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Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists

Introduction Correctly assessing burn size is extremely important since it is directly associated with a patient’s subsequent management. Further, an accurate assessment of the total body surface area (TBSA) involved is crucial to decide if specialty care in a burn unit is necessary, whereby overest...

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Autores principales: Hahn, Barry, Roh, Seungwhan Alex, Price, Christopher, Fu, Wayne, Dibello, Jaclyn, Berwald, Nicole, Greenstein, Josh, Chacko, Jerel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444963/
https://www.ncbi.nlm.nih.gov/pubmed/32850232
http://dx.doi.org/10.7759/cureus.9362
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author Hahn, Barry
Roh, Seungwhan Alex
Price, Christopher
Fu, Wayne
Dibello, Jaclyn
Berwald, Nicole
Greenstein, Josh
Chacko, Jerel
author_facet Hahn, Barry
Roh, Seungwhan Alex
Price, Christopher
Fu, Wayne
Dibello, Jaclyn
Berwald, Nicole
Greenstein, Josh
Chacko, Jerel
author_sort Hahn, Barry
collection PubMed
description Introduction Correctly assessing burn size is extremely important since it is directly associated with a patient’s subsequent management. Further, an accurate assessment of the total body surface area (TBSA) involved is crucial to decide if specialty care in a burn unit is necessary, whereby overestimation has the potential to lead to unnecessary patient transfers and undesirable burdens on the healthcare system and inconvenience to patients. The goal of this study was to identify whether burn injury estimates of TBSA percentage correlate between emergency department (ED) clinician and burn specialists. Methods This was a retrospective study conducted between February 1, 2018 and July 31, 2019 of patients with a burn injury who were evaluated by both an ED clinician and a burn specialist during the same ED visit. Charts were reviewed to identify the documentation of TBSA by pre-hospital personnel, ED nursing staff, ED mid-level providers (MLP), ED attending physicians, burn consultant MLPs, and burn consultant attending physicians. Results During the study period, 189 subjects with both an ED and burn consultant. The median age was 11 years [interquartile range (IQR) 1-49], and 103 (54%) were males. More than half of the subjects (n=106, 56%) were under the age of 18. There was a statistically significant correlation between estimates of TBSA between ED and burn consultants overall (p<0.0001). Furthermore, there was a statistically significant correlation between ED and burn MLPs (p<0.0001) as well as ED and burn attending physicians (p<0.0001). When adjusted for MLP and attending sex, there was still a correlation among all groups (p<0.0001). Conclusions In this study, there was a statistically significant correlation between estimates of TBSA between ED and burn consultants
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spelling pubmed-74449632020-08-25 Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists Hahn, Barry Roh, Seungwhan Alex Price, Christopher Fu, Wayne Dibello, Jaclyn Berwald, Nicole Greenstein, Josh Chacko, Jerel Cureus Emergency Medicine Introduction Correctly assessing burn size is extremely important since it is directly associated with a patient’s subsequent management. Further, an accurate assessment of the total body surface area (TBSA) involved is crucial to decide if specialty care in a burn unit is necessary, whereby overestimation has the potential to lead to unnecessary patient transfers and undesirable burdens on the healthcare system and inconvenience to patients. The goal of this study was to identify whether burn injury estimates of TBSA percentage correlate between emergency department (ED) clinician and burn specialists. Methods This was a retrospective study conducted between February 1, 2018 and July 31, 2019 of patients with a burn injury who were evaluated by both an ED clinician and a burn specialist during the same ED visit. Charts were reviewed to identify the documentation of TBSA by pre-hospital personnel, ED nursing staff, ED mid-level providers (MLP), ED attending physicians, burn consultant MLPs, and burn consultant attending physicians. Results During the study period, 189 subjects with both an ED and burn consultant. The median age was 11 years [interquartile range (IQR) 1-49], and 103 (54%) were males. More than half of the subjects (n=106, 56%) were under the age of 18. There was a statistically significant correlation between estimates of TBSA between ED and burn consultants overall (p<0.0001). Furthermore, there was a statistically significant correlation between ED and burn MLPs (p<0.0001) as well as ED and burn attending physicians (p<0.0001). When adjusted for MLP and attending sex, there was still a correlation among all groups (p<0.0001). Conclusions In this study, there was a statistically significant correlation between estimates of TBSA between ED and burn consultants Cureus 2020-07-23 /pmc/articles/PMC7444963/ /pubmed/32850232 http://dx.doi.org/10.7759/cureus.9362 Text en Copyright © 2020, Hahn et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Hahn, Barry
Roh, Seungwhan Alex
Price, Christopher
Fu, Wayne
Dibello, Jaclyn
Berwald, Nicole
Greenstein, Josh
Chacko, Jerel
Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists
title Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists
title_full Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists
title_fullStr Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists
title_full_unstemmed Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists
title_short Estimates of Total Burned Surface Area by Emergency Department Clinicians and Burn Specialists
title_sort estimates of total burned surface area by emergency department clinicians and burn specialists
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444963/
https://www.ncbi.nlm.nih.gov/pubmed/32850232
http://dx.doi.org/10.7759/cureus.9362
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