Pediatric Burn Care: How Burn Camps Survived and Thrived During the Coronavirus Pandemic.

Burn camps play a vital role in the recovery of burn survivors by allowing them to develop the confidence and skill sets needed to reintegrate back into society. During the COVID-19 pandemic, burn camps across the United States and Canada could not hold any in-person activities. They had to either pause burn camps or quickly adapt to a virtual online platform. A 37-item electronic survey was developed and emailed to burn camp directors in the United States and Canada to determine what adaptations were necessary during the pandemic. This survey allowed directors to provide details on many facets such as camp format, successes observed, and challenges encountered. Twenty-one of 34 (62%) burn camp organizations completed the survey. Thirteen of the 21 (62%) respondents held virtual burn camps in 2020 while everyone else canceled their camps in 2020. The mean number of camps offered per organization decreased from 6.3 in 2019 to 4.7 in 2020. The average number of burn survivors and family members participating also dropped in that same period (2019 aggregate mean = 229.2 vs 2020 aggregate mean = 151.4). Components of virtual camp included video conferencing platforms, "camp-in-a-box" activities, and some prerecorded sessions. Most camp directors believed that their campers were satisfied with the virtual format. Factors allowing for a successful virtual camp included an effective online platform, scheduling adequate duration of programs, and appropriate staffing levels. Most common barriers to an effective virtual camp were participant engagement, special needs/accessibility concerns, and staff effectiveness in this format. While challenging, burn camps can be held in a virtual format successfully with proper planning, staff training, and support of campers and their families.

Identification of substance use disorders in burn patients using simple diagnostic screening tools (AUDIT/DAST-10).

INTRODUCTION AND OBJECTIVES: Substance use is disproportionately high in burn patients and associated with adverse outcomes. Screening methods for substance use disorders may help predict or avoid adverse outcomes. The University of Utah Burn Center records self-reported Alcohol Use Disorders Identification Tests (AUDIT) and Drug Abuse Screening Tests (DAST-10) for all adult burn admissions. This study assessed for association between AUDIT/DAST-10 scores and burn patient outcomes. METHODS: A retrospective chart review of adult burn patients admitted to the University of Utah from 05/01/2014-06/30/2017. Patient demographics, injury data, and substance use data were collected and analyzed. RESULTS: 322 patients underwent AUDIT/DAST-10 screening (n = 322). 56 (17.4%) had positive AUDIT screens (score ≥ 8). 15/50 with alcohol use at time of injury (TOI) had negative AUDIT screens. Median AUDIT score with TOI alcohol use was 12, without TOI alcohol use was 1. 30/55 patients offered alcohol counseling accepted. 14 patients (4.3%) had positive DAST-10 screens (score ≥3). 9/25 with drug use at TOI had negative DAST-10 screens. No patients without TOI drug use had DAST-10 scores >2. 9/11 patients offered drug counseling accepted. Mean standardized length of stay (LOS) per TBSA burn injury was 1.7 days for positive AUDIT, 1.6 days for negative AUDIT. Median standardized LOS was 1.4 days for positive DAST-10, 1.7 days for negative DAST-10. CONCLUSIONS: AUDIT and DAST-10 screens can identify burn patients with problematic substance use, allowing early intervention. Positive screening scores do not independently predict longer hospital stays, increased wound severity, or treatment noncompliance.