. In this case the so-called characteristic fuel burn up and cooling time are determined. These values are obtained from a correlations involving key-nuclides with a certain bandwidth, thus with upper and lower limits. The bandwidth is strongly dependent on secondary reactor parameter such as initial enrichment, temperature and density of the fuel and moderator, hence the reactor type, fuel element geometry and plant operation history. The purpose of our investigation is to look into the scaling and correlation limitations, to define and verify the range of validity and to scrutinize the dependencies and propagation of uncertainties that affect the waste inventory declarations and their independent verification. This is accomplished by numerical assessment and simulation of waste production using well accepted codes SCALE 6.0 and 6.1 to simulate the cooling time and burn up of a spent fuel element. The simulations are benchmarked against spent fuel from the real

Past History of Ocular Trauma in an Iranian Population-Based Study: Prevalence and its Associated Factors

PubMed Central

Hashemi, Hassan; Khabazkhoob, Mehdi; Emamian, Mohammad Hassan; Shariati, Mohammad; Mohazzab-Torabi, Saman; Fotouhi, Akbar

2015-01-01

Purpose: The purpose of this study was to determine the prevalence of a history of ocular trauma and its association to age, sex, and biometric components. Materials and Methods: Residents of Shahroud, Iran aged 40–64 years, were sampled through a cross-sectional study using multistage cluster sampling. Three hundred clusters were randomly selected, and 20 individuals were systematically selected from each cluster. The subjects underwent optometric and ophthalmic examinations, and ocular imaging. A history of ocular trauma was determined through personal interviews. Results: The prevalence of a history of trauma and blunt trauma, sharp trauma, and chemical burns were 8.57%, 3.91%, 3.82%, and 1.93%, respectively. After adjusting for age, the rate of all types of trauma was significantly higher for males. Only the prevalence of chemical burns significantly decreased with aging. A history of hospitalization was stated by 1.64% of the subjects. The axial length was significantly longer in cases with a history of trauma. The corneal curvature was significantly larger in cases with a history of sharp trauma and chemical burns. The prevalence of corneal opacities was significantly higher among cases with a history of the blunt trauma odds ratio (OR = 2.33) and sharp trauma (OR = 4.46). Based on corrected visual acuity, the odds of blindness was 3.32 times higher in those with a history of ocular trauma (P < 0.001). Conclusion: A considerable proportion of the 40–64-year-old population reported a history of ocular trauma. This observation has important health implications. Blindness, corneal opacities, and posterior subcapsular cataract were observed more frequently among these cases, and they demonstrated differences in some ocular biometric components. PMID:26180480

Foot burns: epidemiology and management.

PubMed

Hemington-Gorse, S; Pellard, S; Wilson-Jones, N; Potokar, T

2007-12-01

This is a retrospective study of the epidemiology and management of isolated foot burns presenting to the Welsh Centre for Burns from January 1998 to December 2002. A total of 289 were treated of which 233 were included in this study. Approximately 40% were in the paediatric age group and the gender distribution varied dramatically for adults and children. In the adult group the male:female ratio was 3.5:1, however in the paediatric group the male:female ratio was more equal (1.6:1). Scald burns (65%) formed the largest group in children and scald (35%) and chemical burns (32%) in adults. Foot burns have a complication rate of 18% and prolonged hospital stay. Complications include hypertrophic scarring, graft loss/delayed healing and wound infection. Although isolated foot burns represent a small body surface area, over half require treatment as in patients to allow for initial aggressive conservative management of elevation and regular wound cleansing to avoid complications. This study suggests a protocol for the initial acute management of foot burns. This protocol states immediate referral of all foot burns to a burn centre, admission of these burns for 24-48 h for elevation, regular wound cleansing with change of dressings and prophylactic antibiotics.

Involvement of NADPH oxidases in alkali burn-induced corneal injury.

PubMed

Gu, Xue-Jun; Liu, Xian; Chen, Ying-Ying; Zhao, Yao; Xu, Man; Han, Xiao-Jian; Liu, Qiu-Ping; Yi, Jing-Lin; Li, Jing-Ming

2016-07-01

Chemical burns are a major cause of corneal injury. Oxidative stress, inflammatory responses and neovascularization after the chemical burn aggravate corneal damage, and lead to loss of vision. Although NADPH oxidases (Noxs) play a crucial role in the production of reactive oxygen species (ROS), the role of Noxs in chemical burn-induced corneal injury remains to be elucidated. In the present study, the transcription and expression of Noxs in corneas were examined by RT-qPCR, western blot analysis and immunofluorescence staining. It was found that alkali burns markedly upregulated the transcription and expression of Nox2 and Nox4 in human or mouse corneas. The inhibition of Noxs by diphenyleneiodonium (DPI) or apocynin (Apo) effectively attenuated alkali burn-induced ROS production and decreased 3-nitrotyrosine (3-NT) protein levels in the corneas. In addition, Noxs/CD11b double‑immunofluorescence staining indicated that Nox2 and Nox4 were partially co-localized with CD11b. DPI or Apo prevented the infiltration of CD11b-positive inflammatory cells, and inhibited the transcription of inflammatory cytokines following alkali burn-induced corneal injury. In our mouse model of alkali burn-induced corneal injury, corneal neovascularization (CNV) occurred on day 3, and it affected 50% of the whole area of the cornea on day 7, and on day 14, CNV coverage of the cornea reached maximum levels. DPI or Apo effectively attenuated alkali burn‑induced CNV and decreased the mRNA levels of angiogenic factors, including vascular endothelial growth factor (VEGF), VEGF receptors and matrix metalloproteinases (MMPs). Taken together, our data indicate that Noxs play a role in alkali burn-induced corneal injury by regulating oxidative stress, inflammatory responses and CNV, and we thus suggest that Noxs are a potential therapeutic target in the future treatment of chemical-induced corneal injury.

What's in a Name? Recent Key Projects of the Committee on Organization and Delivery of Burn Care.

PubMed

Hickerson, William L; Ryan, Colleen M; Conlon, Kathe M; Harrington, David T; Foster, Kevin; Schwartz, Suzanne; Iyer, Narayan; Jeschke, Marc; Haller, Herbert L; Faucher, Lee D; Arnoldo, Brett D; Jeng, James C

2015-01-01

The Committee for the Organization and Delivery of Burn Care (ODBC) was charged by President Palmieri and the American Burn Association (ABA) Board of Directors with presenting a plenary session at the 45th Meeting of the ABA in Palm Springs, CA, in 2013. The objective of the plenary session was to inform the membership about the wide range of the activities performed by the ODBC committee. The hope was that this session would encourage active involvement within the ABA as a means to improve the delivery of future burn care. Selected current activities were summarized by key leaders of each project and highlighted in the plenary session. The history of the committee, current projects in disaster management, regionalization, best practice guidelines, federal partnerships, product development, new technologies, electronic medical records, and manpower issues in the burn workforce were summarized. The ODBC committee is a keystone committee of the ABA. It is tasked by the ABA leadership with addressing and leading progress in many areas that constitute current challenges in the delivery of burn care.

Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity

NASA Astrophysics Data System (ADS)

Nguyen, John Quan; Crouzet, Christian; Mai, Tuan; Riola, Kathleen; Uchitel, Daniel; Liaw, Lih-Huei; Bernal, Nicole; Ponticorvo, Adrien; Choi, Bernard; Durkin, Anthony J.

2013-06-01

Frequent monitoring of early-stage burns is necessary for deciding optimal treatment and management. Both superficial and full thickness burns are relatively easy to diagnose based on clinical observation. In between these two extremes are superficial-partial thickness and deep-partial thickness burns. These burns, while visually similar, differ dramatically in terms of clinical treatment and are known to progress in severity over time. The objective of this study was to determine the potential of spatial frequency domain imaging (SFDI) for noninvasively mapping quantitative changes in chromophore and optical properties that may be an indicative of burn wound severity. A controlled protocol of graded burn severity was developed and applied to 17 rats. SFDI data was acquired at multiple near-infrared wavelengths over a course of 3 h. Burn severity was verified using hematoxylin and eosin histology. From this study, we found that changes in water concentration (edema), deoxygenated hemoglobin concentration, and optical scattering (tissue denaturation) to be statistically significant at differentiating superficial partial-thickness burns from deep-partial thickness burns.

Current methods of burn reconstruction.

PubMed

Orgill, Dennis P; Ogawa, Rei

2013-05-01

After reading this article, the participant should be able to: 1. Explain the present challenges in reconstructive burn surgery. 2. Describe the most appropriate treatment methods and techniques for specific burn injury types, including skin grafts, dermal substitutes, and a variety of flap options. 3. Identify the appropriate use, advantages, and disadvantages of specific flaps in the treatment of burn injuries, including local, regional, superthin, prefabricated, prelaminated, and free flaps. Victims of thermal burns often form heavy scars and develop contractures around joints, inhibiting movement. As burns can occur in all cutaneous areas of the body, a wide range of reconstructive options have been utilized. Each method has advantages and disadvantages that must be considered by both patients and surgeons. The authors reviewed the literature for burn reconstruction and focused their discussion on areas that have been recently developed. They reviewed the mechanism of burn injury and discussed how this relates to the pathophysiology of the burn injury. Surgeons now have a wide array of plastic surgical techniques that can be used to treat burn victims. These range from skin grafts and local flaps to free flaps, prefabricated flaps, superthin flaps, and dermal scaffolds. Recent advances in burn reconstruction provide methods to decrease scar tissue and joint contractures. In the future, the authors hope that further developments in burn treatment will foster the development of new technologies that will allow site-specific reconstruction with minimal donor-site morbidity.

Learn Not To Burn.

ERIC Educational Resources Information Center

English, Nancy; Hendricks, Charlotte M.

1997-01-01

Describes the "Learn Not to Burn Preschool Program," a low-cost fire safety awareness and burn prevention curriculum for young children. The program promotes eight burn prevention methods--including practicing an escape plan--using developmentally appropriate learning objectives to increase children's fire safety knowledge, skill, and…

Adult survivors' lived experience of burns and post-burn health: A qualitative analysis.

PubMed

Abrams, Thereasa E; Ogletree, Roberta J; Ratnapradipa, Dhitinut; Neumeister, Michael W

2016-02-01

The individual implications of major burns are likely to affect the full spectrum of patients' physical, emotional, psychological, social, environmental, spiritual and vocational health. Yet, not all of the post-burn health implications are inevitably negative. Utilizing a qualitative approach, this heuristic phenomenological study explores the experiences and perceptions early (ages 18-35) and midlife (ages 36-64) adults providing insight for how participants perceived their burns in relationship to their post-burn health. Participants were interviewed using semi-structured interview questions framed around seven domains of health. Interview recordings were transcribed verbatim then coded line by line, identifying dominant categories related to health. Categories were analyzed identifying shared themes among the study sample. Participants were Caucasian, seven males and one female. Mean age at time of interviews was 54.38 and 42.38 at time of burns. Mean time since burns occurred was 9.38 years with a minimum of (20%) total body surface area (TBSA) burns. Qualitative content analysis rendered three emergent health-related categories and associated themes that represented shared meanings within the participant sample. The category of "Physical Health" reflected the theme physical limitations, pain and sensitivity to temperature. Within the category of "Intellectual Health" were themes of insight, goal setting and self-efficacy, optimism and humor and within "Emotional Health" were the themes empathy and gratitude. By exploring subjective experiences and perceptions of health shared through dialog with experienced burned persons, there are opportunities to develop a more complete picture of how holistic health may be affected by major burns that in turn could support future long-term rehabilitative trajectories of early and midlife adult burn patients. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

The epidemiology of geriatric burns in Iran: A national burn registry-based study.

PubMed

Emami, Seyed-Abolhassan; Motevalian, Seyed Abbas; Momeni, Mahnoush; Karimi, Hamid

2016-08-01

Defining the epidemiology and outcome of geriatric burn patients is critical for specialized burn centers, health-care workers, and governments. Better resource use and effective guidelines are some of the advantages of studies focusing on this aspect. The outcome of these patients serves as an objective criterion for quality control, research, and preventive programs. We used data from the burn registry program in our country. For 2 years, >28,700 burn patients were recorded, 1721 of whom were admitted. Among them, 187 patients were ≥55 years old. Sixty-nine percent of patients were male and 31% female, with a male to female ratio of 2.22:1. The mean±standard deviation (SD) of age was 63.4±8.1. The cause of burns was flame (58.2%) and scalds (20.3%). Most of the burns were sustained at home. The mean duration of hospital stay was 19.5 days (range 3-59 days). The mean (SD) of the total body surface area (TBSA) was 20.3% (8.4%). The median hospital stay (length of stay (LOS)) was 11 days (SD=14). The increase in TBSA was related to a longer LOS (p<0.02). Burn wound infection developed in 44.3% of patients. The presence of inhalation injury was significantly related to mortality (p<0.001). Among the patients, 9% recovered completely, 74.9% recovered partially (requiring further treatment), 1% underwent amputation, and 12.8% died. The lack of insurance coverage did not affect the survival of our geriatric burn patients. However, being alone or single, ignition of clothing, cause of burn, comorbid illnesses, complications following the burn, TBSA, age, and sepsis were positively correlated with mortality. The mean cost of treatment for each patient was about $7450. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Platelet-Rich Plasma Injection in Burn Scar Areas Alleviates Neuropathic Scar Pain

PubMed Central

Huang, Shu-Hung; Wu, Sheng-Hua; Lee, Su-Shin; Lin, Yun-Nan; Chai, Chee-Yin; Lai, Chung-Sheng; Wang, Hui-Min David

2018-01-01

Objective: No effective treatments have yet been developed for burn-induced neuropathic pain. Platelet-rich plasma (PRP) has been reported to ameliorate various types of inflammation pain. However, the effect of PRP on burn-induced neuropathic pain is unclear. Methods: Burn-induced neuropathic pain Sprague-Dawley rat model was confirmed using a mechanical response test 4 weeks after the burn injuries were sustained, following which PRP was injected in the scar area. The rats were divided into four groups (n = 6) as following: Group A, Sham; Group B, Sham + PRP; Group C, Burn; and Group D, Burn + PRP. Four weeks after the PRP injection, the animals were subjected to behavior tests and then sacrificed; specimens were collected for inflammation tests, Masson's trichrome stain and chromosome 10 (PTEN) in the injured skin; and PTEN, phosphorylated mammalian target of rapamycin (p-mTOR), p38, nuclear factor κB (NFκB), chemokine (CC motif) ligand 2 (CCL2), and CCL2 cognate receptor (CCR2) in spinal cord dorsal horns through immunohistochemistry and immunofluorescence staining. Results: PRP significantly alleviated allodynia in burn-induced neuropathic pain 4 weeks after treatment, and PTEN expression in the skin and spinal cord were significantly increased in group D compared with the group C. p-PTEN, p-mTOR, and CCL2 expression in neuron cells; p-p38 and p-NFκB expression in microglia; and p-JNK and p-NFκB activation in spinal astrocytes decreased significantly in the group D compared with the group C. Conclusions: PRP is effective in treating burn-induced neuropathic pain and may be used in clinical practice. PMID:29483815

Burn-related factors affecting anxiety, depression and self-esteem in burn patients: an exploratory study.

PubMed

Jain, M; Khadilkar, N; De Sousa, A

2017-03-31

Burns are physically, psychologically and economically challenging injuries, and the factors leading to them are many and under-studied. The aim of the current study was to assess level of anxiety, depression and self-esteem in burn patients, and look at various burn-related variables that affect them. This cross-sectional study included 100 patients with burn injuries admitted to a tertiary care private hospital in an urban metropolis in India. The patients were assessed for anxiety, depression and self-esteem using the Hamilton anxiety rating scale, Hamilton depression rating scale and Rosenberg self-esteem scale respectively. Assessment was carried out within 2-8 weeks of injury following medical stabilization. The data was tabulated and statistically analyzed. The study sample was predominantly male (54%), married (69%), with a mean age of 34.1 ± 10.8 years. Accidental burns (94%) were the most common modality of injury. The majority (46%) suffered burns involving 20-59% total body surface area (TBSA), and facial burns were present (57%). No significant association was found between TBSA and anxiety, depression or self-esteem, and the same was true for facial burns. Deep burns, however, were significantly associated with anxiety (p=0.03) and depression (p=0.0002). High rates of anxiety and depression are associated with burn injuries and related to burn depth. Adjustment and recovery in these patients depends on various other factors like the patient's psychological status, nature/extent of the injury and ensuing medical care. Further research is warranted to reveal the magnitude and predictors of psychological problems in burn patients.

A retrospective review of burn dressings on a porcine burn model.

PubMed

Wang, Xue-Qing; Kravchuk, Olena; Kimble, Roy M

2010-08-01

This is a study to compare wound healing among three types of dressings on a porcine model with deep-dermal-partial-thickness burns. The burns in this study were from eight animal trials conducted in the past for other purposes and only burns with a uniform pale appearance that had served as controls in original experiments were selected. In total, there were 57 burns in 33 pigs, using one of following three dressings: Acticoat (Silver) (3 trials), Jelonet (Gauze) (3 trials), and Solosite Gel/Jelonet (Gel/Gauze) (2 trials). The wound healing assessments included wound re-epithelialisation during a 6-week period, clinical and histological scar assessments at week 6 after burn. Of all wound healing/scar assessments, only re-epithelialisation showed statistical difference between dressings. Earlier re-epithelialisation was observed in Gel/Gauze dressings compared to Silver and/or Gauze dressings. However, this study revealed huge variation in wound healing outcome between 3 trials within both Silver and/or Gauze dressings, supported by significant differences on re-epithelialisation, clinical and histological scar measurements. In addition, it was found that larger animals healed better than smaller ones, based on weights from 21 pigs. Of all dressings, Silver delivers the best protection for wound colonization/infection. Wound colonization/infection was found to confine wound healing and lead to thinner RND in scars. From this study, we cannot find enough evidence to suggest the beneficial effect of one dressing(s) over others on burn wound healing outcome on a porcine model with small deep-dermal-partial-thickness burns with a relative small sample size.

A review of burns patients admitted to the Burns Unit of Hospital Universiti Kebangsaan Malaysia.

PubMed

Chan, K Y; Hairol, O; Imtiaz, H; Zailani, M; Kumar, S; Somasundaram, S; Nasir-Zahari, M

2002-12-01

This is a retrospective review of 110 patients admitted to the Burns Units between October 1999 and November 2001. The aim was to determine the burns pattern of patients admitted to hospital UKM. There was an increasing trend for patients admitted. Female to male ratio was 1:2. Children consisted 34% of the total admission. Children had significant higher number of scald burns as compare to adult (p < 0.01). Domestic burns were consist of 75% overall admission. Mean percentage of TBSA (total body surface area) burns was 19%. Thirty percent of patients sustained more than 20% of TBSA. Sixty percent of patients had scald burns. Ninety percents of patients with second degree burns that were treated with biologic membrane dressing or split skin graft. Mean duration of hospital stay was 10 days. Over 70% of patients were discharged within 15 days. Overall mortality rate was 6.3%. The patients who died had significantly larger area of burns of more than 20% TBSA (p < 0.05) and a higher incidence of inhalation injury (p < 0.02). Hence, this study suggests a need for better preventive measures by the authority to prevent burns related accident and the expansion of the service provided by the Burns Unit.

Evaluation of infrastructure, equipment and training of 28 burn units/burn centers in Germany, Austria and Switzerland.

PubMed

Vogt, Peter M; Busche, Marc N

2011-03-01

Treatment of burn patients requires special training and skills, and an adequate infrastructure. In the United States, burn center referral criteria and requirements of burn centers are defined by the American Burn Association (ABA) in the Guidelines for the Operation of Burn Centers, and in Germany, by the German Society for Burn Treatment (DGV). The European Burn centers in Austria and the German-speaking part of Switzerland share the standards in the setting of the German-speaking Association for Burn Therapy (DAV) with some modifications. The aim of this study was to evaluate the current infrastructure of burn centers in the three German-speaking countries with respect to the existing guidelines. Therefore, guidelines for burn center referral criteria and burn center requirements were compared between the USA (ABA) and Germany (DGV). In addition, a questionnaire was sent to all burn centers in Germany, Austria and the German-speaking part of Switzerland, in order to collect current information regarding the architectural and medical infrastructure, available equipment and care-providing personnel. The comparison of guidelines for the USA and Germany revealed similar burn center referral criteria for both countries. With respect to burn center requirements, both the USA and Germany have similar requirements, albeit with different focus points. In Germany, the main focus lies on the infrastructural requirements for burn centers, while in the US, the main focus lies on the requirements for medical and nursing personnel. Critical review of the responses from the burn centers of German-speaking countries revealed that the biggest infrastructural differences among centers were observed in burn units providing pediatric care, as compared to adult burn centers. In summary, the DGV guidelines for German-speaking countries reflect an overall adoption of the ABA guidelines, and the burn centers included in this study met those requirements. As a result of the positive

Hospital bioterrorism planning and burn surge.

PubMed

Kearns, Randy D; Myers, Brent; Cairns, Charles B; Rich, Preston B; Hultman, C Scott; Charles, Anthony G; Jones, Samuel W; Schmits, Grace L; Skarote, Mary Beth; Holmes, James H; Cairns, Bruce A

2014-01-01

On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity.

Hospital Bioterrorism Planning and Burn Surge

PubMed Central

Myers, Brent; Cairns, Charles B.; Rich, Preston B.; Hultman, C. Scott; Charles, Anthony G.; Jones, Samuel W.; Schmits, Grace L.; Skarote, Mary Beth; Holmes, James H.; Cairns, Bruce A.

2014-01-01

On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity. PMID:24527874

Rational Selection and Use of Antimicrobials in Patients with Burn Injuries.

PubMed

Hill, David M; Sinclair, Scott E; Hickerson, William L

2017-07-01

Caring for patients with burn injuries is challenging secondary to the acute disease process, chronic comorbidities, and underrepresentation in evidence-based literature. Much current practice relies on extrapolation of guidance from different patient populations and wide variations in universal practices. Identifying infections or sepsis in this hypermetabolic population is imperfect and often leads to overprescribing of antimicrobials, suboptimal dosing, and multidrug resistance. An understanding of pharmacokinetics and pharmacodynamics may aid optimization of dosing regimens to better attain treatment targets. This article provides an overview of the current status of burn infection and attempts recommendations for consideration to improve universally accepted care. Copyright © 2017 Elsevier Inc. All rights reserved.

Burning by prescription in chaparral

Treesearch

Lisle R. Green

1981-01-01

Prescribed burning is frequently suggested for reducing conflagration costs in chaparral. Preparation for a prescribed burn includes environmental impact reports, approval by higher levels of authority, and a burn plan. After objectives are stated, the prescription can be written. Elements of the burn prescription reflect fuel, weather, and other factors that determine...

First Aid: Burns

MedlinePlus

... for: Parents Kids Teens Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns ... Being Safe in the Kitchen Finding Out About Fireworks Safety Playing With Fire? Dealing With Burns Fireworks ...

Paediatric burn unit in Portugal: Beds needed using a bed-day approach.

PubMed

Santos, João V; Viana, João; Amarante, José; Freitas, Alberto

2017-03-01

Despite the high burden of children with burns, there is not a paediatric burn unit (PBU) in Portugal. We aimed to estimate the Portuguese health care providing needs on paediatric burns. We performed a nation-wide retrospective study, between 2009 and 2013, among less than 16 years-old inpatients with burns that met the transfer criteria to a burn unit in Portugal. A bed-day approach was used, targeting an occupancy rate of 70-75%, and possible locations were studied. The primary outcome was the number of beds needed, and secondary outcomes were the overload and revenue for each possible number of beds in a PBU. A total of 1155 children met the transfer criteria to a burn unit, representing a total of 17,371 bed-days. Occupancy rates of 11-bed, 12-bed, 13-bed and 14-bed PBU were, respectively, 79.7%, 75.3%, 71.0% and 66.8%. The 13-bed PBU scenario would represent an overload of 523 bed-days, revenue of more than 5 million Euros and a ratio of 1 PBU bed per 123,409 children. Using a groundbreaking approach, the optimal number of PBU beds needed in Portugal is 13. However, as half of the patients who met burn transfer criteria are not transferred, this bed number might be overestimated if this pattern maintains, despite the underestimation with our method approach. If a PBU is to be created the preferable location is Porto. Cost-effectiveness studies should be performed. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Incidence and characteristics of chemical burns.

PubMed

Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

2017-05-01

Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

A prospective observational study investigating all children presenting to a specialty paediatric burns centre.

PubMed

Stockton, K A; Harvey, J; Kimble, R M

2015-05-01

The aim of this study was to describe the mechanism of injury and outcome of all children who presented to The Stuart Pegg Paediatric Burns Centre (SPPBC) with a burn injury in the year 2013. A detailed proforma was completed prospectively at time of presentation to hospital. During the one year period, 758 children with a median age of 2 years 3 months presented with a burn injury. Overall, 12.7% of patients (n=96) were initially treated as inpatients. Similarities existed between in and outpatients. Over half the children admitted had a scald injury (53.1%). Whilst slightly higher than the outpatient scald rate of 43.1% there was no statistical significant difference. However, there was a significant difference between inpatients and outpatients with respect to other mechanisms of injury. Contact burns were under represented in inpatients (27.1%) compared to outpatients (44.5%), p<0.05. In contrast, flame burns were over represented in inpatients, 11.5% compared to outpatients, 2.9% (p<0.05). Paediatric burns are a common cause of childhood injury. The majority of children present with small to medium sized partial thickness injuries and are managed as outpatients. In order to understand the true impact of paediatric burn injury and to develop appropriate targeted injury prevention campaigns, data repositories must include detailed information regarding outpatient paediatric burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Response measurement of single-crystal chemical vapor deposition diamond radiation detector for intense X-rays aiming at neutron bang-time and neutron burn-history measurement on an inertial confinement fusion with fast ignition

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shimaoka, T., E-mail: t.shimaoka@eng.hokudai.ac.jp; Kaneko, J. H.; Tsubota, M.

A neutron bang time and burn history monitor in inertial confinement fusion with fast ignition are necessary for plasma diagnostics. In the FIREX project, however, no detector attained those capabilities because high-intensity X-rays accompanied fast electrons used for plasma heating. To solve this problem, single-crystal CVD diamond was grown and fabricated into a radiation detector. The detector, which had excellent charge transportation property, was tested to obtain a response function for intense X-rays. The applicability for neutron bang time and burn history monitor was verified experimentally. Charge collection efficiency of 99.5% ± 0.8% and 97.1% ± 1.4% for holes andmore » electrons were obtained using 5.486 MeV alpha particles. The drift velocity at electric field which saturates charge collection efficiency was 1.1 ± 0.4 × 10{sup 7} cm/s and 1.0 ± 0.3 × 10{sup 7} cm/s for holes and electrons. Fast response of several ns pulse width for intense X-ray was obtained at the GEKKO XII experiment, which is sufficiently fast for ToF measurements to obtain a neutron signal separately from X-rays. Based on these results, we confirmed that the single-crystal CVD diamond detector obtained neutron signal with good S/N under ion temperature 0.5–1 keV and neutron yield of more than 10{sup 9} neutrons/shot.« less

Chemical and Common Burns in Children.

PubMed

Yin, Shan

2017-05-01

Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals-most commonly acids and alkalis-that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.

Burn Wise Funding

EPA Pesticide Factsheets

EPA is working with federal, state, tribal and local agencies to find and promote viable funding options to replace wood-burning appliances with cleaner home heating. Includes Guide to Financing Options for Wood-burning Appliance Changeouts.

Studying the effects of fuel treatment based on burn probability on a boreal forest landscape.

PubMed

Liu, Zhihua; Yang, Jian; He, Hong S

2013-01-30

Fuel treatment is assumed to be a primary tactic to mitigate intense and damaging wildfires. However, how to place treatment units across a landscape and assess its effectiveness is difficult for landscape-scale fuel management planning. In this study, we used a spatially explicit simulation model (LANDIS) to conduct wildfire risk assessments and optimize the placement of fuel treatments at the landscape scale. We first calculated a baseline burn probability map from empirical data (fuel, topography, weather, and fire ignition and size data) to assess fire risk. We then prioritized landscape-scale fuel treatment based on maps of burn probability and fuel loads (calculated from the interactions among tree composition, stand age, and disturbance history), and compared their effects on reducing fire risk. The burn probability map described the likelihood of burning on a given location; the fuel load map described the probability that a high fuel load will accumulate on a given location. Fuel treatment based on the burn probability map specified that stands with high burn probability be treated first, while fuel treatment based on the fuel load map specified that stands with high fuel loads be treated first. Our results indicated that fuel treatment based on burn probability greatly reduced the burned area and number of fires of different intensities. Fuel treatment based on burn probability also produced more dispersed and smaller high-risk fire patches and therefore can improve efficiency of subsequent fire suppression. The strength of our approach is that more model components (e.g., succession, fuel, and harvest) can be linked into LANDIS to map the spatially explicit wildfire risk and its dynamics to fuel management, vegetation dynamics, and harvesting. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mental health outcomes of burn: A longitudinal population-based study of adults hospitalized for burns.

PubMed

Logsetty, Sarvesh; Shamlou, Amir; Gawaziuk, Justin P; March, Justin; Doupe, Malcolm; Chateau, Dan; Hoppensack, Mike; Khan, Sazzadul; Medved, Maria; Leslie, William D; Enns, Murray W; Stein, Murray B; Asmundson, Gordon J G; Sareen, Jitender

2016-06-01

This study investigates the increased risk of mental health outcomes and health care utilization associated with burn with two year of follow-up using a longitudinal population-based matched cohort design. Adult burn survivors (n=157) were identified from a provincial burn registry and matched 1:5 with non-burn control subjects from the general population (matching variables age and gender). The prevalence of mental health outcomes and the rates of health care utilization between the groups were compared for the 2years pre and post index date using anonymously linked population-based administrative health care data. Rates were adjusted for age, gender and sociodemographic characteristics. While the burn cohort had an increased prevalence of mental health problems after burn compared to the control cohort, the burn group also had an increased prevalence of pre-burn depression (16.6% vs 7.8%; p=0.0005) and substance use disorders (8.9% vs 3.2%; p=0.001) when compared to controls. Once the pre-existing prevalence of mental illness was taken into account there was no significant change in the prevalence of mental health problems when comparing the burn group to controls over time. Although burns may not increase rates of mental health issues and health care utilization, burn survivors are a vulnerable group who already demonstrate increased rates of psychopathology and need for care. The present study highlights the importance of assessment and treatment of mental health outcomes in this population. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Products with Natural Components to Heal Dermal Burns: A Patent Review.

PubMed

de Melo Costa, Aida Carla Santana; Pereira Ramos, Karen Perez; Serafini, Mairim Russo; de Carvalho, Fernanda Oliveira; Teixeira, Luciana Garcez Barretto; Garcao, Diogo Costa; Shanmugam, Saravanan; de Souza Araujo, Adriano Antunes; Nunes, Paula Santos

2015-01-01

Burns are a global public health problem, and non-fatal burn injuries are a leading cause of morbidity. The scale of the problem has led researchers to seek to develop new prod- ucts (both synthetic and natural) for use in the treatment of burn lesions. The aim of this study was to examine all patents in databases between 2010 and 2015 related to natural prod- ucts for the treatment of burn-related wounds that targeted tissue repair and healing. The search term "burn" and the code A61K36/00 (plant and other natural derivatives used in medicinal prepara- tions) from the international classification of patents were used to identify treatments. The search was performed in the WIPO, ESPACENET and USPTO databases. The highest number of patent ap- plications was found in the WIPO data base (617), followed by ESPACENET(23) and USPTO(6). The USA and China were the countries with the most patent applications, and 2008 was the year that had the highest number of applications. Patent applications written in Spanish, English and Portuguese and that were published between 2010 and 2015 were se- lected. 559 patent applications in other languages, and 63 that did not result in the creation of new products between 2010 and 2015 were excluded and the remaining 13 patents application were selected for full reading of the text. Through this study we were able to identify and summarize the new active natural compounds that can be used in the treatment of burns, both in terms of tissue recovery and analgesia.

Titanium subhydride potassium perchlorate (TiH1.65/KClO4) burn rates from hybrid closed bomb-strand burner experiments.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cooper, Marcia A.; Oliver, Michael S.

2012-08-01

A hybrid closed bomb-strand burner is used to measure the burning behavior of the titanium subhydride potassium perchlorate pyrotechnic with an equivalent hydrogen concentration of 1.65. This experimental facility allows for simultaneous measurement of the closed bomb pressure rise and pyrotechnic burn rate as detected by electrical break wires over a range of pressures. Strands were formed by pressing the pyrotechnic powders to bulk densities between 60% and 90% theoretical maximum density. The burn rate dependance on initial density and vessel pressure are measured. At all initial strand densities, the burn is observed to transition from conductive to convective burningmore » within the strand. The measured vessel pressure history is further analyzed following the closed bomb analysis methods developed for solid propellants.« less

Car radiator burns: a prevention issue.

PubMed

Rabbitts, Angela; Alden, Nicole E; Conlin, Tara; Yurt, Roger W

2004-01-01

Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.

Effects of a skin rehabilitation nursing program on skin status, depression, and burn-specific health in burn survivors.

PubMed

Roh, Young Sook; Seo, Cheong Hoon; Jang, Ki Un

2010-01-01

The objective of this study was to identify the effects of a skin rehabilitation nursing program (SRNP) on skin status, depression, and burn-specific health in Korean burn survivors. A pretest-posttest design with a nonequivalent control group was used to examine the effects of SRNP for 3 months in a group of 26 burn survivors. The SRNP group of 13 burn survivors received massage therapy 30 minutes three times a week for 3 months compared to a control group of 13 burn survivors receiving typical care. The SRNP group showed no significant changes in the burn scar, subjective skin status, depression, or burn-specific health. Burn survivors receiving SRNP had reduced burn scar depth after the intervention compared to the control group. The findings of this study demonstrate that SRNP for burn survivors may improve burn scars, and findings suggest that future studies with a larger sample should be conducted using SRNP as an intervention for burn survivors.

Oral Rehydration Therapy in Burn Patients

ClinicalTrials.gov

2014-04-24

Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns

ERIC Educational Resources Information Center

Disseldorp, Laurien M.; Niemeijer, Anuschka S.; Van Baar, Margriet E.; Reinders-Messelink, Heleen A.; Mouton, Leonora J.; Nieuwenhuis, Marianne K.

2013-01-01

Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM[R]…

Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: a prospective study of admissions and outpatients.

PubMed

Othman, Nasih; Kendrick, Denise; Al-Windi, Ahmad

2015-03-01

While it is globally observed that young children are at a higher risk of burn injuries, little is known about childhood burns in Iraqi Kurdistan. This study was undertaken to describe the epidemiology of burns amongst pre-school children in this region. A prospective study was undertaken from November 2007 to November 2008 involving all children aged 0-5 years attending the burns centre in Sulaimaniyah province for a new burn injury whether treated as an outpatient or admitted to hospital. 1,122 children attended the burns centre of whom 944 (84%) were interviewed (male 53%, female 47%). Mean age was 1.9 years with children aged 1 year comprising 32% and those aged 2 years comprising 21% of the sample. The incidence of burns was 1044/100,000 person-years (1030 in females and 1057 in males). Mechanisms of injury included scalds (80%), contact burns (12%) flames (6%) and other mechanisms (2%). Almost 97% of burns occurred at home including 43% in the kitchen. Winter was the commonest season (36%) followed by autumn (24%). There were 3 peak times of injury during the day corresponding to meal times. The majority of burns were caused by hot water (44%) and tea (20%) and the most common equipment/products responsible were tea utensils (41%). There were 237 admissions with an admission rate of 95 per 100,000 person-years. Scald injuries accounted for most admissions (84%). Median total body surface area affected by the burn or scald (TBSA) was 11% and median hospital stay was 7 days. In-hospital mortality was 8%. Mortality rate was 4% when TBSA was ≤25%, and 100% when TBSA was over 50%. Burn incidence is high in young children especially those aged 1-2 years. Preventive interventions targeted at families with young children & focusing on home safety measures could be effective in reducing childhood burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Burn Wise - Partners

EPA Pesticide Factsheets

Within this site you will find information for consumers to make informed decisions about what it means to burn wise. And partners will learn about how they can work with EPA to bring cleaner-burning appliances to market.

Current knowledge of burn injury first aid practices and applied traditional remedies: a nationwide survey.

PubMed

Kattan, Abdullah E; AlShomer, Feras; Alhujayri, Abdulaziz K; Addar, Abdullah; Aljerian, Albaraa

2016-01-01

Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender ( r  = 0.87, P  < 0.001), younger age group (19-25 years) ( r  = 0.077, P  < 0.001), from central region ( r  = 0.012, P  < 0.001), and university graduate ( r  = 0.05, P  = 0.002). Nearly half of those who knew of traditional remedies did not have previous knowledge of burn first aid. Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.

Probing the Physics of Burning DT Capsules Using Gamma-ray Diagnostics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayes-Sterbenz, Anna Catherine; Hale, Gerald M.; Jungman, Gerard

2015-02-01

The Gamma Reaction History (GRH) diagnostic developed and lead by the Los Alamos National Laboratory GRH Team is used to determine the bang time and burn width of imploded inertial confinement fusion capsules at the National Ignition Facility. The GRH team is conceptualizing and designing a new Gamma-­to-Electron Magnetic Spectrometer (GEMS), that would be capable of an energy resolution ΔE/E~3-­5%. In this whitepaper we examine the physics that could be explored by the combination of these two gamma-ray diagnostics, with an emphasis on the sensitivity needed for measurements. The main areas that we consider are hydrodynamical mixing, ablator areal densitymore » and density profile, and temporal variations of the density of the cold fuel and the ablator during the DT burn of the capsule.« less

Assault by burning in Jordan.

PubMed

Haddadin, W

2012-12-31

Criminal attacks by burns on women in Jordan are highlighted in this retrospective study carried out of all proved cases of criminal burns in female patients treated at the burn unit of the Royal Rehabilitation Center in Jordan between January 2005 and June 2012. Thirteen patients were included in our study, out of a total of 550 patients admitted, all in the age range of 16-45 yr. Of these 13 women, six were burned by acid throwing, five by hot water, and two by direct flames from fuel thrown over them. Burn percentage ranged from 15 to 75% of the total body surface area, with involvement in most cases of the face and upper trunk. The mean hospital stay was 33 days and the mortality rate was 3/13, i.e. 23%. Violence against women exists in Jordanian society, yet burning assaults are rare. Of these, burning by throwing acid is the most common and most disfiguring act, with a higher mortality rate in domestic environments.

Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

PubMed

Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

2015-01-01

After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

Magnetized Target Fusion Driven by Plasma Liners

NASA Technical Reports Server (NTRS)

Thio, Y. C. Francis; Kirkpatrick, Ronald C.; Knapp, Charles E.; Rodgers, Stephen L. (Technical Monitor)

2002-01-01

Magnetized target fusion is an emerging, relatively unexplored approach to fusion for electrical power and propulsion application. The physical principles of the concept are founded upon both inertial confinement fusion (ICF) and magnetic confinement fusion (MCF). It attempts to combine the favorable attributes of both these orthogonal approaches to fusion, but at the same time, avoiding the extreme technical challenges of both by exploiting a fusion regime intermediate between them. It uses a material liner to compress, heat and contain the fusion reacting plasma (the target plasma) mentally. By doing so, the fusion burn could be made to occur at plasma densities as high as six orders of magnitude higher than conventional MCF such as tokamak, thus leading to an approximately three orders of magnitude reduction in the plasma energy required for ignition. It also uses a transient magnetic field, compressed to extremely high intensity (100's T to 1000T) in the target plasma, to slow down the heat transport to the liner and to increase the energy deposition of charged-particle fusion products. This has several compounding beneficial effects. It leads to longer energy confinement time compared with conventional ICF without magnetized target, and thus permits the use of much lower plasma density to produce reasonable burn-up fraction. The compounding effects of lower plasma density and the magneto-insulation of the target lead to greatly reduced compressional heating power on the target. The increased energy deposition rate of charged-particle fusion products also helps to lower the energy threshold required for ignition and increasing the burn-up fraction. The reduction in ignition energy and the compressional power compound to lead to reduced system size, mass and R&D cost. It is a fusion approach that has an affordable R&D pathway, and appears attractive for propulsion application in the nearer term.

Burns functional disabilities among burn survivors: a study in Komfo Anokye Teaching Hospital, Ghana

PubMed Central

Agbenorku, Pius

2013-01-01

Aim: To determine the types of functional disabilities in adult and paediatric burns survivors, with specific emphasis on potential risk and socio-economic factors of burn disabilities present in Ghana. Patients and Methods: The descriptive study was carried out in Komfo Anokye Teaching Hospital, Kumasi, Ghana from May 2011 to April 2012. Burn survivors who came for follow-up visits after been discharged home and had functional disability were the participants of the study. They were physically examined and interviewed using a pre-tested questionnaire after their informed consent/or that of their parents (in the cases of paediatrics burns survivors) was sought. Results: A total of 70 participants consented for the study. Their ages ranged from 8/12 – 78 years, with a mean age of 12±1.7 years. Majority (60.0%, N=42) of the participants had third degree burns. The nature of disabilities of participants were mostly scar contractures (42.9%, N=30) of which 36.7% (N=11) had impeded arm elevation; 23.3% (N=7) could not fold the palm or move the digits. From the multiple regression analysis risk factors for burn victim to have disability were paediatric age (OR=11.1, P=0.043), third degree of burn (OR=6.2, P=0.001) and anatomical part affected (OR=18.3, P=0.031). Socio-economic factors that affected burn disability victims were nuclear family compensation (OR=4.2, P=0.021), community mockery/stigmatization (OR=0.1, P=0.052) and caretakers time and finance (OR=5.2, P=0.033). Conclusion: The commonest functional disabilities recorded were scar contractions of the axilla region which had impeded the ability of the patients to lift the arm. Risk factors for burns disability included childhood age, third degree of burn incurred and anatomical part affected. Social factors influencing the lives of burn survivors with disability were good family and negative community interactions. Significant economical factors recorded were caretakers’ time and financial constrains. PMID

Impact of managed moorland burning on DOC concentrations in soil solutions and stream waters

NASA Astrophysics Data System (ADS)

Palmer, Sheila; Wearing, Catherine; Johnson, Kerrylyn; Holden, Joseph; Brown, Lee

2013-04-01

In the UK uplands, prescribed burning of moorland vegetation is a common practice to maintain suitable habitats for game birds. Many of these landscapes are in catchments covered by significant deposits of blanket peat (typically one metre or more in depth). There is growing interest in the effect of land management on the stability of these peatland carbon stores, and their contribution to dissolved and particulate organic carbon in surface waters (DOC and POC, respectively) and subsequent effects on stream biogeochemistry and ecology. Yet there are surprisingly few published catchment-scale studies on the effect of moorland burning on DOC and POC. As part of the EMBER project, stream chemistry data were collected approximately monthly in ten upland blanket peat catchments in the UK, five of which acted as controls and were not subject to burning. The other five catchments were subject to a history of prescribed burning, typically in small patches (300-900 m2) in rotations of 8-25 years. Soil solution DOC was also monitored at four depths at two intensively studied sites (one regularly burned and one control). At the two intensive sites, soil solution DOC was considerably higher at the burned site, particularly in surface solutions where concentrations in excess of 100 mg/L were recorded on several occasions (median 37 mg/L over 18 months). The high soil solution DOC concentrations at the burned site occurred in the most recently burned plots (less than 2 years prior to start of sampling) and the lowest DOC concentrations were observed in plots burned 15-25 years previously. On average, median stream DOC and POC concentrations were approximately 43% and 35% higher respectively in burned catchments relative to control catchments. All streams exhibited peak DOC in late summer/early autumn with higher peak DOC concentrations in burned catchments (20-66 mg/L) compared to control catchments (18-54 mg/L). During winter months, DOC concentrations were low in control

Burn injury pain: the continuing challenge.

PubMed

Summer, Gretchen J; Puntillo, Kathleen A; Miaskowski, Christine; Green, Paul G; Levine, Jon D

2007-07-01

The development of more effective methods of relieving pain associated with burn injury is a major unmet medical need. Not only is acute burn injury pain a source of immense suffering, but it has been linked to debilitating chronic pain and stress-related disorders. Although pain management guidelines and protocols have been developed and implemented, unrelieved moderate-to-severe pain continues to be reported after burn injury. One reason for this is that the intensity of pain associated with wound care and rehabilitation therapy, the major source of severe pain in this patient population, varies widely over the 3 phases of burn recovery, making it difficult to estimate analgesic requirements. The effects of opioids, the most commonly administered analgesics for burn injury procedural pain, are difficult to gauge over the course of burn recovery because the need for an opioid may change rapidly, resulting in the overmedication or undermedication of burn-injured patients. Understanding the mechanisms that contribute to the intensity and variability of burn injury pain over time is crucial to its proper management. We provide an overview of the types of pain associated with a burn injury, describe how these different types of pain interfere with the phases of burn recovery, and summarize pharmacologic pain management strategies across the continuum of burn care. We conclude with a discussion and suggestions for improvement. Rational management, based on the underlying mechanisms that contribute to the intensity and variability of burn injury pain, is in its infancy. The paucity of information highlights the need for research that explores and advances the identification of mechanisms of acute and chronic burn injury pain. Researchers continue to report that burn pain is undertreated. This review examines burn injury pain management across the phases of burn recovery, emphasizing 3 types of pain that require separate assessment and management. It provides insights

Trout Creek 1999 Burn

Treesearch

Sherel Goodrich

2008-01-01

A small prescribed fire near the mouth of Trout Creek in Strawberry Valley, Wasatch County, Utah, on the Uinta National Forest provided an opportunity to compare production and vascular plant composition in unburned and burned areas. At four years post burn, production of herbaceous plants was about four times greater in the burned area than in the unburned area. Most...

Reliability enhancement through optimal burn-in

NASA Astrophysics Data System (ADS)

Kuo, W.

1984-06-01

A numerical reliability and cost model is defined for production line burn-in tests of electronic components. The necessity of burn-in is governed by upper and lower bounds: burn-in is mandatory for operation-critical or nonreparable component; no burn-in is needed when failure effects are insignificant or easily repairable. The model considers electronic systems in terms of a series of components connected by a single black box. The infant mortality rate is described with a Weibull distribution. Performance reaches a steady state after burn-in, and the cost of burn-in is a linear function for each component. A minimum cost is calculated among the costs and total time of burn-in, shop repair, and field repair, with attention given to possible losses in future sales from inadequate burn-in testing.

Burned bodies: post-mortem computed tomography, an essential tool for modern forensic medicine.

PubMed

Coty, J-B; Nedelcu, C; Yahya, S; Dupont, V; Rougé-Maillart, C; Verschoore, M; Ridereau Zins, C; Aubé, C

2018-06-07

Currently, post-mortem computed tomography (PMCT) has become an accessible and contemporary tool for forensic investigations. In the case of burn victims, it provides specific semiologies requiring a prudent understanding to differentiate between the normal post-mortem changes from heat-related changes. The aim of this pictorial essay is to provide to the radiologist the keys to establish complete and focused reports in cases of PMCT of burn victims. Thus, the radiologist must discern all the contextual divergences with the forensic history, and must be able to report all the relevant elements to answer to the forensic pathologist the following questions: Are there tomographic features that could help to identify the victim? Is there evidence of remains of biological fluids in liquid form available for toxicological analysis and DNA sampling? Is there another obvious cause of death than heat-related lesions, especially metallic foreign bodies of ballistic origin? Finally, what are the characteristic burn-related injuries seen on the corpse that should be sought during the autopsy? • CT is highly useful to find features permitting the identification of a severely burned body. • PMCT is a major asset in gunshot injuries to depict ballistic foreign bodies in the burned cadavers. • CT is able to recognise accessible blood for tests versus heat clot (air-crescent sign). • Heat-related fractures are easily differentiated from traumatic fractures. • Epidural collections with a subdural appearance are typical heat-related head lesions.

Installation for burning-out scrap metal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gutschmidt, P.

1982-08-24

Disclosed is an installation for burning-out scrap metal goods for the purpose of reclaiming scrap metal, comprising at least one furnace wagon, which is capable of being loaded with the scrap metal goods to be burned out; at least one burning-out chamber into which the furnace wagon is movable for burning-out the scrap metal goods to produce scrap steel; means for heating the burning-out chamber to a temperature of at least about 600* C.; at least one afterburning chamber communicating with the burning-out chamber for afterburning flue gases produced in the burning-out chamber at a temperature from about 1100* tomore » 1200* C.; a waste gas purifying plant communicating with the afterburning chamber for eliminating the flue gas impurities and for the scrubbing of the flue-gases originating from the afterburning chamber; and at least one cooling chamber arranged adjacent to and in selective communication with the burning-out chamber for cooling the burned-out material.« less

Physical rehabilitation of pediatric burns.

PubMed

Atiyeh, B; Janom, H H

2014-03-31

Significant improvements have been made in the acute treatment of pediatric burn injuries over the past 3 decades which have significantly decreased mortality. Each year, more burned children are necessitating serious medical attention during their convalescence. For children with serious consequences resulting from burns that can persist from childhood through adolescence into adulthood, the value of long-term rehabilitation cannot be over stated. Burn injury management should not focus only on the immediate treatment. Long-term functional outcome and the required rehabilitation that burn victims must go through should be given equal if not more attention. The present is a review of the available modalities utilized for the physical rehabilitation of convalescent pediatric burns in order to overcome the catabolic state, improve muscle power and fitness, reduce disfiguring scars and prevent contractures.

Burn hazards of the deployed environment in wartime: epidemiology of noncombat burns from ongoing United States military operations.

PubMed

Kauvar, David S; Wade, Charles E; Baer, David G

2009-10-01

Service in the deployed military environment carries risks for accidental (noncombat-related) burns. Examining these risks can assist in the development of military burn prevention measures. This study endeavored to examine noncombat burn epidemiology in the context of similar civilian data. We performed a retrospective cohort study of consecutive casualties evacuated from operational military theaters in Iraq and Afghanistan to the sole tertiary military burn center in the US. Military data were compared with database samples of the US population from the American Burn Association and the Centers for Disease Control and Prevention. The main causes of the 180 noncombat burns seen from March 2003 to June 2008 were waste burning, fuel mishaps, and unintentional ordinance detonations. Overall prevalence of noncombat burns was 19.5 burns/100,000 person-years lived. If causes specific to military operations are removed, military prevalence was 13.0/100,000. More than one-third of noncombat burns occurred in the first year of the study; a period of stability followed. A similar US population had an accidental burn prevalence of 7.1/100,000 from 2003 to 2007. Burn size, presence of inhalation injury, and burn center mortality were not different from those in a similar civilian cohort. Deployed service members have a greater risk of unintentional burns than a similar civilian cohort does. This is in part because of the specific dangers of military activities. More attention to deployed military burn prevention is needed, especially early in combat support operations.

How much do parents know about first aid for burns?

PubMed

Davies, M; Maguire, S; Okolie, C; Watkins, W; Kemp, A M

2013-09-01

Prompt first aid reduces burn morbidity. With an estimated 19,000 children attending emergency departments (ED) with a burn or scald every year in the UK, a parent's knowledge of first aid is particularly important. This study evaluates the extent and source of this knowledge. Parents attending the emergency and antenatal departments of a University Hospital answered a structured questionnaire detailing demographics, knowledge of burns first aid and its source. Knowledge was stratified into 4 categories: contraindicated, poor, inadequate and adequate. Individual chi-squared tests and ordered logistic regressions were performed to relate knowledge to demographic features. The 106 respondents (44% men) reflected a wide range of socio-economic (SE) grouping and educational level. Overall 32% had an adequate knowledge of burns first aid while 43% had poor or no knowledge. There was no significant correlation between gender, educational status or age and knowledge; however those from higher SE groups (p<0.05) and those who had undergone first aid training (p<0.01) had greater knowledge. Among 40% of parents who had undergone first aid training, 74% had adequate knowledge. The logistic regression accounting for all significant variables showed that previous first aid training was the most influential factor in knowledge of first aid (p<0.001). Interestingly, although 2/3 of parents wanted further training, 75% of those who did not had poor or no first-aid knowledge. Overall, the knowledge of burns first aid among parents is inadequate and correlates with lower SE groups. There was a significant association between knowledge and previous first aid training. Results suggest that targeting burns first aid training to all new parents, particularly those in low income households, would be of value. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Irradiation performance of PFBR MOX fuel after 112 GWd/t burn-up

NASA Astrophysics Data System (ADS)

Venkiteswaran, C. N.; Jayaraj, V. V.; Ojha, B. K.; Anandaraj, V.; Padalakshmi, M.; Vinodkumar, S.; Karthik, V.; Vijaykumar, Ran; Vijayaraghavan, A.; Divakar, R.; Johny, T.; Joseph, Jojo; Thirunavakkarasu, S.; Saravanan, T.; Philip, John; Rao, B. P. C.; Kasiviswanathan, K. V.; Jayakumar, T.

2014-06-01

The 500 MWe Prototype Fast Breeder Reactor (PFBR) which is in advanced stage of construction at Kalpakkam, India, will use mixed oxide (MOX) fuel with a target burnup of 100 GWd/t. The fuel pellet is of annular design to enable operation at a peak linear power of 450 W/cm with the requirement of minimum duration of pre-conditioning. The performance of the MOX fuel and the D9 clad and wrapper material was assessed through Post Irradiation Examinations (PIE) after test irradiation of 37 fuel pin subassembly in Fast Breeder Test Reactor (FBTR) to a burn-up of 112 GWd/t. Fission product distribution, swelling and fuel-clad gap evolution, central hole diameter variation, restructuring, fission gas release and clad wastage due to fuel-clad chemical interaction were evaluated through non-destructive and destructive examinations. The examinations have indicated that the MOX fuel can safely attain the desired target burn-up in PFBR.

Burns in patients over 90: a fifteen-year series from a regional burns centre.

PubMed

Shariff, Zakir; Rodrigues, Jeremy N; Anwar, Umair; Austin, Orla; Phipps, Alan

2015-03-01

The elderly constitute an expanding subgroup within society, and may have differences in health needs compared to younger patients. The specific needs and outcomes of elderly patients with burns have been widely studied. However, the definition of elderly often used in previous studies is a cut off of 65 years old. Within this broadly defined group, the very elderly may have distinct health care needs and issues. This study investigated aetiology, management and outcome of burns in those over 90 years treated at a single UK burns service over a period of 15 years between 1998 and 2013, and compares these data to published data describing 'younger' elderly burns patients. Twenty two patients were included, with a 2:1 female:male ration, and a mean 9%TBSA burn. Six of the 22 died during their admission, and those who survived averaged 8 days inpatient stay per %TBSA. The very elderly with burns may fare worse than younger elderly patients. Although burns in the very elderly are relatively infrequent events, they require significant resource. Further work to optimise their outcome is required. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Burn Wise Educational Materials for Businesses

EPA Pesticide Factsheets

Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients.

PubMed

Wang, Xue-Qing; Mill, Julie; Kravchuk, Olena; Kimble, Roy M

2010-12-01

This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39±0.032 cm, with the thickest at 6 months (0.40±0.036 cm). There were 17 scald burn scars (0.34±0.045 cm), 4 contact burn scars (0.61±0.092 cm), and 10 flame burn scars (0.42±0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue <125, light blue 125-250, and green 250-440 PU. The thickness of these scars was significantly different between the predominant colours of burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

Animal models in burn research.

PubMed

Abdullahi, A; Amini-Nik, S; Jeschke, M G

2014-09-01

Burn injury is a severe form of trauma affecting more than 2 million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury, to elucidate the pathophysiology, and to explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research.

Assault by burning in Jordan

PubMed Central

Haddadin, W.

2012-01-01

Summary Criminal attacks by burns on women in Jordan are highlighted in this retrospective study carried out of all proved cases of criminal burns in female patients treated at the burn unit of the Royal Rehabilitation Center in Jordan between January 2005 and June 2012. Thirteen patients were included in our study, out of a total of 550 patients admitted, all in the age range of 16-45 yr. Of these 13 women, six were burned by acid throwing, five by hot water, and two by direct flames from fuel thrown over them. Burn percentage ranged from 15 to 75% of the total body surface area, with involvement in most cases of the face and upper trunk. The mean hospital stay was 33 days and the mortality rate was 3/13, i.e. 23%. Violence against women exists in Jordanian society, yet burning assaults are rare. Of these, burning by throwing acid is the most common and most disfiguring act, with a higher mortality rate in domestic environments. PMID:23766757

Methylated spirit burns: an ongoing problem.

PubMed

Jansbeken, J R H; Vloemans, A F P M; Tempelman, F R H; Breederveld, R S

2012-09-01

Despite many educational campaigns we still see burns caused by methylated spirit every year. We undertook a retrospective study to analyse the impact of this problem. We retrospectively collected data of all patients with burns caused by methylated spirit over twelve years from 1996 to 2008. Our main endpoints were: incidence, age, mechanism of injury, total body surface area (TBSA) burned, burn depth, need for surgery and length of hospital stay. Ninety-seven patients with methylated spirit burns were included. During the study period there was no decrease in the number of patients annually admitted to the burn unit with methylated spirit burns. 28% of the patients (n=27) were younger than eighteen years old, 15% (n=15) were ten years old or younger. The most common cause of burns was carelessness in activities involving barbecues, campfires and fondues. Mean TBSA burned was 16% (SD 12.4). 70% (n=68) had full thickness burns. 66% (n=64) needed grafting. Mean length of hospital stay was 23 days (SD 24.7). The use of methylated spirit is an ongoing problem, which continues to cause severe burns in adults and children. Therefore methylated spirit should be banned in households. We suggest sale only in specialised shops, clear labelling and mandatory warnings. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Smartphone applications in burns.

PubMed

Wurzer, Paul; Parvizi, Daryousch; Lumenta, David B; Giretzlehner, Michael; Branski, Ludwik K; Finnerty, Celeste C; Herndon, David N; Tuca, Alexandru; Rappl, Thomas; Smolle, Christian; Kamolz, Lars P

2015-08-01

Since the introduction of applications (apps) for smartphones, the popularity of medical apps has been rising. The aim of this review was to demonstrate the current availability of apps related to burns on Google's Android and Apple's iOS store as well as to include a review of their developers, features, and costs. A systematic online review of Google Play Store and Apple's App Store was performed by using the following search terms: "burn," "burns," "thermal," and the German word "Verbrennung." All apps that were programmed for use as medical apps for burns were included. The review was performed from 25 February until 1 March 2014. A closer look at the free and paid calculation apps including a standardized patient was performed. Four types of apps were identified: calculators, information apps, book/journal apps, and games. In Google Play Store, 31 apps were related to burns, of which 20 were calculation apps (eight for estimating the total body surface area (TBSA) and nine for total fluid requirement (TFR)). In Apple's App Store, under the category of medicine, 39 apps were related to burns, of which 21 were calculation apps (19 for estimating the TBSA and 17 for calculating the TFR). In 19 out of 32 available calculation apps, our study showed a correlation of the calculated TFR compared to our standardized patient. The review demonstrated that many apps for medical burns are available in both common app stores. Even free available calculation apps may provide a more objective and reproducible procedure compared to manual/subjective estimations, although there is still a lack of data security especially in personal data entered in calculation apps. Further clinical studies including smartphone apps for burns should be performed. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Exogenous peripheral blood mononuclear cells affect the healing process of deep-degree burns

PubMed Central

Yu, Guanying; Li, Yaonan; Ye, Lan; Wang, Xinglei; Zhang, Jixun; Dong, Zhengxue; Jiang, Duyin

2017-01-01

The regenerative repair of deep-degree (second degree) burned skin remains a notable challenge in the treatment of burn injury, despite improvements being made with regards to treatment modality and the emergence of novel therapies. Fetal skin constitutes an attractive target for investigating scarless healing of burned skin. To investigate the inflammatory response during scarless healing of burned fetal skin, the present study developed a nude mouse model, which was implanted with normal human fetal skin and burned fetal skin. Subsequently, human peripheral blood mononuclear cells (PBMCs) were used to treat the nude mouse model carrying the burned fetal skin. The expression levels of matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinases (TIMP)-1 were investigated during this process. In the present study, fetal skin was subcutaneously implanted into the nude mice to establish the murine model. Hematoxylin and eosin staining was used to detect alterations in the skin during the development of fetal skin and during the healing process of deep-degree burned fetal skin. The expression levels of MMP-9 and TIMP-1 were determined using immunochemical staining, and their staining intensity was evaluated by mean optical density. The results demonstrated that fetal skin subcutaneously implanted into the dorsal skin flap of nude mice developed similarly to the normal growth process in the womb. In addition, the scarless healing process was clearly observed in the mice carrying the burned fetal skin. A total of 2 weeks was required to complete scarless healing. Following treatment with PBMCs, the burned fetal skin generated inflammatory factors and enhanced the inflammatory response, which consequently resulted in a reduction in the speed of healing and in the formation of scars. Therefore, exogenous PBMCs may alter the lowered immune response environment, which is required for scarless healing, resulting in scar formation. In conclusion, the present

The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.

PubMed

Bache, Sarah E; Fitzgerald O'Connor, Edmund; Theodorakopoulou, Evgenia; Frew, Quentin; Philp, Bruce; Dziewulski, Peter

2017-02-01

Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, p<0.0001 on testing with Lin's correlation coefficient). A significant relationship was shown between the HABS score and a reliable binary outcome of the requirement for surgical excision on Mann-Whitney U testing (U=152; Z=9.8; p=0.0001). A receiver operator characteristic (ROC) curve analysis found a cut off score of 5.5, indicating that those with a HABS score below 6 did not require an operation, whereas those with a score above 6 did. The HABS score was shown to be more sensitive and specific that assessment of burn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Range shortening, radiation transport, and Rayleigh-Taylor instability phenomena in ion-beam-driven inertial-fusion-reactor-size targets: Implosion, ignition, and burn phases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Long, K.A.; Tahir, N.A.

In this paper we present an analysis of the theory of the energy deposition of ions in cold materials and hot dense plasmas together with numerical calculations for heavy and light ions of interest to ion-beam fusion. We have used the g-smcapso-smcapsr-smcapsg-smcapso-smcapsn-smcaps computer code of Long, Moritz, and Tahir (which is an extension of the code originally written for protons by Nardi, Peleg, and Zinamon) to carry out these calculations. The energy-deposition data calculated in this manner has been used in the design of heavy-ion-beam-driven fusion targets suitable for a reactor, by its inclusion in the m-smcapse-smcapsd-smcapsu-smcapss-smcapsa-smcaps code of Christiansen,more » Ashby, and Roberts as extended by Tahir and Long. A number of other improvements have been made in this code and these are also discussed. Various aspects of the theoretical analysis of such targets are discussed including the calculation of the hydrodynamic stability, the hydrodynamic efficiency, and the gain. Various different target designs have been used, some of them new. In general these targets are driven by Bi/sup +/ ions of energy 8--12 GeV, with an input energy of 4--6.5 MJ, with output energies in the range 600--900 MJ, and with gains in the range 120--180. The peak powers are in the range of 500--750 TW. We present detailed calculations of the ablation, compression, ignition, and burn phases. By the application of a new stability analysis which includes ablation and density-gradient effects we show that these targets appear to implode in a stable manner. Thus the targets designed offer working examples suited for use in a future inertial-confinement fusion reactor.« less

Comparison and analysis of the results of direct-driven targets implosion

NASA Astrophysics Data System (ADS)

Demchenko, N. N.; Dolgoleva, G. V.; Gus'kov, S. Yu; Kuchugov, P. A.; Rozanov, V. B.; Stepanov, R. V.; Zmitrenko, N. V.; Yakhin, R. A.

2017-10-01

The article presents calculation results, which were received for the implosion of the typical cryogenic thermonuclear direct-drive targets that are intended for use at the OMEGA facility, NIF and Russian laser facility. The compression and burning characteristics, which were obtained using various numerical codes of different scientific groups, are compared. The data indicate good agreement between the numerical results. Various sources of target irradiation inhomogeneity and their influence on the implosion parameters are considered. The nominal scales of these disturbances for various facilities are close to each other. The main negative effect on the efficiency of compression and burning is due to the accidental offset of the target from the center of the chamber.

Lawn mower-related burns.

PubMed

Still, J; Orlet, H; Law, E; Gertler, C

2000-01-01

Lawn mower-related injuries are fairly common and are usually caused by the mower blades. Burns may also be associated with the use of power lawn mowers. We describe 27 lawn mower-related burn injuries of 24 male patients and 3 female patients. Three of the patients with burn injuries were children. Burn sizes ranged from 1% to 99% of the total body surface area (mean, 18.1%). Two of the patients died. The hospital stay ranged from 1 day to 45 days. Twenty-six injuries involved gasoline, which is frequently associated with refueling accidents. Safety measures should involve keeping children away from lawn mowers that are being used. The proper use and storage of gasoline is stressed.

Biomass Burning Data and Information

Atmospheric Science Data Center

2015-04-21

Biomass Burning Data and Information This data set represents ... geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ... models of the atmosphere. Project Title:  Biomass Burning Discipline:  Tropospheric Composition ...

Predicting the proportion of full-thickness involvement for any given burn size based on burn resuscitation volumes.

PubMed

Liu, Nehemiah T; Salinas, José; Fenrich, Craig A; Serio-Melvin, Maria L; Kramer, George C; Driscoll, Ian R; Schreiber, Martin A; Cancio, Leopoldo C; Chung, Kevin K

2016-11-01

The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full-thickness (FT) involvement affected overall 24-hour burn resuscitation volumes. We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns that required resuscitation using our computerized decision support system for burn fluid resuscitation. We defined the degree of FT involvement as FT Index (FTI; percentage of FT injury/percentage of total body surface area (TBSA) burned [%FT / %TBSA]) and compared variables on actual 24-hour fluid resuscitation volumes overall as well as for any given burn size. A total of 203 patients admitted to our burn center during the study period were included in the analysis. Mean age and weight were 47 ± 19 years and 87 ± 18 kg, respectively. Mean %TBSA was 41 ± 20 with a mean %FT of 18 ± 24. As %TBSA, %FT, and FTI increased, so did actual 24-hour fluid resuscitation volumes (mL/kg). However, increase in FTI did not result in increased volume indexed to burn size (mL/kg per %TBSA). This was true even when patients with inhalation injury were excluded. Further investigation revealed that as %TBSA increased, %FT increased nonlinearly (quadratic polynomial) (R = 0.994). Total burn size and FT burn size were both highly correlated with increased 24-hour fluid resuscitation volumes. However, FTI did not correlate with a corresponding increase in resuscitation volumes for any given burn size, even when patients with inhalation injury were excluded. Thus, there are insufficient data to presume that those who receive more volume at any given burn size are likely to be mostly full thickness or vice versa. This was influenced by a relatively low sample size at each 10%TBSA increment and larger burn sizes disproportionately having more FT burns. A more

Animal Models in Burn Research

PubMed Central

Abdullahi, A.; Amini-Nik, S.; Jeschke, M.G

2014-01-01

Burn injury is a severe form of trauma affecting more than two million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury; to elucidate the pathophysiology and explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review paper aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research. PMID:24714880

Patch mosaic burning for biodiversity conservation: a critique of the pyrodiversity paradigm.

PubMed

Parr, Catherine L; Andersen, Alan N

2006-12-01

Fire management is increasingly focusing on introducing heterogeneity in burning patterns under the assumption that "pyrodiversity begets biodiversity." This concept has been formalized as patch mosaic burning (PMB), in which fire is manipulated to create a mosaic of patches representative of a range of fire histories to generate heterogeneity across space and time. Although PMB is an intuitively appealing concept, it has received little critical analysis. Thus we examined ecosystems where PMB has received the most attention and has been the most extensively implemented: tropical and subtropical savannas of Australia and Africa. We identified serious shortcomings of PMB: the ecological significance of different burning patterns remains unknown and details of desired fire mosaics remain unspecified. This has led to fire-management plans based on pyrodiversity rhetoric that lacks substance in terms of operational guidelines and capacity for meaningful evaluation. We also suggest that not all fire patterns are ecologically meaningful: this seems particularly true for the highly fire-prone savannas of Australia and South Africa. We argue that biodiversity-needs-pyrodiversity advocacy needs to be replaced with a more critical consideration of the levels of pyrodiversity needed for biodiversity and greater attention to operational guidelines for its implementation.

ISBI Practice Guidelines for Burn Care.

PubMed

2016-08-01

Practice guidelines (PGs) are recommendations for diagnosis and treatment of diseases and injuries, and are designed to define optimal evaluation and management. The first PGs for burn care addressed the issues encountered in developed countries, lacking consideration for circumstances in resource-limited settings (RLS). Thus, the mission of the 2014-2016 committee established by the International Society for Burn Injury (ISBI) was to create PGs for burn care to improve the care of burn patients in both RLS and resource-abundant settings. An important component of this effort is to communicate a consensus opinion on recommendations for burn care for different aspects of burn management. An additional goal is to reduce costs by outlining effective and efficient recommendations for management of medical problems specific to burn care. These recommendations are supported by the best research evidence, as well as by expert opinion. Although our vision was the creation of clinical guidelines that could be applicable in RLS, the ISBI PGs for Burn Care have been written to address the needs of burn specialists everywhere in the world. Copyright © 2016. Published by Elsevier Ltd.

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

Clothing burns in Canadian children

PubMed Central

Stanwick, Richard S.

1985-01-01

A Canadian survey of 11 tertiary care pediatric centres with specialized burn facilities revealed that an estimated 37 children up to 9 years of age are admitted annually to such hospitals because of clothing burns. Sleepwear accounts for an estimated 21 such burns per year. Girls were found to suffer the most severe burns and represented eight of the nine children in the series who died. Loose and flowing garments dominated the girls' styles. The results of multiple-regression analysis confirmed that style of clothing (loose and flowing as opposed to snug) was the most significant predictor of burn severity, length of hospital stay, the need for skin grafting and survival. The ignition situation (avoidance of parental supervision at the time of injury) was the only other important predictor. The success of regulatory actions in other countries in reducing the incidence of severe clothing burns is reviewed, and preventive strategies for Canada are explored. ImagesFig. 2 PMID:3995433

Community integration after burn injuries.

PubMed

Esselman, P C; Ptacek, J T; Kowalske, K; Cromes, G F; deLateur, B J; Engrav, L H

2001-01-01

Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

Nitramine propellants. [gun propellant burning rate

NASA Technical Reports Server (NTRS)

Cohen, N. S.; Strand, L. D. (Inventor)

1978-01-01

Nitramine propellants without a pressure exponent shift in the burning rate curves are prepared by matching the burning rate of a selected nitramine or combination of nitramines within 10% of burning rate of a plasticized active binder so as to smooth out the break point appearance in the burning rate curve.

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

Etiology, incidence and gender-specific patterns of severe burns in a German Burn Center - Insights of 25 years.

PubMed

Schiefer, Jennifer Lynn; Perbix, Walter; Grigutsch, Daniel; Zinser, Max; Demir, Erhan; Fuchs, Paul Christian; Schulz, Alexandra

2016-05-01

Burns often require special treatment in specialized burn centers. One of the specialized German burn centers is located in Cologne-Merheim. Only little is known about the etiology of burns in Germany, their monthly distribution and changes over the past 25 years. We therefore retrospectively analyzed the etiology for all patients treated at the burn intensive care unit (BICU) of Cologne in the last 25 years and categorized them into groups. Thereafter all groups were analyzed according to distribution of age, gender and occurrence. In this way we were able to show that the number of severe burns did not decrease over the time under evaluation and that it did not show seasonal variation. Injured females were older than males but fewer in number. The highest numbers of burns were related to fire, followed by electricity, hot liquids, chemicals and heat contact. Work-related burns occurred mostly with males. However, most of the burns were not work-related for either gender. The number of burns in Germany and in the world is still high, and prevention strategies do not always have the desired effect. This study aims to fill the gap in published burn knowledge in Germany by way of describing the gender differences and etiology characteristics. It can therefore help to identify risks and expand effective burn prevention strategies. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

The NAv1.7 blocker protoxin II reduces burn injury-induced spinal nociceptive processing.

PubMed

Torres-Pérez, Jose Vicente; Adamek, Pavel; Palecek, Jiri; Vizcaychipi, Marcela; Nagy, Istvan; Varga, Angelika

2018-01-01

Controlling pain in burn-injured patients poses a major clinical challenge. Recent findings suggest that reducing the activity of the voltage-gated sodium channel Na v 1.7 in primary sensory neurons could provide improved pain control in burn-injured patients. Here, we report that partial thickness scalding-type burn injury on the rat paw upregulates Na v 1.7 expression in primary sensory neurons 3 h following injury. The injury also induces upregulation in phosphorylated cyclic adenosine monophosphate response element-binding protein (p-CREB), a marker for nociceptive activation in primary sensory neurons. The upregulation in p-CREB occurs mainly in Na v 1.7-immunopositive neurons and exhibits a peak at 5 min and, following a decline at 30 min, a gradual increase from 1 h post-injury. The Na v 1.7 blocker protoxin II (ProTxII) or morphine injected intraperitoneally 15 min before or after the injury significantly reduces burn injury-induced spinal upregulation in phosphorylated serine 10 in histone H3 and phosphorylated extracellular signal-regulated kinase 1/2, which are both markers for spinal nociceptive processing. Further, ProTxII significantly reduces the frequency of spontaneous excitatory post-synaptic currents in spinal dorsal horn neurons following burn injury. Together, these findings indicate that using Na v 1.7 blockers should be considered to control pain in burn injury. • Burn injury upregulates Na v 1.7 expression in primary sensory neurons. • Burn injury results in increased activity of Na v 1.7-expressing primary sensory neurons. • Inhibiting Na v 1.7 by protoxin II reduces spinal nociceptive processing. • Na v 1.7 represents a potential target to reduce pain in burn injury.

The impact of socio-economic deprivation on burn injury: A nine-year retrospective study of 6441 patients.

PubMed

Marsden, N J; Battle, C E; Combellack, E J; Sabra, A; Morris, K; Dickson, W A; Whitaker, I S; Evans, P A

2016-03-01

Low socio-economic status is thought to be associated with increased burn risk, however the significance and generalisability across different populations and cultures has been questioned. A nine-year retrospective study of burn presentations to a large teaching hospital (2005-2014) was performed to investigate the association between socio-economic status and burns. Demographic and injury data was collected via the trust 'Information portal'. The Welsh Index of Multiple: Deprivation 2011 was used to score for socio-economic status. Chi-squared test and Odds Ratios were calculated and statistical significance defined as p<0.05 throughout. 6441 burns were identified, with 755 (11.7%) admitted. Overall incidence rates were the highest published in the UK (0.35/1000/year) with sub group analysis showing the highest rates in under fives and males. Significant relationships between both age and burn mechanism and gender and burn mechanism (p=0.0005) were identified. Scald (67.1%) was the most common mechanism with the upper limb (48%) most commonly burned. Chi square analysis demonstrated a significant relationship between socio-economic deprivation, age and burn incidence (p≤0.0005), with a disproportionately high number of burns in patients under the age of 16 in the most deprived quintile (OR 1.23; 95% CI 1.06-1.44). This study specifically highlights patients under the age of 16 living in poorer socio-economic areas as the most at risk of suffering burns receiving hospital attention. This study demonstrates burns as a significant public health issue, and the results should aid in designing specific burn prevention strategies to target high-risk groups. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Automobile carburetor- and radiator-related burns.

PubMed

Renz, B M; Sherman, R

1992-01-01

Seventy-nine persons who had sustained automobile engine carburetor- and radiator-related burns were admitted to Grady Memorial Hospital Burn Unit between June 1, 1984 and September 30, 1990. Forty patients with carburetor-priming flame burns had a mean age of 31.5 years, a mean burn size of 13.4% total body surface area, and a mean length of stay of 13.8 days. There were 37 male patients. Four patients had an inhalation injury. Twenty-two surgical procedures were performed on 13 patients. One patient was an innocent bystander, and one patient died. The clothing of 16 patients had ignited, which resulted in larger, deeper burns and in one death. Burns predominantly involved the right sides of the face, head, and torso; the right upper extremity; and the right hand. Thirty-nine patients had scald burns that were associated with uncapping a radiator. These patients had a mean age of 29.6 years, a mean burn size of 8.9% total body surface area, and a mean length of stay of 6.4 days. There were 36 male patients and three innocent bystanders. One autografting procedure was performed, and there were no deaths in this group of patients. The burn-prone person is the young adult male. The circumstances that result in such dangerous behavior are predictable, and resultant burn injuries are preventable.

Is there a threshold age and burn size associated with poor outcomes in the elderly after burn injury?

PubMed Central

Jeschke, Marc G; Pinto, Ruxandra; Costford, Sheila R.; Amini-Nik, Saeid

2016-01-01

Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care. PMID:26803373

Local Burn Injury Promotes Defects in the Epidermal Lipid and Antimicrobial Peptide Barriers in Human Autograft Skin and Burn Margin: Implications for Burn Wound Healing and Graft Survival

PubMed Central

Plichta, Jennifer K.; Holmes, Casey J.; Gamelli, Richard L.; Radek, Katherine A.

2016-01-01

Burn injury increases the risk of morbidity and mortality by promoting severe hemodynamic shock and risk for local or systemic infection. Graft failure due to poor wound healing or infection remains a significant problem for burn subjects. The mechanisms by which local burn injury compromises the epithelial antimicrobial barrier function in the burn margin, containing the elements necessary for healing of the burn site, and in distal unburned skin, which serves as potential donor tissue, are largely unknown. The objective of this study was to establish defects in epidermal barrier function in human donor skin and burn margin, in order to identify potential mechanisms that may lead to graft failure and/or impaired burn wound healing. In the present study, we established that epidermal lipids and respective lipid synthesis enzymes were significantly reduced in both donor skin and burn margin. We further identified diverse changes in the gene expression and protein production of several candidate skin antimicrobial peptides (AMPs) in both donor skin and burn margin. These results also parallel changes in cutaneous AMP activity against common burn wound pathogens, aberrant production of epidermal proteases known to regulate barrier permeability and AMP activity, and greater production of pro-inflammatory cytokines known to be induced by AMPs. These findings suggest that impaired epidermal lipid and AMP regulation could contribute to graft failure and infectious complications in subjects with burn or other traumatic injury. PMID:27183442

A rare case of failed healing in previously burned skin after a secondary burns.

PubMed

Goldie, Stephen J; Parsons, Shaun; Menezes, Hana; Ives, Andrew; Cleland, Heather

2017-01-01

Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5% TBSA burn on skin scarred by a previous 40% total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings; however, they failed to heal and became infected requiring surgical management. Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

Burns in a major burns center in East China from 2005 to 2014: Incidence and outcome.

PubMed

Fan, Xiaoming; Ma, Bing; Zeng, Ding; Fang, Xiao; Li, Haihang; Xiao, Shichu; Wang, Guangyi; Tang, Hongtai; Xia, Zhaofan

2017-11-01

Information about epidemiology on burns is rare in China. The aim of this article is to describe the pattern of burns in East China during a 10-year time period. A retrospective data analysis was performed on all hospitalized patients to the burn center at the Changhai hospital, one of major burn centers in East China, from 2005 to 2014. We included 3376 patients in this study. Among them, 48.1% were from 27 provinces out of Shanghai and nearly 90% were from East China. August saw the most admissions and November saw the fewest. Spring and summer separately dominated in number of female and male patients. Children aged 2-5 and working-age adult were the most commonly treated. Home was the commonest place of injury, followed by industrial-related places, outdoors, public buildings, and vehicles or roads. Scalds remained the primary reason, followed by fire, contact burns, electricity, and chemicals. The average %TBSA of male patients was 14.2±21.3, significantly different from that of female patients (10.4±16.9). Extremities were the most vulnerable body region burned, followed by the trunk, face and hands. The average hospital length of stay in male patients was 25.4±72.4 days, significantly different from that of females' 19.9±27.6 days. The total mortality was 1.8% and the lethal area burned resulting in 50% mortality was 96.5% TBSA. Compared with published data, these result are encouraging, which demonstrate that burn care and treatment has made significant progress. Burn clinicians should bear not only the responsibility to treat and cure burns, but also the popularization of knowledge about burn precautions and emergency treatments. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Outpatient presentations to burn centers: data from the Burns Registry of Australia and New Zealand outpatient pilot project.

PubMed

Gabbe, Belinda J; Watterson, Dina M; Singer, Yvonne; Darton, Anne

2015-05-01

Most studies about burn injury focus on admitted cases. To compare outpatient and inpatient presentations at burn centers in Australia to inform the establishment of a repository for outpatient burn injury. Data for sequential outpatient presentations were collected at seven burn centers in Australia between December 2010 and May 2011 and compared with inpatient admissions from these centers recorded by the Burns Registry of Australia and New Zealand for the corresponding period. There were 788 outpatient and 360 inpatient presentations. Pediatric outpatients included more children <3 years of age (64% vs 33%), scald (52% vs 35%) and contact burns (39% vs 24%). Adult outpatients included fewer males (58% vs 73%) and intentional injuries (3.3% vs 10%), and more scald (46% vs 30%) and contact burns (24% vs 13%). All pediatric, and 98% of adult, outpatient presentations involved a %TBSA<10. The pattern of outpatient presentations was consistent between centers. Outpatient presentations outnumbered inpatient admissions by 2.2:1. The pattern of outpatient burns presenting to burn centers differed to inpatient admission data, particularly with respect to etiology and burn severity, highlighting the importance of the need for outpatient data to enhance burn injury surveillance and inform prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

[Cement burns: a 10-year retrospective study in our burn unit. About 55 cases].

PubMed

Besset, M; Quignon, R; Dhennin, C; Yassine, A; Penaud, A

2014-06-01

Although cement burns represents only a small percentage of admissions to burn centers, their diagnosis and treatment are specific. Our retrospective study concerns all patients treated for cement burns in our unit between 1999 and 2009. This is the largest series described. Fifty-five patients, aged from 23 to 63, were treated in our burn unit from 1999 to 2009. A review of medical and socioeconomic data was made from computer data files. This population is predominantly male, young and active. These burns occurred mainly in a domestic accident situation (78.2%). Burns were limited but deep and concerned especially lower limbs. The average duration of treatment was 39days. Forty-four patients were treated medically. The mean duration of sick live for these patients was 63 days. It was only of 21 days for those treated surgically. Aesthetic and functional sequelae were present in 88% of medically treated patients and in 18% of patients treated surgically. This study demonstrates that early surgical diagnosis and the coverage (care) of these burns allows to limit the socioeconomic echo and to reduce the risk of after-effects for this population of patients mainly young and active. The necessity of strengthening the precautionary measures with these users who are informed enough about the risks incurred during the misuse of the cement is also a reality. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Deep sole burns in several participants in a traditional festival of the firewalking ceremony in Kee-lung, Taiwan--clinical experiences and prevention strategies.

PubMed

Chang, Shun-Cheng; Hsu, Chih-Kang; Tzeng, Yuan-Sheng; Teng, Shou-Cheng; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chen, Tim-Mo; Feng, Chun-Che

2012-11-01

Firewalking is a common Taoist cleansing ceremony in Taiwan, but burns associated with the practice have rarely been reported. We analyzed the patients with plantar burns from one firewalking ceremony. In one firewalking ceremony, 12 Taoist disciples suffered from contact burns to the soles of their feet while walking over burning coals. Eight of them had at least second-degree burns over areas larger than 1% of their total body surface areas (TBSAs). The age, sex, medical history, date of injury, time taken to traverse the fire pit, depth and TBSA of the burns, treatment, length of stay, and outcome were recorded and analyzed. Deep, disseminated second- to third-degree burns were noted and healing took as long as three weeks in some patients. Because disseminated hypertrophic scars form after burns, the soles involved regain much of their tensile strength while walking. The patients experienced only a few difficulties in their daily lives three months after injury. From our experience treating patients with deep disseminated second- to third-degree plantar burns caused by firewalking, we conclude that they should be treated conservatively, with secondary healing rather than a skin graft. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Clothing-related burns in New South Wales, Australia: impact of legislation on a continuing problem.

PubMed

Harvey, Lara A; Connolley, Siobhan; Harvey, John G

2015-02-01

To combat the risk of nightwear burns a mandatory standard regulating the design, flammability and labelling requirements of children's nightwear was introduced in Australia in 1987. This population-based study examined the trends, characteristics and causes of clothing-related burns to inform a review of the current standard, and to facilitate the development of targeted prevention strategies. Clothing-related burns for 1998-2013 were identified from hospitalisation data for all hospitals in NSW and detailed information regarding circumstance of injury from a burn data registry. To investigate percentage annual change (PAC) in trends negative binomial regression analysis was performed. There were 541 hospitalisations for clothing-related burns, 18% were nightwear-related and 82% were for other clothing. All clothing burns decreased by an estimated 4% per year (95% CI -6.2 to -2.1). Nightwear-related burns decreased by a significantly higher rate (PAC -7.4%; 95% CI -12.5 to -2.1) than other clothing (PAC -2.5%; 95%CI -4.7 to -0.1). Exposure to open heat source (campfire/bonfire) was the most common cause, followed by cooking. Of factors known to be associated with clothing burns, accelerant use was reported in 27% of cases, cigarettes 17%, loose skirt or dress 8%, and angle grinders in 6% of cases. Hospitalisations for clothing burns are relatively uncommon in NSW and rates, particularly of nightwear burns, have decreased over the last 15 years. Strategies for continued reduction of these injuries include increasing the scope of the current clothing standard or developing new standards to include all children's clothing and adult nightwear, and increasing community awareness of the risk associated with open heat sources, accelerant use and loose clothing. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Lenticular burns following argon panretinal photocoagulation.

PubMed Central

Bloom, S. M.; Mahl, C. F.; Schiller, S. B.

1992-01-01

Photocoagulation burns of the crystalline lens are a rare complication of posterior segment laser surgery. These burns occur more commonly in eyes with cataracts and with small, high-power, long-duration argon blue-green burns. We describe the first occurrence of lenticular burns caused by a fractured laser fibre optic cord. Images PMID:1340772

Impact of prescribed and repeated vegetation burning on blanket peat hydrology

NASA Astrophysics Data System (ADS)

Holden, Joseph; Brown, Lee; Palmer, Sheila; Johnston, Kerrylyn; Wearing, Catherine; Irvine, Brian

2013-04-01

In some peatlands there has been a tradition over the past century of burning vegetation to manage the landscape for a range of purposes. These include producing an environment suitable for game birds used in the gun sports industry and reducing the biomass fuel load to reduce possible wildfire damage to the peat. However, there have been few studies that have interrogated the impacts of this activity on peatland hydrological processes both at the plot scale and at the catchment scale. The EMBER project measured water tables, overland flow, hydraulic conductivity, stream discharge, and a myriad of aquatic invertebrate and peat physical and water chemistry indicators (at plot and stream scale) in ten upland blanket peat catchments in the UK. Five catchments were subject to a history of prescribed rotational patch burning with burning taking place each year over a proportion of the catchment (typically 5-10 %) but where for an individual patch the interval was typically 10-20 years. The other five catchments acted as controls which were not subject to burning, nor confounded by other detrimental activities such as drainage or forestry. Stream flows were flashier in response to rainfall in the catchments with prescribed burning patches and had greater rainfall to runoff efficiencies. Water tables were found to be significantly shallower with a smaller interquartile range for unburnt catchments. In the burnt catchments, more recently burnt plots had significantly greater mean water table depths and water table residence times were much less frequent within the upper 10 cm of the peat profile compared to plots that been burned more than a decade before. The water table residence curves will be explored in the presentation. The occurrence of overland flow was significantly impacted by both burning and time since burn with significantly less overland flow recorded for more recently burnt sites. This ties in well with our water table data since blanket peat systems are

Repeated Prescribed Burning in Aspen

Treesearch

Donald A. Perala

1974-01-01

Infrequent burning weather, low flammability of the aspen-hardwood association, and prolific sprouting and seeding of shrubs and hardwoods made repeated dormant season burning a poor tool to convert good site aspen to conifers. Repeat fall burns for wildlife habitat maintenance is workable if species composition changes are not important.

The consequences of global biomass burning

NASA Technical Reports Server (NTRS)

Levine, Joel S.

1991-01-01

Global biomass burning encompasses forest burning for land clearing, the annual burning of grasslands, the annual burning of agricultural stubble and waste after harvests, and the burning of wood as fuel. These activities generate CO2, CH4 and other hydrocarbons, CO, H2, NO, NH3, and CH3Cl; of these, CO, CH4 and the hydrocarbons, and NO, are involved in the photochemical production of tropospheric O3, while NO is transformed to NO2 and then to nitric acid, which falls as acid rain. Biomass burning is also a major source of atmospheric particulates and aerosols which affect the transmission of incoming solar radiation and outgoing IR radiation through the atmosphere, with significant climatic effects.

Burn Wound Healing and Tissue Engineering.

PubMed

Singer, Adam J; Boyce, Steven T

In 2016 the American Burn Association held a State of the Science conference to help identify burn research priorities for the next decade. The current paper summarizes the work of the sub-committee on Burn Wound Healing and Tissue Engineering. We first present the priorities in wound healing research over the next 10 years. We then summarize the current state of the science related to burn wound healing and tissue engineering including determination of burn depth, limiting burn injury progression, eschar removal, management of microbial contamination and wound infection, measuring wound closure, accelerating wound healing and durable wound closure, and skin substitutes and tissue engineering. Finally, a summary of the round table discussion is presented.

The P38alpha and P38delta MAP kinases may be gene therapy targets in the future treatment of severe burns.

PubMed

Wang, Shuyun; Huang, Qiaobing; Guo, Xiaohua; Brunk, Ulf T; Han, Jiahuai; Zhao, Keseng; Zhao, Ming

2010-08-01

Microvascular barrier damage, induced by thermal injury, imposes life-threatening problems owing to the pathophysiological consequences of plasma loss and impaired perfusion that finally may lead to multiple organ failure. The aim of the present study was to define the signaling role of selected mitogen-activated protein kinases (MAPKs) in general vessel hyperpermeability caused by burns and to look for a potential gene therapy. Rearrangement of cytoskeletons and cell tight junctions were evaluated by phalloidin labeling of actin and immunocytochemical demonstration of the ZO-1 protein, whereas blood vessel permeability was evaluated by a fluorescence ratio technique. The p38 MAPK inhibitor SB203580 largely blocked burn serum-induced stress-fiber formation and tight-junction damage. Using the adenoviral approach to transfect dominant negative forms of p38 MAPKs, we found that p38alpha and p38delta had similar effects. The in vivo part of the study showed that transfection of these two constructs significantly lowered general venular hyperpermeability and enhanced the survival of burned animals. Because the p38 MAPK pathway seems to play a crucial role in burn-induced vascular hyperpermeability, general transfection with p38 MAP dominant negative constructs might become a new therapeutic method to block burn-induced plasma leakage.

Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: an audit of 698 patients.

PubMed

Harish, Varun; Raymond, Andrew P; Issler, Andrea C; Lajevardi, Sepehr S; Chang, Ling-Yun; Maitz, Peter K M; Kennedy, Peter

2015-02-01

The purpose of this study was to compare burn size estimation between referring centres and Burn Units in adult patients transferred to Burn Units in Sydney, Australia. A review of all adults transferred to Burn Units in Sydney, Australia between January 2009 and August 2013 was performed. The TBSA estimated by the referring institution was compared with the TBSA measured at the Burns Unit. There were 698 adults transferred to a Burns Unit. Equivalent TBSA estimation between the referring hospital and Burns Unit occurred in 30% of patients. Overestimation occurred at a ratio exceeding 3:1 with respect to underestimation, with the difference between the referring institutions and Burns Unit estimation being statistically significant (P<0.001). Significant overestimation occurs in the early transfer of burn-injured patients as well as in patients transferred more than 48h after the burn (P<0.005). Underestimation occurs with less frequency but rises with increasing time after the burn (P<0.005) and with increasing TBSA. Throughout the temporal spectrum of transferred patients, severe burns (≥20% TBSA) were found to have more satisfactory burn size estimations compared with less severe injuries (<20% TBSA; P<0.005). There are significant inaccuracies in burn size assessment by referring centres. The systemic tendency for overestimation occurs throughout the entire TBSA spectrum, and persists with increasing time after the burn. Underestimation occurs less frequently but rises with increasing time after the burn and with increasing TBSA. Severe burns (≥20% TBSA) are more accurately estimated by the referring hospital. The inaccuracies in burn size assessment have the potential to result in suboptimal treatment and inappropriate referral to specialised Burn Units. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

[Burn injuries in children].

PubMed

Brudvik, Christina; Hoem, Eli Leirdal; Luggenes, Brita; Vindenes, Hallvard

2011-01-07

Burn injuries in children may cause permanent harm. This study reports data on incidence, injury mechanisms and products that cause burn injuries (in the period 01.01.07-31.12.07) and compares findings with those from previous studies (in 1989 and 1998). Semi-structured questionnaires were filled in by patients or next-of-kin and health workers at Bergen Accident and Emergency Department, casualty centres in three municipalities in western Norway (Fana, Åsane and Loddefjord) and at the National Burns Centre, Haukeland University Hospital. Missing data were retrieved retrospectively from medical records. We recorded 142 children with burn injuries; 35% were boys under two years of age. The annual incidence was the same as earlier; 6.6 per 1,000 under five years and 3.1 per 1,000 children under 15 years living in the community of Bergen. Contact injuries and scalds were most common and were caused by contact with ovens, stoves and hot food or liquids. Most children (93%) had less severe burns; 6% (9) were hospitalized (four of them had a non-western background). Almost 95% were given first aid by cooling. Children under two years, especially boys, are most at risk of burn injuries. Ovens were the cause more often now than before. The incidence has been the same the last 20 years and is the same as that in Trondheim ten years ago. The fact that the small city, Harstad, (northern Norway) attained substantially less injuries after the introduction of preventive actions indicates that such actions are needed to reduce the number of burn injuries among children.

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

The evaluation of physical exam findings in patients assessed for suspected burn inhalation injury.

PubMed

Ching, Jessica A; Shah, Jehan L; Doran, Cody J; Chen, Henian; Payne, Wyatt G; Smith, David J

2015-01-01

The purpose of this investigation was to evaluate the utility of singed nasal hair (SN), carbonaceous sputum (CS), and facial burns (FB) as indicators of burn inhalation injury, when compared to the accepted standard of bronchoscopic diagnosis of inhalation injury. An institutional review board approved, retrospective review was conducted. All patients were suspected to have burn inhalation injury and subsequently underwent bronchoscopic evaluation. Data collected included: percent burn TBSA, burn injury mechanism, admission physical exam findings (SN, CS, FB), and bronchoscopy findings. Thirty-five males and twelve females met inclusion criteria (n = 47). Bronchoscopy was normal in 31 patients (66%). Data were analyzed as all patients and in subgroups according to burn TBSA and an enclosed space mechanism of injury. Physical exam findings (SN, CS, FB) were evaluated individually and in combination. Overall, the sensitivities, specificities, positive predictive values, and negative predictive values calculated were poor and inconsistent, and they did not improve within subgroup analysis or when physical findings were combined. Further statistical analysis suggested the physical findings, whether in isolation or in combination, have poor discrimination between patients that have and do not have inhalation injury (AUC < 0.7, P > .05) and poor agreement with the diagnosis made by bronchoscopy (κ < 0.4, P > .05). This remained true in the subgroup analysis as well. Our data demonstrated the findings of SN, CS, and FB are unreliable evidence for inhalation injury, even in the context of an enclosed space mechanism of injury. Thus, these physical findings are not absolute indicators for intubation and should be interpreted as one component of the history and physical.

Development of the life impact burn recovery evaluation (LIBRE) profile: assessing burn survivors' social participation.

PubMed

Kazis, Lewis E; Marino, Molly; Ni, Pengsheng; Soley Bori, Marina; Amaya, Flor; Dore, Emily; Ryan, Colleen M; Schneider, Jeff C; Shie, Vivian; Acton, Amy; Jette, Alan M

2017-10-01

Measuring the impact burn injuries have on social participation is integral to understanding and improving survivors' quality of life, yet there are no existing instruments that comprehensively measure the social participation of burn survivors. This project aimed to develop the Life Impact Burn Recovery Evaluation Profile (LIBRE), a patient-reported multidimensional assessment for understanding the social participation after burn injuries. 192 questions representing multiple social participation areas were administered to a convenience sample of 601 burn survivors. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to identify the underlying structure of the data. Using item response theory methods, a Graded Response Model was applied for each identified sub-domain. The resultant multidimensional LIBRE Profile can be administered via Computerized Adaptive Testing (CAT) or fixed short forms. The study sample included 54.7% women with a mean age of 44.6 (SD 15.9) years. The average time since burn injury was 15.4 years (0-74 years) and the average total body surface area burned was 40% (1-97%). The CFA indicated acceptable fit statistics (CFI range 0.913-0.977, TLI range 0.904-0.974, RMSEA range 0.06-0.096). The six unidimensional scales were named: relationships with family and friends, social interactions, social activities, work and employment, romantic relationships, and sexual relationships. The marginal reliability of the full item bank and CATs ranged from 0.84 to 0.93, with ceiling effects less than 15% for all scales. The LIBRE Profile is a promising new measure of social participation following a burn injury that enables burn survivors and their care providers to measure social participation.

BurnCase 3D software validation study: Burn size measurement accuracy and inter-rater reliability.

PubMed

Parvizi, Daryousch; Giretzlehner, Michael; Wurzer, Paul; Klein, Limor Dinur; Shoham, Yaron; Bohanon, Fredrick J; Haller, Herbert L; Tuca, Alexandru; Branski, Ludwik K; Lumenta, David B; Herndon, David N; Kamolz, Lars-P

2016-03-01

The aim of this study was to compare the accuracy of burn size estimation using the computer-assisted software BurnCase 3D (RISC Software GmbH, Hagenberg, Austria) with that using a 2D scan, considered to be the actual burn size. Thirty artificial burn areas were pre planned and prepared on three mannequins (one child, one female, and one male). Five trained physicians (raters) were asked to assess the size of all wound areas using BurnCase 3D software. The results were then compared with the real wound areas, as determined by 2D planimetry imaging. To examine inter-rater reliability, we performed an intraclass correlation analysis with a 95% confidence interval. The mean wound area estimations of the five raters using BurnCase 3D were in total 20.7±0.9% for the child, 27.2±1.5% for the female and 16.5±0.1% for the male mannequin. Our analysis showed relative overestimations of 0.4%, 2.8% and 1.5% for the child, female and male mannequins respectively, compared to the 2D scan. The intraclass correlation between the single raters for mean percentage of the artificial burn areas was 98.6%. There was also a high intraclass correlation between the single raters and the 2D Scan visible. BurnCase 3D is a valid and reliable tool for the determination of total body surface area burned in standard models. Further clinical studies including different pediatric and overweight adult mannequins are warranted. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

The Burns Registry of Australia and New Zealand: progressing the evidence base for burn care.

PubMed

Cleland, Heather; Greenwood, John E; Wood, Fiona M; Read, David J; Wong She, Richard; Maitz, Peter; Castley, Andrew; Vandervord, John G; Simcock, Jeremy; Adams, Christopher D; Gabbe, Belinda J

2016-03-21

Analysis of data from the Burns Registry of Australia and New Zealand (BRANZ) to determine the extent of variation between participating units in treatment and in specific outcomes during the first 4 years of its operation. BRANZ, an initiative of the Australian and New Zealand Burn Association, is a clinical quality registry developed in accordance with the Australian Commission on Safety and Quality in Healthcare national operating principles. Patients with burn injury who fulfil pre-defined criteria are transferred to and managed in designated burn units. There are 17 adult and paediatric units in Australia and New Zealand that manage almost all patients with significant burn injury. Twelve of these units treat adult patients. Data on 7184 adult cases were contributed by ten acute adult burn units to the registry between July 2010 and June 2014.Major outcomes: In-hospital mortality, hospital length of stay, skin grafting rates, and rates of admission to intensive care units. Considerable variations in unit profiles (including numbers of patients treated), in treatment and in outcomes were identified. Despite the highly centralised delivery of care to patients with severe or complex burn injury, and the relatively small number of specialist burn units, we found significant variation between units in clinical management and in outcomes. BRANZ data from its first 4 years of operation support its feasibility and the value of further development of the registry. Based on these results, the focus of ongoing research is to improve understanding of the reasons for variations in practice and of their effect on outcomes for patients, and to develop evidence-informed clinical guidelines for burn management in Australia and New Zealand.

Pediatric burns mortality risk factors in a developing country’s tertiary burns intensive care unit

PubMed Central

Agbenorku, Pius; Agbenorku, Manolo; Fiifi-Yankson, Papa Kwesi

2013-01-01

Aim: This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. Methods: The data for the three years retrospective study (May 2009 – April 2012) was obtained from the pediatric burn admissions records and patients’ folders of the Reconstructive Plastic Surgery & Burns Unit (RPSBU), Komfo Anokye Teaching Hospital (KATH), Ghana. Data retrieved included: Demographic features, Total Burned Surface Area (TBSA) incurred; Aetiology of burns; Duration of the admission; Outcome of admission; Part of the body affected and Cost incurred. Ethical approval for this study was obtained from the KNUST-SMS/KATH Committee on Human Research, Publications and Ethics. Data analyses were performed with SPSS 17.0 version. Results: Information on 197 patients was completely retrieved for the study. Burns mortality rate for the study was identified to be 21.3% (N=42). The mean age of the 42 dead patients was 3.7±0.3 years, ranging from 0-13 years, while, males (54.8%, N= 23) outnumbered females (45.2%, N=19). The TBSA burned interquartile range was 48%. In terms of etiology of burns Scald (73.8%, N=31) was the commonest cause of injury. Mortality risk factors identified were Age <6 years (P=0.028); Scald especially hot water and soup (P=0.016); TBSA >36% (P=0.028) and Inhalation injury (P=0.040). Conclusion: Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana’s RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana. PMID:23875121

Genital burns in the national burn repository: incidence, etiology, and impact on morbidity and mortality.

PubMed

Harpole, Bethany G; Wibbenmeyer, Lucy A; Erickson, Bradley A

2014-02-01

To better characterize national genital burns (GBs) characteristics using a large burn registry. We hypothesized that mortality and morbidity will be higher in patients with GBs. The National Burn Repository, a large North American registry of hospitalized burn patients, was queried for patients with GB. Burn characteristics and mechanism, demographics, mortality, and surgical interventions were retrieved. Outcomes of interest were mortality, hospital-acquired infection (HAI), and surgical intervention on the genitalia. Adjusted odds ratios (aOR) for outcomes were determined with binomial logistic regression controlling for age, total burn surface area, race, length of stay, gender, and inhalation injury presence. GBs were present in 1245 cases of 71,895 burns (1.7%). Patients with GB had significantly greater average total burn surface area, length of stay, and mortality. In patients with GB, surgery of the genitalia was infrequent (10.4%), with the aOR of receiving surgery higher among men (aOR 2.7, P <.001) and those with third-degree burns (aOR 3.1, P <.002). Presence of a GB increased the odds of HAI (aOR 3.0, P <.0001) and urinary tract infections (aOR 3.4, P <.0001). GB was also an independent predictor of mortality (aOR 1.54) even after adjusting for the increased HAI risk. GBs are rare but associated with higher HAI rates and higher mortality after adjusting for well-established mortality risk factors. Although a cause and effect relationship cannot be established using these registry data, we believe this study suggests the need for special management considerations in GB cases to improve overall outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Burn severity mapping in Australia 2009

USGS Publications Warehouse

McKinley, Randy; Clark, J.; Lecker, Jennifer

2012-01-01

In 2009, the Victoria Department of Sustainability and Environment estimated approximately 430,000 hectares of Victoria Australia were burned by numerous bushfires. Burned Area Emergency Response (BAER) teams from the United States were deployed to Victoria to assist local fire managers. The U.S. Geological Survey Earth Resources Observation and Science Center (USGS/EROS) and U.S. Forest Service Remote Sensing Applications Center (USFS/RSAC) aided the support effort by providing satellite-derived "soil burn severity " maps for over 280,000 burned hectares. In the United States, BAER teams are assembled to make rapid assessments of burned lands to identify potential hazards to public health and property. An early step in the assessment process is the creation of a soil burn severity map used to identify hazard areas and prioritize treatment locations. These maps are developed primarily using Landsat satellite imagery and the differenced Normalized Burn Ratio (dNBR) algorithm.

[Influence of three-level collaboration network of pediatric burns treatment in Anhui province on treatment effects of burn children].

PubMed

Xia, Z G; Zhou, X L; Kong, W C; Li, X Z; Song, J H; Fang, L S; Hu, D L; Cai, C; Tang, Y Z; Yu, Y X; Wang, C H; Xu, Q L

2018-03-20

Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher's exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 ( χ (2)=2.672, P >0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close ( χ (2)=3.382, Z =-1.917, -1.911, χ (2)=3.133, P >0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 ( χ (2)=11.777, 6.948, 4.310, P <0.05). Cure rates of children with extremely severe burns transferred from the two periods of time were close ( χ (2)=1.181, P >0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns

Burns in sub-Saharan Africa: A review.

PubMed

Nthumba, Peter M

2016-03-01

Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. An online search of publications on burns from sub-Saharan countries was performed. A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Management of post burn hand deformities

PubMed Central

Sabapathy, S. Raja; Bajantri, Babu; Bharathi, R. Ravindra

2010-01-01

The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor. PMID:21321661

The efficacy of hair and urine toxicology screening on the detection of child abuse by burning.

PubMed

Hayek, Shady N; Wibbenmeyer, Lucy A; Kealey, Lyn Dee H; Williams, Ingrid M; Oral, Resmiye; Onwuameze, Obiora; Light, Timothy D; Latenser, Barbara A; Lewis, Robert W; Kealey, Gerald P

2009-01-01

Abuse by burning is estimated to occur in 1 to 25% of children admitted with burn injuries annually. Hair and urine toxicology for illicit drug exposure may provide additional confirmatory evidence for abuse. To determine the impact of hair and urine toxicology on the identification of child abuse, we performed a retrospective chart review of all pediatric patients admitted to our burn unit. The medical records of 263 children aged 0 to 16 years of age who were admitted to our burn unit from January 2002 to December 2007 were reviewed. Sixty-five children had suspected abuse. Of those with suspected abuse, 33 were confirmed by the Department of Health and Human Services and comprised the study group. Each of the 33 cases was randomly matched to three pediatric (0-16 years of age) control patients (99). The average annual incidence of abuse in pediatric burn patients was 13.7+/-8.4% of total annual pediatric admissions (range, 0-25.6%). Age younger than 5 years, hot tap water cause, bilateral, and posterior location of injury were significantly associated with nonaccidental burn injury on multivariate analysis. Thirteen (39.4%) abused children had positive ancillary tests. These included four (16%) skeletal surveys positive for fractures and 10 (45%) hair samples positive for drugs of abuse (one patient had a fracture and a positive hair screen). In three (9.1%) patients who were not initially suspected of abuse but later confirmed, positive hair test for illicit drugs was the only indicator of abuse. Nonaccidental injury can be difficult to confirm. Although inconsistent injury history and burn injury pattern remain central to the diagnosis of abuse by burning, hair and urine toxicology offers a further means to facilitate confirmation of abuse.

Possible risk factors associated with burn wound colonization in burn units of Gaza strip hospitals, Palestine

PubMed Central

Al Laham, N.A.; Elmanama, A.A.; Tayh, G.A.

2013-01-01

Summary The epidemiological pattern and risk factors of burns and burn infections varies widely in different parts of the world. This study aims to determine the epidemiologic pattern of burn injuries and possible risk factors associated with burn infections in burn units of Gaza strip hospitals. A total of 118 patients were included in the study. The data collected included: patient age and gender, the causes, site, degree, and TBSA of the burns, as well as surgical operations, length of hospital stay, and microbiological profile of samples collected from patients, the environment, and from health care staff. Pediatric and adult patients accounted for 72% and 28% respectively. 58.5% of all patients were male and 41.5% were female. The most common etiological factors in children were scalding, while in adults these were open fire and flammable liquids. The mean TBSA was 12% with a range from 1–90%. Second and third degree burns accounted for 78% and 22% respectively. The area of the body most often affected was the torso (39%), followed by the lower limb (29.7%), and upper limb (17.8%). The predominant microorganisms isolated from burn wounds were Pseudomonas aeruginosa, Enterobacter spp. and Staphylococcus spp. The study showed the highest risk groups to be children and males, and enabled us to identify possible risk factors that can help in future efforts toward prevention and minimizing nosocomial infections in burn units of Gaza strip hospitals. PMID:24133399

Burn-related peripheral neuropathy: A systematic review.

PubMed

Tu, Yiji; Lineaweaver, William C; Zheng, Xianyou; Chen, Zenggan; Mullins, Fred; Zhang, Feng

2017-06-01

Peripheral neuropathy is the most frequent disabling neuromuscular complication of burns. However, the insidious and progressive onset of burn neuropathy makes it often undiagnosed or overlooked. In our study, we reviewed the current studies on the burn-related peripheral neuropathy to summarize the morbidity, mechanism, detecting method and management of peripheral neuropathy in burn patients. Of the 1533 burn patients included in our study, 98 cases (6.39%) were presented with peripheral neuropathy. Thermal and electrical burns were the most common etiologies. Surgical procedures, especially nerve decompression, showed good effect on functional recovery of both acute and delayed peripheral neuropathy in burn patients. It is noteworthy that, for early detection and prevention of peripheral neuropathy, electrodiagnostic examinations should be performed on burn patients independent of symptoms. Still, the underlying mechanisms of burn-related peripheral neuropathy remain to be clarified. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Do burns increase the severity of terror injuries?

PubMed

Peleg, Kobi; Liran, Alon; Tessone, Ariel; Givon, Adi; Orenstein, Arie; Haik, Josef

2008-01-01

The use of explosives and suicide bombings has become more frequent since October 2000. This change in the nature of terror attacks has marked a new era in the Israeli-Palestinian conflict. We previously reported that the incidence of thermal injuries has since risen. However, the rise in the incidence of burns among victims of terror was proportionate to the rise in the incidence of burns among all trauma victims. This paper presents data from the Israeli National Trauma Registry during the years 1997--2003, to compare the severity of injuries and outcome (mortality rates) in terror victims with and without burn injuries. We also compare the severity of injuries and outcome (mortality rates) for patients with terror-attack related burns to non terror-attack related burns during the same period. Data was obtained from the Israeli National Trauma Registry for all patients admitted to 8 to 10 hospitals in Israel between 1997 and 2003. We analyzed and compared demographic and clinical characteristics of 219 terror-related burn patients (terror/burn), 2228 terror patients with no associated burns (Terror/no-burn) and 6546 non terror related burn patients (burn/no-terror). Severity of injuries was measured using the injury severity score, and burn severity by total body surface percentage indices. Admission rates to Intensive Care Units (ICU) and total length of hospitalization were also used to measure severity of injuries. In-hospital mortality rates were used to indicate outcome. Of burn/terror patients, 87.2% suffered other accompanying injuries, compared with 10.4% of burn/no-terror patients. Of burn/terror patients, 49.8% were admitted to ICU compared with only 11.9% of burn/no-terror patients and 23.8% of no-burn/terror patients. Mean length of hospital stay was 18.5 days for the terror/burn group compared with 11.1 days for the burn/no-terror group and 9.5 days for the terror/no-burn group. Burn/terror patients had a significantly higher injury severity score

Increasing the utility of the Functional Assessment for Burns Score: Not just for major burns.

PubMed

Smailes, Sarah T; Engelsman, Kayleen; Rodgers, Louise; Upson, Clara

2016-02-01

The Functional Assessment for Burns (FAB) score is established as an objective measure of physical function that predicts discharge outcome in adult patients with major burn. However, its validity in patients with minor and moderate burn is unknown. This is a multi-centre evaluation of the predictive validity of the FAB score for discharge outcome in adult inpatients with minor and moderate burns. FAB assessments were undertaken within 48 h of admission to (FAB 1), and within 48 h of discharge (FAB 2) from burn wards in 115 patients. Median age was 45 years and median burn size 4%. There were significant improvements in the patients' FAB scores (p<0.0001), 98 patients were discharged home (no social care) and 17 patients discharged to further inpatient rehabilitation or home with social care. FAB 1 score (≤ 14) is strongly associated with discharge to inpatient rehabilitation or home with social care (p=0.0001) and as such can be used to facilitate early discharge planning. FAB 2 (≤ 30) independently predicts discharge outcome to inpatient rehabilitation or home with social care (p<0.0001), increasing its utility to patients with minor and moderate burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

[Hand burns in children and Aquacel(®) Burn gloves, an alternative to prolonged hospital stays].

PubMed

Ridel, P; Perrot, P; Truffandier, M V; Bellier-Waast, F; Duteille, F

2015-04-01

Occlusive dressings for second-degree hand burns in children must prevent infection and promote healing. For good management of analgesia, these treatments often require children to be hospitalized. Our goal was to find an alternative to conventional care protocol that would reduce the number of dressings and therefore the length of hospitalization. We report our experience with the use of Aquacel(®) Burn. Non-randomized monocentric prospective study was conducted from 2012 to 2014. The glove was used in the operating room within 72hours after the burn in children younger than 15 years old with isolated superficial to deep 2nd degree hand burns. Once the glove was perfectly stuck to the burn, the children could go back home. We saw them 10 to 12 days after the accident to be sure there was no indication of skin graft. Twenty gloves were used in 16 children aged from 16 months to 13 years. The average length of stay (ALOS) was five days to put the glove on and one day to remove it. Four hands were grafted. Once we get used to the product, Aquacel(®) Burn gloves have reduced the ALOS before skin graft in cases of isolated hand burns in children. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

[The post-burn process--a determinant in local surgical treatment of deep burns].

PubMed

Bäumer, F; Henrich, H A

1988-12-01

Afterburning has been studied in the animal experiment by use of intravital dye indicators and by measuring partial oxygen pressure. After third degree burn the oxygen conduction of the damaged skin increased. The afterburning was seen to be finished on the 5th day after the burn trauma. The histological changes in the depth of the afterburn area reaches to the subcutis. The extend of the afterburn area was not related to the applied temperature or the duration of the experimental burn injury.

A 10-year experience with major burns from a non-burn intensive care unit.

PubMed

Ibarra Estrada, Miguel Ángel; Chávez Peña, Quetzalcóatl; García Guardado, Dante Ismael; López Pulgarín, José Arnulfo; Aguirre Avalos, Guadalupe; Corona Jiménez, Federico

2014-09-01

The aim of this study was to review clinical data and outcomes of patients with burns in a Mexican non-burn intensive care unit (ICU). We did a retrospective analysis of our single-centre database of burn patients admitted to the ICU in the Hospital Civil Fray Antonio Alcalde (University Hospital). The sample was divided for analysis into two groups according to the outcome 'death' or 'discharge' from ICU. Overall mortality was 58.2%, without a decreasing trend in mortality rates through the years. We identified the presence of third-degree burns (odds ratio (OR) 1.5, p=0.003), and >49% total burned surface area (TBSA; OR 3.3, p≤0.001) was associated with mortality. Mean age was higher in deceased patients (38.2 years vs. 31.3 years, p=0.003) as was the TBSA (62.8% vs. 36.4%, p≤0.001). At multivariate analysis, inhalation injury was not associated with increased mortality, but it was with more mechanical ventilation days. Early surgical debridement/cleansing was performed in most patients; however, the mean of the procedures was 1.7 per patient in both groups. We identified significant factors associated with mortality. These variables and prognosis from non-burn ICUs differ broadly compared with burn intensive care units (BICUs); thus, more structured, multidisciplinary and specialised treatment strategies are still needed. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Fire episodes in the Inland Northwest (1540-1940) based on fire history data

Treesearch

Stephen W. Barrett; Stephen F. Arno; James P. Menakis

1997-01-01

Presents maps of major fire episodes in the inland northwestern United States between 1540 and 1940 based on a compilation of fire history studies. Estimates annual acreage historically burned in this region and compares that with recent fire years.

Innovative Technology Development for Comprehensive Air Quality Characterization from Open Burning

DTIC Science & Technology

2012-04-01

Burning/Open Detonation (OB/OD) has been used as a safe, effective , and economic way to demilitarize munitions for energetic material disposal. Field...target analyte i (lb/lb i in ordnance) ERDC-CERL Engineer Research Development Center, Construction Engineering Research Laboratory GC/FID gas ...chromatograph(y) - flame ionization detector GC/MS gas chromatography/mass spectrometry GPS global positioning system ISO International Organization for

Pre-hospital care in burn injury

PubMed Central

Shrivastava, Prabhat; Goel, Arun

2010-01-01

The care provided to the victims of burn injury immediately after sustaining burns can largely affect the extent and depth of the wound. Although standard guidelines have been formulated by various burn associations, they are still not well known to public at large in our country. In burn injuries, most often, the bystanders are the first care providers. The swift implementation of the measures described in this article for first aid in thermal, chemical, electrical and inhalational injuries in the practical setting, within minutes of sustaining the burn, plays a vital role and can effectively reduce the morbidity and mortality to a great extent. In case of burn disasters, triage needs to be carried out promptly as per the defined protocols. Proper communication and transport from the scene of the accident to the primary care centre and onto the burn care facility greatly influences the execution of the management plans PMID:21321651

The overall patterns of burns

PubMed Central

Almoghrabi, A.; Abu Shaban, N.

2011-01-01

Summary Burn patterns differ across the whole world and not only in relation to lack of education, overcrowding, and poverty. Cultures, habits, traditions, psychiatric illness, and epilepsy are strongly correlated to burn patterns. However, burns may also occur because of specific religious beliefs and activities, social events and festivals, traditional medical practices, occupational activities, and war. PMID:22639565

Patients with burning mouth sensations. A clinical investigation of causative factors in a group of "compete denture wearers" Jordanian population.

PubMed

Mukatash-Nimri, Gadeer Elea; Al-Nimri, Marwan A; Al-Jadeed, Omar G; Al-Zobe, Zaid R; Aburumman, Khuzama K; Masarwa, Nader A

2017-01-01

To find out the prevalence of "true" burning mouth syndrome and study the association between patients' spontaneous complaints of burning mouth and systemic conditions in a group of middle age and elderly "denture wearers" patients in Jordan. A group of 129 patients (112 female and 17 male) of "complete denture wearers" subjects aged 40 years and over attended prosthetic clinic at King Hussein Medical Hospital complaining from oral burning, with no oral lesion possibly responsible for the burning sensations were selected. Assessment of oral and general status was done based on questioners, detailed history taking, medical records and extra and intraoral examination. The existed complete dentures retention, stability, jaw relationship and the free way space were evaluated. The current blood test and instrumental protocol for examination of patients with burning mouth complains were performed for each patient. Then those studied patients with burning mouth sensations including "true" burning mouth syndrome have been compared to the controls with regard to the presence of local problem, undermined local, systemic or psychological disease. The diagnosis of "true" burning mouth syndrome was established in (2.3%) of the studied population two females and one male. In most patients (58%) more than one site was affected. Significant positive associations were found between local factors (i.e., wearing complete dentures with unsatisfactory retention or jaw relationship, dry mouth or candidasis) and patients suffering from burning mouth sensation. The results also show that some systemic or psychological disorders were significantly more present among patients with burning mouth symptoms when compared to the control group ( p  < 0.05). Spontaneous symptoms of burning mouth without mucosal signs should be considered as a manifestation of undermind pathology and/or distress, and the multi-factorial causes of burning mouth syndrome and sensation need to be referred to the

A new metric for quantifying burn severity: The Relativized Burn Ratio

Treesearch

Sean A. Parks; Gregory K. Dillon; Carol Miller

2014-01-01

Satellite-inferred burn severity data have become increasingly popular over the last decade for management and research purposes. These data typically quantify spectral change between pre-and post-fire satellite images (usually Landsat). There is an active debate regarding which of the two main equations, the delta normalized burn ratio (dNBR) and its relativized form...

Death and Doctor Hornbook by Robert Burns: a view from medical history.

PubMed

Nicolson, Malcolm

2010-06-01

Robert Burns's poem, Death and Doctor Hornbook, 1785, tells of the drunken narrator's late night encounter with Death. The Grim Reaper is annoyed that ‘Dr Hornbook’, a local schoolteacher who has taken to selling medications and giving medical advice, is successfully thwarting his efforts to gather victims. The poet fears that the local gravedigger will be unemployed but Death reassures him that this will not be the case since Hornbook kills more than he cures. Previous commentators have regarded the poem as a simple satire on amateur doctoring. However, it is here argued that, if interpreted in the light of the exoteric and inclusive character of 18th century medical knowledge and practice, the poem is revealed to have a much broader reference as well as being more subtle and morally ambiguous. It is a satire on 18th century medicine as a whole.

Is location of burns related to outcome? A comparison between burns on extremities and burns on head and/or trunk in patients with low to intermediate TBSA in a burn center in The Netherlands.

PubMed

Menger, Tirsa; Krijnen, Pieta; Tuinebreijer, Willem E; Breederveld, Roelf S

2014-01-01

In the literature no study was found about the effect of location of burns on outcome. The objective of this retrospective study was to investigate the effect of location on outcome parameters of 371 patients, admitted to our burn center from January 2009 to December 2011. The patients were included in the study if more than 80% of the burn(s) was localized either on the extremities or on the head and/or trunk. Two groups of TBSA were elaborated, low: 0 to 5% and intermediate: 5 to 15%. Two-hundred ninety-two patients (78.7%) had a low TBSA (<5%) and 79 (21.3%) an intermediate TBSA (5-15%). None of the included patients died. The patients with an intermediate TBSA were on average 8.0 days longer admitted compared with the patients with a low TBSA adjusted for age and depth (95% confidence interval: 6.5-9.4). The patients with burns on the head and/or trunk were more often admitted to the intensive care unit, mostly as a result of suspected inhalation injury (6.2 vs 0.9%; P = .008). More complications were seen in the intermediate TBSA group. In this study no difference in outcome was found between burns on the head and/or trunk or on extremities. The patients with burns on the head and/or trunk group are more frequently admitted to intensive care.

The year in burns 2013.

PubMed

Wolf, Steven E; Phelan, Herbert A; Arnoldo, Brett D

2014-12-01

Approximately 3415 research articles were published with burns in the title, abstract, and/or keyword in 2013. We have continued to see an increase in this number; the following reviews articles selected from these by the Editor of one of the major journals (Burns) and colleagues that in their opinion are most likely to have effects on burn care treatment and understanding. As we have done before, articles were found and divided into the following topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. The articles are mentioned briefly with notes from the authors; readers are referred to the full papers for details. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Anxiety and depression in burn patients.

PubMed

Alvi, Tabassum; Assad, Fatima; Aurangzeb; Malik, M A Nasir

2009-01-01

The psychological aspects of burn injury have been researched in different parts of world producing different outcomes. Therefore objective of this research is to determine the frequency of Anxiety and Depression in burn patients. To assess the socio-demographic distribution of patients developing Anxiety and Depression and to determine the effects of burn related factors on development of Anxiety and Depression. A Case series was conducted at the Department of Burn, Pakistan Ordinance Factory Hospital, Wah Cantt. for a duration of 12 months commencing from June 2007 and concluded in May 2008. The study population comprised of hospitalized patients with 1% to 50%, selected through non probable sampling technique who were assessed for Anxiety and Depression on fifteen day after burn injury. Testing protocol comprised of questionnaire having socio-demographic variables and burn related variables. Beck Depression Inventory and Beck Anxiety Inventory was applied to evaluate Anxiety and Depression in Burn patients. Descriptive statistics like mean with Standard Deviation was calculated for age. Frequencies along with percentages were calculated for socio-demographic variables. The frequencies and proportions were also calculated for presence and extent of severity of depression and anxiety in burn patients. Fifty patients were included in the study, thirty patients (60%) were male and 20 (40%) were females. The mean age of participants was 33.64 +/- 19 years. Majority of participants, 38 (76%) had sustained burn injury up to 25%. Flame was found to be most common agent of burn injuries affecting 19 (38%) patients. Depression was seen amongst 29 (58%) patients. Thirteen (26 %) patients had mild, 7 (14%) had moderate and 9 (18%) had severe Depressive symptoms. Anxiety was seen among 41 (82%) patients, thirteen (26%) patients had mild, 11 (22%) had moderate and 17 (34%) had severe Anxiety symptoms. Anxiety was present in 41 (82%) and Depression was present in 29 (58

Survey of the Statewide Impact of Payer Source on Referral of Small Burns to Burn Centers.

PubMed

Penny, Rachel; Coffey, Rebecca; Jones, Larry; Bailey, J Kevin

It is generally agreed that patients with large burns will be referred to organized burn centers, however, the referral of patients with smaller burns is less certain. A two-part survey was conducted to identify referral patterns for burn patients that meet American Burn Association referral criteria, and any effect insurance type might have on the referral patterns. The emergency departments of our state hospital association's member hospitals were contacted seeking a referral for a fictitious patient with a third-degree scald of the dominant hand. The referral sites were contacted twice, first stating that the patient had commercial insurance, next stating that the patient had Medicaid. Data collected included wait time for an appointment or reasons for denial of an appointment. Of 218 hospitals, 46 were excluded because they did not offer emergency care, and eight because they were listed as burn centers on the American Burn Association website. Of the remaining 164, 119 (73%) would refer to a burn center, 21 (13%) to a plastic surgeon, 10 (6%) to a hand surgeon, 7 (4%) to a wound center, 7 (4%) to another nonburn physician resource. There was no difference in wait time to the first available appointment with regards to insurance type (6.56 ± 4.68 vs 6.53 ± 5.05 days). Our state's referral pattern gives us insight into the regional referral pattern. This information will be used to guide a focused education and communication program to provide better service for the burn victims of our state.

Determination of burning area and port volume in complex burning regions of a solid rocket motor

NASA Technical Reports Server (NTRS)

Kingsbury, J. A.

1977-01-01

An analysis of the geometry of the burning in both star-cylindrical port interface regions and regions of partially inhibited slots is presented. Some characteristics parameters are defined and illustrated. Methods are proposed for calculating burning areas which functionally depend only on the total distance burned. According to this method, several points are defined where abrupt changes in geometry occur, and these are tracked throughout the burn. Equations are developed for computing port perimeter and port area at pre-established longitudinal positions. Some common formulas and some newly developed formulas are then used to compute burning surface area and port volume. Some specific results are presented for the solid rocket motor committed to the space shuttle project.

Pavement temperature and burns: streets of fire.

PubMed

Harrington, W Z; Strohschein, B L; Reedy, D; Harrington, J E; Schiller, W R

1995-11-01

To measure pavement temperatures over a 24-hour period to determine when patients are at risk for burns and to report cases of pavement burns with predisposing factors. Descriptive study of pavement temperatures and retrospective case series of 23 patients with pavement burns admitted to the Maricopa Medical Center during the years 1986 to 1992. Twenty-three patients with pavement burns serious enough for them to be admitted to the burn center. We measured the temperatures of asphalt, cement, and other outdoor materials hourly for one 24-hour period using a thermocouple thermometer. Asphalt pavement was hot enough to cause burns from 9 AM to 7 PM during the summer months. It was hot enough to cause a second-degree burn within 35 seconds from 10 AM to 5 PM. The group of burned patients could be divided into three categories: incapacitated, restrained, and sensory deficient. All burns involved less than 13% of the total body surface area. During summer days in the desert, pavement is often hot enough to cause burns and does so with regularity in the southwestern United States. No one should be allowed to remain in contact with hot pavement, even transiently.

Seeding versus natural regeneration: A comparison of vegetation change following thinning and burning in ponderosa pine

Treesearch

Judith D. Springer; Amy E. M. Waltz; Peter Z. Fule; Margaret M. Moore; W. Wallace Covington

2001-01-01

The decision whether to seed with native species following restoration treatments should be based on existing vegetation, species present in or absent from the soil seed bank, past management history, microclimate conditions and soils. We installed three permanent monitoring plots in two areas (total 18.6 ha) at Mt. Trumbull, AZ. Trees were thinned and the sites burned...

Burn and Scald Prevention

MedlinePlus

... ĵ ĵ Remove all clothing, diapers, jewelry and metal from the burned area. These can hide underlying burns and retain heat, which can increase skin damage. For more information and free fire-safety resources, visit www.usfa.fema.gov. Click ...

How to manage burns in primary care.

PubMed Central

Waitzman, A. A.; Neligan, P. C.

1993-01-01

Burns are common injuries; more than 200,000 occur in Canada annually. Nearly all burn injuries can be managed on on outpatient basis. Appropriate treatment depends on burn depth, extent, and location. Special types of burns, such as chemical, tar, and electrical injuries, need specific management strategies. Prevention through education is important to reduce the incidence of burns. Images Figure 2 Figure 3 PMID:8268745

Management of patients in a dedicated burns intensive care unit (BICU) in a developing country.

PubMed

Hashmi, Madiha; Kamal, Rehana

2013-05-01

programmes targeted at the vulnerable population, i.e. women and young children at home and men at their work place is the single most cost-effective way of reducing the incidence of burns in developing countries. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Burn Incidence and Treatment in the U.S.

MedlinePlus

... state health data systems, and the National Burn Repository (NBR) of the American Burn Association (ABA). ABA ... Burn Admissions to Burn Centers (ABA National Burn Repository 2015) Survival Rate: 96.8% Gender: 68% Male, ...

Effects of site preparation on seedling, growth: a preliminary comparison of broadcast burning and pile burning.

Treesearch

Don Minore

1986-01-01

Site preparation is often necessary to obtain adequate forest regeneration, but inappropriate treatment may reduce subsequent growth. Broadcast-burned and piled-and-burned plantations were studied in southwestern Oregon to determine if burning method affected the growth of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco var. menziesii...

When a hero becomes a patient: firefighter burn injuries in the National Burn Repository.

PubMed

Matt, Sarah E; Shupp, Jeffery W; Carter, Elizabeth A; Flanagan, Katherine E; Jordan, Marion H

2012-01-01

Firefighters receive significant training and are outfitted with state-of-the-art protective equipment. However, given the unpredictable nature of their work environment, injuries still occur. The National Burn Repository (NBR) was viewed as a resource for defining the epidemiology of these injuries on a national level and to identify predictive factors for outcomes in this population. The NBR was queried for the occupation of "firefighter" for the years 1990-2008. Records were screened for completeness, and 597 patients were identified for analysis. Data examined included demographics, %TBSA burn, length of stay (LOS), injury circumstance, and disposition. Multiple linear regression models were created to determine factors related to outcome measures. The majority of patients were white (84%) and male (96%). The mean age was 35 years. Most injuries were caused by fire/flame (73%). Only six deaths (1%) were reported. Most injuries were work-related (86%), and most patients were discharged home (92%). Inhalation injury was documented in 9% of patients. The mean LOS was 6.5 ± 11.3 days (median 2 days), and few patients had critical care requirements. The average %TBSA was 6 ± 11.7%. Patients with larger injuries had increased LOS. The presence of inhalation injury, elevated carboxyhemoglobin levels, and advancing age were significantly associated with larger burns. From the NBR data, most firefighter burn injuries were small, and few firefighter burn patients required critical care resources or had significant disability. Firefighters comprise a small number of burn center admissions each year, yet they are an important population to consider for burn prevention efforts.

A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India.

PubMed

Daruwalla, Nayreen; Belur, Jyoti; Kumar, Meena; Tiwari, Vinay; Sarabahi, Sujata; Tilley, Nick; Osrin, David

2014-11-30

Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause - accidental or non-accidental, suicidal or homicidal - is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. We conducted semi-structured interviews with 33 women admitted to two major burns units, their families, and 26 key informant doctors, nurses, and police officers. We used framework analysis to examine the context in which burns occurred and the sequence of medicolegal action after admission to hospital. Interviewees described accidents, attempted suicide, and attempted homicide. Distinguishing between these was difficult because the underlying combination of poverty and cultural precedent was common to all and action was contingent on potentially conflicting narratives. Space constraint, problems with cooking equipment, and inflammable clothing increased the risk of accidental burns, but coexisted with household conflict, gender-based violence, and alcohol use. Most burns were initially ascribed to accidents. Clinicians adhered to medicolegal procedures, the police carried out their investigative requirements relatively rapidly, but both groups felt vulnerable in the face of the legal process. Women's understandable reticence to describe burns as non-accidental, the contested nature of statements, their perceived history of changeability, the limited quality and validity of forensic evidence, and the requirement for resilience on the part of clients underlay a general pessimism. The similarities between accident and intention cluster so tightly as to make them challenging to distinguish, especially given women's understandable reticence to describe burns as non-accidental. The contested status of

Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"?

PubMed

Hranjec, Tjasa; Turrentine, Florence E; Stukenborg, George; Young, Jeffrey S; Sawyer, Robert G; Calland, James F

2012-05-01

Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value < 0.0001). The additional variable, %FTB, was also found to be a statistically significant determinant, although it did not greatly improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes.