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1.
Invest. educ. enferm ; 38(1): [E09], febrero 15 2020. Tab 1, Tab 2
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1052009

RESUMO

Objective. To describe the care experiences of students in burn units. Methods. Qualitative research of the phenomenological descriptive type which was conducted with the participation of eight senior nursing students in Shiraz College of Nursing and Midwifery, Iran. The method used for gathering data about Student experiences in Care Services for Burn Cases was the individual semi-structured interview. The Colaizzi method was used for analysing and interpreting the data. Results. Three main themes emerged: the attractive but stressful experience, trying to adjust and metamorphosis in attitude. Taking care of burned patients led to metamorphosis and adaptation to the requirements of burn care due to the students' improved attitudes, awareness and potentials. This finally turned the stressful nature of taking care of a burn patient into an attractive experience for them. Conclusion. Students with little clinical experience of stressful working situations in burn units faced different challenges. Due to the specific nature of taking care of burned patients, the clinical experiences of nursing students who offer these services are unique.


Objetivo. Describir las experiencias de atención de los estudiantes en las unidades de quemados. Métodos. Investigación cualitativa del tipo descriptivo fenomenológico que se realizó con la participación de ocho estudiantes senior de enfermería en el Shiraz College of Nursing and Midwifery en Irán. El método utilizado para reunir datos sobre las experiencias de los estudiantes en los servicios de atención de pacientes quemados fue la entrevista individual semiestructurada. El método Colaizzi se utilizó para analizar e interpretar los datos. Resultados. Emergieron tres temas principales: la experiencia atractiva pero estresante, tratando de adaptarse, y la metamorfosis en actitud. El cuidado a los pacientes quemados condujo a la metamorfosis y a la adaptación a los requerimientos del cuidado de las quemaduras, debido a que los estudiantes mejoraron las actitudes, mostraron mayor conciencia y desarrollaron potencialidades. Esto finalmente convirtió la naturaleza estresante de cuidar a un paciente quemado en una experiencia atractiva para ellos. Conclusión. Los estudiantes con poca experiencia clínica de situaciones laborales estresantes pueden enfrentar diversos desafíos en las unidades de quemados. Debido a la naturaleza específica del cuidado de este tipo de pacientes, las experiencias clínicas son únicas para los estudiantes de enfermería.


Objetivo. Descreva as experiências de atenção do aluno em unidades de queimados. Métodos. Pesquisa qualitativa, do tipo descritivo fenomenológico, realizada com a participação de oito estudantes seniores de enfermagem da Faculdade de Enfermagem e Obstetrícia Shiraz, no Irã. O método utilizado para coletar dados sobre as experiências dos estudantes nos serviços de queimados foi a entrevista individual semiestruturada. O método Colaizzi foi utilizado para analisar e interpretar os dados. Resultados. Surgiram três temas principais: a experiência atraente, porém estressante, tentando se adaptar e a metamorfose na atitude. Cuidar de pacientes queimados levou à metamorfose e adaptação às exigências do cuidado com queimaduras, porque os alunos melhoraram atitudes, mostraram maior consciência e desenvolveram potencialidades. Isso finalmente transformou a natureza estressante de cuidar de um paciente queimado em uma experiência atraente para eles. Conclusão. Alunos com pouca experiência clínica em situações estressantes de trabalho podem enfrentar vários desafios em unidades de queima. Devido à natureza específica do atendimento a esses pacientes, as experiências clínicas são únicas para os estudantes de enfermagem.


Assuntos
Humanos , Estudantes de Enfermagem , Unidades de Queimados , Atitude , Pesquisa Qualitativa , Educação em Enfermagem , Cuidados de Enfermagem
2.
J Surg Res ; 245: 45-50, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31401246

RESUMO

BACKGROUND: Dermatome-induced lacerations are a known complication; however, there is a paucity of literature discussing the incidence and predisposing factors. The aim of this study was to determine the incidence and risk factors to develop a preventive algorithm. METHODS: An 18-question survey was sent to all US and Canadian burn unit directors. Surgeons were queried about type and location of their practices, average annual caseload of skin graft harvesting, and number of dermatome-induced lacerations. The survey also asked about donor site location, harvesting technique and equipment, laceration severity, and causative factors. An algorithm was developed based on the results. RESULTS: Fifty-six responses (42% response rate) were received from the burn unit directors. They reported an estimated 133 lacerations over the past 5 y. The overall incidence of dermatome-induced lacerations was approximately 0.1% per year (1.3 per 1000 cases). The most commonly attributed causes were excessive pressure (25.0%) and patient factors (18.4%). Most lacerations occurred when using air dermatomes (73.0%) with a 4-inch guard (63.5%), 0.010- to 0.015-inch thickness (78.4%), and 30°-45° angulation (47.3%); the most common brand was Zimmer (71.6%). The dermatome was typically set up by a scrub tech or nurse (48.6%), whereas the skin harvesting was performed by residents (39.2%) or attendings (35.1%). Lacerations typically extended to subcutaneous tissue (70.3%), with no neurovascular injury (86.5%). CONCLUSIONS: Our study showed that dermatome-induced lacerations are rare events and that certain factors predispose patients to injury. An algorithm was developed to provide guidance on risk factor identification and the set up and use of dermatomes.


Assuntos
Queimaduras/cirurgia , Lacerações/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Coleta de Tecidos e Órgãos/instrumentação , Sítio Doador de Transplante/patologia , Unidades de Queimados/estatística & dados numéricos , Canadá/epidemiologia , Estudos Transversais , Humanos , Incidência , Lacerações/etiologia , Lacerações/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Medição de Risco , Fatores de Risco , Transplante de Pele/efeitos adversos , Transplante de Pele/instrumentação , Transplante de Pele/métodos , Inquéritos e Questionários/estatística & dados numéricos , Coleta de Tecidos e Órgãos/efeitos adversos , Transplante Autólogo/efeitos adversos , Transplante Autólogo/instrumentação , Transplante Autólogo/métodos , Estados Unidos/epidemiologia , Cicatrização
3.
Rev Infirm ; 68(256): 18-20, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31870471

RESUMO

Pre-hospital management of a severe burn begins with an early assessment of the burn (burned skin surface, depth, location) and the concerned patient (age, comorbidities, injury associations). The immediate vital prognosis is more often due to associated injuries (trauma or poisoning) rather than burns. The patient must be referred by medical regulation to a burn treatment centre.


Assuntos
Queimaduras , Serviços Médicos de Emergência , Unidades de Queimados , Queimaduras/terapia , Hospitais , Humanos , Prognóstico
4.
Rev. bras. cir. plást ; 34(4): 509-516, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047916

RESUMO

Introdução: O suicídio é um sério problema de saúde pública. Estima-se que para cada óbito existam 10 tentativas. Dentre os meios utilizados, as queimaduras têm destaque devido à gravidade das lesões, a alta taxa de letalidade e os grandes prejuízos funcionais, estéticos e psicológicos. As mulheres, por constituírem a maioria dos pacientes com história de tentativa de suicídio e morte por queimaduras, representam um grupo vulnerável que merece recorte para aprofundamento do estudo. Métodos: Estudo retrospectivo, de caráter descritivo de série temporal. Foi desenvolvido na Unidade Tratamento de Queimados e no Instituto de Medicina Legal em Brasília (DF), entre os anos de 2010 e 2015. Resultados: Foram identificadas 42 mulheres com história de suicídio por queimaduras, tentado ou consumado. Houve 15 óbitos relacionados diretamente à lesão térmica. Houve um predomínio da faixa etária entre 30 e 44 anos, seguida por 15 a 29 anos. Em 64,3% dos casos o evento aconteceu no DF. Em relação aos agentes etiológicos, o mais comum foi o álcool (71,4%). A média de superfície corporal queimada foi de 34,38%, sendo que as pacientes que faleceram apresentaram áreas queimadas maiores (59,53%) do que as que sobreviveram (20,4%). Conclusão: Os dados obtidos no DF corroboram informações da literatura. Apesar do progresso envolvendo manejo e tratamento dos pacientes queimados, a prevenção continua sendo a melhor atitude.


Introduction: Suicide is a serious public health problem. For every death, there are an estimated 10 suicide attempts. Among the means of suicide, burns are prominent due to the lesion severity, the high mortality rate, and the severe functional, aesthetic, and psychological damage. Women comprise the majority of patients with a history of attempting suicide and death by burns and represent a vulnerable group that deserves attention. Methods: This retrospective descriptive time-series study was performed in the Burn Treatment Unit at the Institute of Legal Medicine in Brasília, Distrito Federal (DF) between 2010 and 2015. Results: A total of 42 women with a history of suicide by burns, attempted or consummated, were identified; 15 deaths were directly related to the thermal injury. Suicide by burns was the most predominant among patients aged 30 to 44 years was observed, followed by those aged 15 to 29 years. In 64.3% of cases, the event occurred in the Brasília, Distrito Federal (DF). Alcohol was the most common etiological agent (71.4%). The average burned body surface area was 34.38%, and the patients who died presented larger burned areas (59.53%) than that in those who survived (20.4%). Conclusion: The data obtained from the Brasília, Distrito Federal (DF) corroborate information from the literature. Despite progress involving the management and treatment of burn patients, prevention remains the best strategy.


Assuntos
Humanos , Feminino , Adolescente , Adulto , História do Século XXI , Suicídio , Tentativa de Suicídio , Unidades de Queimados , Queimaduras , Saúde Pública , Funções Essenciais da Saúde Pública , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Unidades de Queimados/normas , Unidades de Queimados/estatística & dados numéricos , Queimaduras/mortalidade , Queimaduras/psicologia , Queimaduras/terapia
5.
Zhonghua Shao Shang Za Zhi ; 35(11): 798-803, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775468

RESUMO

Objective: To explore the resistance mechanism and gene type of carbapenems-resistant Klebsiella pneumoniae (CRKP) in burn care unit. Methods: A total of 27 CRKP strains were primarily isolated from 22 patients [20 males, 2 females, aged (42±16) years] admitted to burn care unit of Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as our department) from January to December 2017. After identification of bacteria, the months of detection and distribution of sample source were analyzed. Drug resistance tests of 15 antibiotics were conducted. Polymerase chain reaction was used to detect the drug resistant genes. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were used to analyze the gene type of strains. Results: (1) During the whole year of 2017, CRKP strains were mostly detected in August (8 strains), September (6 strains), and October (5 strains), with no CRKP in January, March, June, November, and December. Five strains from bed units were detected in August (2 strains), September (1 strain), and October (2 strains). (2) Twenty-seven CRKP strains were derived from blood samples (40.7%, 11/27), wound exudate samples (18.5%, 5/27), deep vein catheter samples (11.1%, 3/27), sputum samples (7.4%, 2/27), urine samples (3.7%, 1/27), and bed unit samples (18.5%, 5/27). (3) The 27 CRKP strains were detected with drug-resistance rates of 100.0% to 7 antibiotics including cefoperazone/sulbactam, piperacillin/tazobactam, cefazolin, ceftriaxone, cefepime, ertapenem, and compound sulfamethoxazole, no drug-resistance to tigecycline, with drug-resistance rates higher than 81.0% to the rest 7 antibiotics. (4) Detection rates for resistance gene bla(CTX-M-10), bla(SHV), bla(TEM), bla(CTX-M-14), bla(ACT), and bla(KPC) were all above 92.5%. (5) According to PFGE, the 27 CRKP strains had 6 types (A, A(1), A(2), B, C, and D). Strains of type A were mainly detected in February, May, and September, with detection rate of 37.0% (10/27). Strains of type C were mainly detected in July, August, and October, with detection rate of 48.1% (13/27). Strains of types A(1), A(2), B, and D were scatteredly detected, with detection rate of 3.7% (1/27) respectively. According to MLST, the 27 CRKP strains had 6 STs. ST11 was the most frequent type, accounting for 74.1% (20/27), which was detected in August to October. The detection rate of ST395, ST2230, ST215, ST260, and STnew ranged from 3.7%(1/27) to 7.4%(2/27), and the strains were scatteredly detected. Conclusions: The main source of CRKP from burn care unit of our department was bloodstream. All the CRKP strains showed high drug-resistance rate and complicated resistance mechanism. There were small scale outbreaks caused by CRKP of type A, type C, and ST11, which should be paid more attention to in clinical treatment and infection control.


Assuntos
Queimaduras/microbiologia , Carbapenêmicos/farmacologia , Farmacorresistência Bacteriana , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/efeitos dos fármacos , Adulto , Antibacterianos/farmacologia , Unidades de Queimados , Feminino , Humanos , Klebsiella pneumoniae/classificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , beta-Lactamases/genética
6.
Saudi Med J ; 40(10): 1027-1031, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31588482

RESUMO

OBJECTIVES:   To investigate the prevalence and associated risk factors for venous thromboembolism (VTE) in burn patients.  Methods: This is a cross-sectional study eliciting the risk factors in burn patients who developed thromboembolism. The study took place at the Adult  Burn Unit, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Charts of all patients admitted to the burn unit from January 2010 to December 2016 were reviewed. Only patients 16 years of age and older were included. The research team with a consultant plastic surgeon developed the data sheet. A total of 304 patient records met the inclusion criteria. Logistic regression analysis was used to determine the risk factors for developing VTE. Results: Out of the entire study group of 304 patients, the majority (88.8%) of the participants received prophylactic anticoagulation. Twelve patients (3.9%)  developed VTE. All patients who developed VTE received prophylactic anticoagulation. Age, gender, body mass index, and degree of burn were not risk factors for VTE. However, electric burns were found to be an independent significant risk factor for developing VTE using a multivariate logistic regression. Conclusion: Electric burns were found to be the only independent significant risk factor of developing VTE.


Assuntos
Unidades de Queimados/estatística & dados numéricos , Queimaduras/complicações , Tromboembolia/etiologia , Adulto , Anticoagulantes/uso terapêutico , Queimaduras/terapia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores de Risco , Arábia Saudita/epidemiologia , Tromboembolia/epidemiologia , Tromboembolia/prevenção & controle
8.
J Med Microbiol ; 68(10): 1540-1543, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31483245

RESUMO

Four group A streptococcus (GAS) bacteraemia occurred in a small burn unit within 2 weeks. The GAS patient isolates, characterized as emm89, shared the same PFGE pulsotype with two other strains isolated 2 months later. The outbreak investigation revealed that a nurse was the most likely source of GAS transmission, as she was confirmed to carry the same outbreak strain in her throat and had direct and regular contact with the six outbreak patients in the unit. The outbreak was controlled after the nurse had undergone eradication treatment. This report highlights the emergence of the emm89 clone and its capacity to elicit invasive GAS outbreaks.


Assuntos
Unidades de Queimados/estatística & dados numéricos , Infecção Hospitalar/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/isolamento & purificação , Adulto , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Proteínas da Membrana Bacteriana Externa/genética , Proteínas da Membrana Bacteriana Externa/metabolismo , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Feminino , Humanos , Pessoa de Meia-Idade , Epidemiologia Molecular , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/classificação , Streptococcus pyogenes/genética , Tunísia , Adulto Jovem
9.
J Forensic Leg Med ; 67: 19-23, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31376649

RESUMO

In cases of death due to burn injury, it may be of great medico-legal importance to determine if the death is caused by fatal burn injury or due to other factors related to treatment. Therefore, this study aimed to investigate early predictors of mortality in patients with thermal burns admitted to Burn Unit, Ain Shams University Hospitals during a period of one year (2011). The study included 152 cases, mortalities represented 20.4% of the included cases (31 cases). Binary logistic regression analysis showed that, total body surface area (TBSA) of the burns and APACHE III score were significant predictors of mortality. This model resulted in accurate classification of 95.9% of the cases. Further multi-centric studies on larger sample sizes are recommended to validate the results of this study. Also, it is important to study the effect of co-morbidities as confounding factors on the prediction of mortality in patients with thermal burns.


Assuntos
Queimaduras/mortalidade , APACHE , Adolescente , Adulto , Superfície Corporal , Unidades de Queimados , Criança , Egito/epidemiologia , Feminino , Hospitais Universitários , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
12.
J Wound Care ; 28(6): 317-322, 2019 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-31166860

RESUMO

OBJECTIVE: Self-inflicted burns typically result in extensive injuries requiring intensive care and attention in a specialised burn unit. Burn units should be familiar with the optimal management of self-inflicted burns, including the psychological and psychiatric treatment. This paper describes the experiences of managing these challenging injuries in a German burn centre. METHODS: A retrospective review of patients with self-inflicted burns admitted to the burn centre between 2000 and 2017. Demographics, details of injury, presence of psychiatric disorder, clinical course, operative management and patient outcomes were recorded and compared with a control group without self-inflicted burns. Outcome measures included graft take rate, complications and need for further surgery. RESULTS: There were a total of 2055 burn patient admissions, with 17 cases (0.8%) of self-inflicted burns. The mean age was 36±11 years with an mean percentage total body surface area (%TBSA) burned of 43.5±22.5% which was not significantly different from the control group (p=0.184). Schizophrenia and personality disorder were the most common diagnoses in the self-inflicted burns patients (n=11; 65%). Of these, four had sustained previous self-inflicted burns. Length of hospital stay was significantly longer in the self-inflicted burn group than in the control group (49.0±16.7 days, respectively, p=0.002). CONCLUSION: Attempted suicide by self-inflicted burns represents <1% of burn admissions. This population demonstrates a high incidence of prior psychiatric disorders. Successful treatment includes multidisciplinary management of acute medical, surgical, and psychiatric care.


Assuntos
Queimaduras/terapia , Hidratação , Transtornos Mentais/psicologia , Transplante de Pele , Tentativa de Suicídio , Escala Resumida de Ferimentos , Adolescente , Adulto , Idoso , Asfixia/mortalidade , Unidades de Queimados , Queimaduras/mortalidade , Queimaduras/psicologia , Estudos de Casos e Controles , Causas de Morte , Cuidados Críticos , Transtorno Depressivo Maior/psicologia , Feminino , Alemanha , Insuficiência Cardíaca/mortalidade , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Mortalidade , Insuficiência de Múltiplos Órgãos/mortalidade , Traumatismo Múltiplo/mortalidade , Transtornos da Personalidade/psicologia , Transtornos Psicóticos/psicologia , Estudos Retrospectivos , Esquizofrenia , Comportamento Autodestrutivo/terapia , Choque/mortalidade , Adulto Jovem
13.
PLoS One ; 14(5): e0216489, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31112548

RESUMO

As burn injuries are a major cause of death and infirmity, successful service delivery is vital in health systems. In Iran, a few specialised burns hospitals (SBHs) located in big provinces provide burn services in which burn patients with more severe conditions are referred to. However, SBHs are faced with several challenges for delivering due treatment for burn patients. So, for the first time in Iran, the main aim of the study was to identify the challenges of delivering burn services in SBHs. For this purpose, we conducted a qualitative study during February 2017 to April 2018. Key informants were purposefully selected and interviewed at national and provincial levels from the Ministry of Health, medical universities, and informants working in eight SBHs. The saturation point was reached at 21 face-to-face semi-structured interviews. A thematic analysis approach was employed to analyse transcribed documents assisted by MAXQDA Plus version 12. Our results reveal four themes and twelve subthemes on the challenges of delivering services in SBHs. Themes and (subthemes) including burn care continuum (preventive care, pre-hospital care, hospital care, follow-up, and home care), regionalisation of burning services (access to other specialties and medical services, access to specialized care in provinces without a SBH, standardised regionalisation system for burn related services (BRSs), costs of providing BRSs (expensive services and supplies and long hospitalisation), and non-compliance with standardised care (guidelines to provide burn care and physical space to provide BRSs). Results suggest that improving BRSs delivery in Iran may be reached by strengthening burn care continuum, regionalising burn care, allocating sufficient budgets to burn services and formulating burn care guidelines. These policy actions can be better addressed via intra-sectoral collaborations.


Assuntos
Unidades de Queimados , Acesso aos Serviços de Saúde , Hospitalização , Hospitais Especializados , Centros de Traumatologia , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino
15.
Rev. enferm. UFPE on line ; 13(5): 1361-1369, maio 2019. ilus, tab, graf
Artigo em Português | BDENF - Enfermagem | ID: biblio-1024411

RESUMO

Objetivo: descrever o acidente e o perfil de crianças e adolescentes vítimas de queimaduras internados em um Centro de Terapia de Queimados de um Hospital Geral. Método: trata-se de um estudo quanti-qualitativo, descritivo, observacional, transversal realizado com dados dos registros de prontuário de internos na faixa etária de um dia a 18 anos, de 2014 a 2016, e entrevista com os responsáveis pelos internos, e apresentaramse os resultados em forma de tabelas. Resultados: ressalta-se que a maioria dos acidentes ocorreu em crianças do sexo masculino (63,33%), na faixa etária menor que cinco anos de idade (62,22%). O principal fator causal foi a escaldadura (65,00 %), com lesão de segundo grau (58,88%) e com topografia múltipla (63,33%). Conclusão: conclui-se que a maioria dos acidentes por queimaduras aconteceu no ambiente doméstico com a presença da mãe ou responsável no ambiente, sugere que a prevenção deve ser trabalhada, com educação para riscos e modificação do ambiente em que a criança vive.(AU)


Objective: to describe the accident and the profile of children and adolescents victims of burns hospitalized at a Burnout Therapy Center of a General Hospital. Method: this is a quantitative, descriptive, observational, cross-sectional study carried out with records of records of inmates in the age group from one day to 18 years, from 2014 to 2016, and interviews with those responsible for inmates, and the results were presented in the form of tables. Results: most of the accidents occurred in male children (63.33%), in the age group less than five years old (62.22%). The main causal factor was scald (65.00%), with second degree lesion (58.88%) and multiple topography (63.33%). Conclusion: it is concluded that the majority of burn injuries happened in the home environment with the presence of the mother or responsible in the environment, suggests that prevention should be worked out, with education for risks and modification of the environment in which the child lives.(AU)


Objetivo: describir el accidente y el perfil de niños y adolescentes víctimas de quemaduras internados en un Centro de Terapia de Quemados de un Hospital General. Método: se trata de un estudio cuali-cuantitativo, descriptivo, observacional, transversal realizado con datos de los registros de prontuario de internos en el grupo de edad de un día a 18 años, de 2014 a 2016, y entrevista con los responsables de los internos, y se presentaron los resultados en forma de tablas. Resultados: se resalta que la mayoría de los accidentes ocurrió en niños del sexo masculino (63,33%), en el grupo de edad menor a cinco años de edad (62,22%). El principal factor causal fue la escaldadura (65,00%), con lesión de segundo grado (58,88%) y con topografía múltiple (63,33%). Conclusión: se concluye que la mayoría de los accidentes por quemaduras ocurrió en el ambiente doméstico con la presencia de la madre o responsable en el ambiente, sugiere que la prevención debe ser trabajada, con educación para riesgos y modificación del ambiente en que el niño vive.(AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Ferimentos e Lesões , Unidades de Queimados , Queimaduras , Acidentes , Criança , Adolescente , Prevenção de Acidentes , Hospitalização , Acidentes Domésticos , Registros Médicos , Epidemiologia Descritiva , Estudos Transversais
17.
Burns ; 45(4): 805-817, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31031020

RESUMO

OBJECTIVES: The purpose of this study was to establish patterns in types of burns referred to the Outpatient Clinic (OP) at Vancouver General Hospital (VGH). METHODS: A 2-year retrospective chart review was conducted of patients presenting to the OP Clinic from June 1, 2016 - June 1, 2018. Data collected included: patient demographics, depth of burn, Total Body Surface Area (TBSA), anatomical location of burn, geographical location of referral, and operative versus non-operative management. RESULTS: The OP Clinic served 470 patients for burn injuries with a total of 1852 visits. Of these, 20% were follow-up visits post-admission, and 73.6% were primary referrals from the emergency department (ED) or elsewhere. The vast majority (69.6%) of burns were less than 5% TBSA. Half involved the hands (50.9%), and half were superficial dermal in depth (45.1%). A third of patients attended only one appointment with the OP Clinic before discharge and 15% did not receive any treatment. CONCLUSIONS: The results of our study demonstrate gaps in current provincial referral guidelines leading to a significant number of "unnecessary referrals." Further research could correlate the results to current provincial referral guidelines to estimate their current efficacy in practical use.


Assuntos
Traumatismos do Braço/terapia , Queimaduras/terapia , Traumatismos da Mão/terapia , Traumatismos da Perna/terapia , Ambulatório Hospitalar , Encaminhamento e Consulta/normas , Adolescente , Adulto , Assistência ao Convalescente/estatística & dados numéricos , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Traumatismos do Braço/patologia , Superfície Corporal , Colúmbia Britânica , Unidades de Queimados , Queimaduras/patologia , Serviço Hospitalar de Emergência , Feminino , Clínicos Gerais , Traumatismos da Mão/patologia , Hospitalização , Humanos , Traumatismos da Perna/patologia , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Índices de Gravidade do Trauma , Adulto Jovem
18.
Zhonghua Yi Shi Za Zhi ; 49(1): 19-24, 2019 Jan 28.
Artigo em Chinês | MEDLINE | ID: mdl-30970420

RESUMO

Chinese modern burn surgery belongs to the western medicine system. From 1930s, the knowledge of modern burn surgery spread over China. Its development had experienced four stages: enlightening stage, exploratory stage, mature stage, and remodeling stage. Before the 1950s, medical personnel began to study those knowledges. The clinical treatment developed slowly and had little experience. From the 1950s to 1960s, Chinese burn surgery professionals made the painstaking exploration and accumulated rich clinical experiences. The success of severe burns treatment attracted worldwide attention. From the 1970s to the mid-1990s, as the regulations of burn diagnosis and treatment established in China, the clinical treatment developed widely. The world's leading therapeutic effects have achieved. The professional education system has been founded, and the professional societies have created. Those made medical personnel can access the scientific research achievement. Therefore, the leading talents emerged. Chinese modern burn surgery entered a mature stage. Since the late-1990s, Chinese modern burn surgery entered a remodeling stage. Besides increasing the cure rate and decrease disability rate of burn gradually, Chinese modern burn surgery need solve new problems such as that standardization of diagnosis and treatment sets up, the scope of diagnosis and treatment expands, professional training improves, etc.


Assuntos
Unidades de Queimados , Queimaduras , Unidades de Queimados/história , Queimaduras/cirurgia , China , História do Século XX , História do Século XXI , Humanos
19.
Rev Col Bras Cir ; 46(2): e2115, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31017179

RESUMO

OBJECTIVE: to evaluate the effectiveness of the adopted strategy and the care quality for pediatric trauma in the survival of patients attended after a disaster in a city in the interior of Minas Gerais state, compared to the expected results of studies on infant mortality in major burns. METHODS: retrospective observational analysis of ten patients who were burned and transferred to a trauma reference center. We used the modified R-Baux score to estimate the expected mortality. We compared the expected mortality predicted by R-Baux score and the actual mortality determined from one-ratio test. We also compared time of post-trauma admission with mortality and burned body surface area with mortality. RESULTS: mean R-Baux score was 75.2, which means an expected mortality of 5% among major burn patients. However, in this study, mortality in the group of children with large burned body surface area was of 60%, p=0.001, a rate far beyond that expected in literature. CONCLUSION: despite the innumerable variables, we consider the hypothesis of the pediatric trauma care infrastructure being inferior than the one needed in the state. This study suggests a greater incentive for public policies concerning pediatric trauma care, prepared referral center, well-established transfer agreements, and optimization of catastrophe plans, in order to reduce morbimortality of patients who survive the first hour after trauma.


Assuntos
Unidades de Queimados/estatística & dados numéricos , Queimaduras/mortalidade , Queimaduras/terapia , Vítimas de Crime/estatística & dados numéricos , Fatores Etários , Superfície Corporal , Brasil , Criança , Pré-Escolar , Feminino , Mortalidade Hospitalar , Humanos , Escala de Gravidade do Ferimento , Masculino , Valores de Referência , Estudos Retrospectivos , Análise de Sobrevida
20.
Burns ; 45(5): 1189-1198, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30948279

RESUMO

INTRODUCTION: The number of burns in Portugal remains considerably large and therefore constitutes a major public health problem. There is a shortage of studies describing the epidemiological and clinical impact of seasonality on burn centre admissions, particularly in high income countries. METHODS: This retrospective analysis included all patients (>18 years old) with acute burns admitted to a specialized Burn Center in Lisbon (Hospital São José) between 20 of September 2010 and 19 of September 2017 (7 years). Clinical data was obtained from electronic medical records. The patients were categorized into four groups, according to each season. RESULTS: Six hundred and sixteen (616) patients were included in this analysis, the majority being male (55.2%). There were no significant differences between the number of patients admitted in each season nor in gender distribution. Older patients were admitted during winter. Hospitalisation time was higher for patients admitted in the winter and surface area injured was higher for those admitted during summer. Fire burns were the most common aetiology in all seasons. Work related burns and suicide attempts were more frequent in the summer. Most patients had more than one anatomical area affected (73.9%) and winter was specifically associated with more frequent isolated lower limb burns. Winter and fire burns were associated with deeper injuries. More patients underwent surgery during winter (80.7%) than in the remaining seasons (average 65%) but the average number of surgeries per season did not change significantly. The overall mortality rate was 6.8% and the need for mechanical ventilation was 28.9%. Concerning both variables we did not find major differences across seasons. Mortality was associated with older patients, deeper and more extensive burns and need for mechanical ventilation. CONCLUSION: Winter seems to be associated with older patients and with the most severe burns (deeper and more often needing surgery). This study was designed to fill the gap in seasonal burn profile in Portugal and it helps in establishing preventive strategies and better resource allocation.


Assuntos
Queimaduras/epidemiologia , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Estações do Ano , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Superfície Corporal , Unidades de Queimados , Queimaduras/mortalidade , Queimaduras/patologia , Queimaduras/terapia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Mortalidade , Portugal/epidemiologia , Respiração Artificial , Adulto Jovem
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