Burn visits to a pediatric burn center during the COVID-19 pandemic and ‘Stay at home’ period

Sethuraman, Usha; Stankovic, Curt; Singer, Adam J.; Vitale, Lisa; Krouse, Carolyn B.; Cloutier, Dawn; Donoghue, Lydia; Klein, Jessica; Kannikeswaran, Nirupama

doi:10.1016/j.burns.2020.08.004

Cited by 32 publications

(30 citation statements)

References 3 publications

(3 reference statements)

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“…The major mechanism of burn injuries under stay-at-home orders or lockdowns is universally reported as flame burns [12] , [19] , [24] , and similar results were obtained in this study. The relatively higher incidence of injuries in a closed space and inhalation injuries is likely due to the prolonged stay of people at home.…”

Section: Discussionsupporting

confidence: 89%

“…Considering that no increase in the proportion or number of pediatric patients was identified in this study, the discrepancy between studies might have been introduced by age-specific changes in the number of burn injuries presenting at burn centers during the pandemic. It should be noted that a pediatric burn center in the US suggested the closure of most pediatric offices had affected the number of pediatric burn patient emergency department (ED) visits [19] . Furthermore, the similar reduction of incidence has been observed in other diseases, such as severe trauma, fractures, during the pandemic [20] , [21] , [22] .…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of burn injury during COVID-19 pandemic in Tokyo: A descriptive study

et al. 2021

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Introduction Coronavirus disease 2019 (COVID-19) has drastically changed everyday life worldwide. This study aimed to determine how COVID-19 affected the characteristics and outcomes of patients with severe burn injury by examining a city-wide burn database in Tokyo. Patients and Methods A descriptive study was conducted in 14 burn centers using the Tokyo Burn Unit Association registry from 1999–2020. The pandemic started in 2020, while the stay-at-home order lasted from April to May. The demographics, mechanisms, severity, and clinical outcomes were assessed before and during these two time periods. Results In total, 7061 patients with burn injury were enrolled. During the pandemic, there were less patients during the pandemic than previous years, except for April–May; this decreased toward the end of 2020. There were also more scald/contact burns in the upper extremity, less intended and assault injuries, shorter length of hospital stay, and lower in-hospital mortality. During the stay-at-home order, there was increased incidence of flame burns, inhalation injuries, and in-hospital mortality, as well as higher total body surface area of full-thickness burns. Conclusions This study described the characteristics of burns during the COVID-19 pandemic. The association between the stay-at-home order and severity of burns should be further examined.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Characteristics of burn injury during COVID-19 pandemic in Tokyo: A descriptive study

et al. 2021

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“…Burn injuries admitted to our regional burn center increased during the COVID-19 epoch, contrasting with previous trends of decreasing pediatric burn admissions at Parkland Hospital from 1974 to 2010 [11] . Sethuraman et al highlight the increased proportion of burn visits and severity during the stay-at-home period in the metro Detroit area, with a significant increase in proportion of house fire related burns [12] . Although they had a 66.6% reduction in overall ED visits and a 35% reduction in overall burn visits, they note an increase in house fire proportion, burn alerts, total body surface area (TBSA) burned, proportion of children with > 5% TBSA, and intensive care unit admissions.…”

Section: Discussionmentioning

confidence: 99%

Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital

Sanford

Zagory

Blackwell

et al. 2021

Journal of Pediatric Surgery

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Background: Trauma is the leading cause of morbidity and mortality in the pediatric population. However, during the societal disruptions secondary to the coronavirus (COVID-19) stay-at-home regulations, there have been reported changes to the pattern and severity of pediatric trauma. We review our twoinstitution experience. Methods: Pediatric trauma emergency department (ED) encounters from the National Trauma Registry for a large, tertiary, metropolitan level 1 pediatric trauma center and pediatric burn admission at the regional burn center were extracted for children less than 19 years from March 15th thru May 15th during the years 2015-2020. The primary outcome was the difference in encounters during the COVID-19 (2020) epoch versus the pre-COVID-19 epoch (2015)(2016)(2017)(2018)(2019). Results: There were 392 pediatric trauma encounters during the COVID-19 epoch as compared to 451, 475, 520, 460, 432 (mean 467.6) during the pre-COVID-19 epoch. Overall trauma admissions and ED trauma encounters were significantly lower ( p < 0.001) during COVID-19. Burn injury admissions ( p < 0.001) and penetrating trauma encounters ( p = 0.002) increased during the COVID-19 epoch while blunt trauma encounters decreased ( p < 0.001). Trauma occurred among more white ( p = 0.01) and privately insured ( p < 0.001) children, but no difference in suspected abuse, injury severity, mortality, age, or gender were detected. Sub-analysis showed significant decreases in motor vehicle crashes ( p < 0.001), pedestrians struck by automobile ( p < 0.001), all-terrain vehicle (ATV)/motorcross/bicycle/skateboard involved injuries ( p = 0.02), falls ( p < 0.001), and sports related injuries ( p < 0.001). Fewer injuries occurring in the playground or home play equipment such as trampolines neared significance ( p = 0.05). Interpersonal violence (assault, NAT, self-harm) was lower during the COVID-19 era ( p = 0.04). For burn admissions, there was a significant increase in flame burns ( p < 0.001). Conclusions: Stay-at-home regulations alter societal patterns, leading to decreased overall and blunt traumas. However, the proportion of penetrating and burn injuries increased. Owing to increased stressors and time spent at home, healthcare professionals should keep a high suspicion for abuse and neglect.

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“…Mortality in pediatric burns is closely related to patient age [ 3 , 10 , 11 ] and etiology of the burn; flame burns are the most common cause of death. Mortality and morbidity are also associated with higher degree burns.…”

Section: Discussionmentioning

confidence: 99%

“…Almost 50% of burn injury patients in the world are children and 25% of them are admitted to hospital with severe burns [ 3 ]. Major and minor burn injuries in children require urgent medical evaluation and appropriate, dedicated treatment to avoid the recognised potential life-threatening complications, as well as aesthetic and functional sequelae [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

Pelizzo

Vestri

et al. 2021

Healthcare

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Considerable reorganization of the regional network for pediatric burn treatment during the pandemic was required to cope with severe burn injuries in small children. In support of the emergency network for burns during the COVID-19 pandemic, we referred to regional indications for centralization in our hospital for all children aged less than 5 years who presented with severe burns, >15% of total body surface area (TBSA), or who necessitated admittance to the pediatric intensive care unit (PICU). A new service with a dedicated management protocol was set up to treat pediatric burns in our SARS-CoV-2 pediatric hospital during the lockdown period. A multidisciplinary burn treatment team was set up to offer compassionate and comprehensive burn care. Patient’s clinical data, burn features, treatment and follow up were recorded. A higher number of admissions was recorded from February to December 2020 compared with the same period in 2019 (52 vs. 32 admissions). Eighteen patients were admitted to the COVID-19 Service (10 M/8 F; 3.10 ± 2.6 yrs); ten children (55.5%) were hospitalized in the ward and eight in the ICU (44.5%). Fifty percent of the cases presented with lesions extending over >15% TBSA; in one case, TBSA was 35%. All patients suffered 2nd-degree burns; while five patients also had 3rd degree lesions covering more than 15% TBSA. All of the injuries occurred at home. No major secondary infections were recorded. Successful treatment was achieved in 94.4% of cases. The average length of stay was 15.2 ± 12.6 days. A proactive, carefully planned service, involving a multidisciplinary team, was created to ensure appropriate care in a pediatric hospital during the COVID-19 period, despite the effective pandemic associated challenges. Better health promotion in pediatric burn cases should also include dedicated TBSA assessment and a database of children’s burn characteristics.

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Burn visits to a pediatric burn center during the COVID-19 pandemic and ‘Stay at home’ period

Cited by 32 publications

References 3 publications

Characteristics of burn injury during COVID-19 pandemic in Tokyo: A descriptive study

Characteristics of burn injury during COVID-19 pandemic in Tokyo: A descriptive study

Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital

Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

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