Volume 200 - Issue 2
First aid for burns: too little, too late and often wrong
Authors: Ela J Hyland, John G Harvey and Andrew J A Holland
Med J Aust 2014; 200 (2): 85. || doi: 10.5694/mja13.11179
Published online: 3 February 2014
Published online: 3 February 2014
Nearly a third of children presenting with burns receive inadequate, inappropriate or no first aid
To the Editor: The Australian and New Zealand Burns Association (ANZBA) defines adequate first aid for acute burns as 20 minutes of cold running water within the first 3 hours of a burn injury.1 Despite first aid campaigns, inappropriate and inadequate first aid treatment for burns continues to occur.2
Following Sydney Children’s Hospitals Network Human Research Ethics Committee approval, we performed a retrospective analysis of the first aid received by 4368 children who presented to the Burns Unit at The Children’s Hospital at Westmead between 1 January 2008 and 31 December 2012.
Nearly a third of children (34% of inpatients and 30% of outpatients) received inadequate, inappropriate or no first aid, irrespective of the size of the burn. Inadequate first aid included cold compresses or wet wraps in 414 children (9.5%) and Burnaid (Rye Pharmaceuticals) in 238 (5.4%). Inappropriate first aid included ice in 227 children (5.2%), with a wide range of bathroom products, foods, creams and oils used in most of the remaining patients. In 144 children (3.3%), the first aid received was not documented.
Products prescribed by general practitioners, ambulance officers or obtained from pharmacies, such as silver sulfadiazine cream, antiseptics and antibiotic ointments, were often used (455 children; 10.4%). Of the 70 children (1.6%) who were treated with bathroom products, toothpaste was the most common. Of the 49 children (1.1%) who had food applied, dairy products, such as yoghurt, were the most widespread. Of the 19 children (0.4%) who received oils, plant oils, such as tea tree oil, were the most frequent. Alternative treatment from a Chinese medicine practitioner or a “witch doctor” was used in 13 children (0.3%) (Box).
Twenty minutes of cool running water has been proven to be the most effective in reducing progression of burn depth and time to re-epithelisation.3 Unfortunately, products such as ice and toothpaste, which may have adverse effects, continue to be used on acute burns.4 While most children in our study eventually received appropriate first aid, 31.1% did not. There remains a need to educate health practitioners and the wider community about appropriate first aid for burns.
Competing interests
No relevant disclosures.
Acknowledgements
We would like to acknowledge the State Burn Injury Service, New South Wales, for its valuable contribution.
References
- Australian and New Zealand Burns Association. Emergency management of severe burns manual. 8th ed. Sydney: The Education Committee of the Australian and New Zealand Burns Association Ltd, 2008. 0_BABDGHBI
- Davies M, Maguire S, Okolie C, et al. How much do parents know about first aid for burns? Burns 2013; 39: 1083-1090. 0_i1143049
- Barlett N, Yuan J, Holland AJ, et al. Optimal duration of cooling for an acute scald contact burn injury in a porcine model. J Burn Care Res 2008; 29: 828-834. 0_i1143051
- Cuttle L, Pearn J, McMillan JR, Kimble RM. A review of first aid treatments for burn injuries. Burns 2009; 35: 768-775. 0_i1143054