Do pre-burn center management algorithms work? Evaluation of pre-admission diagnosis and treatment adequacy of burn patients referred to a burn center

Abstract

Interventions for burn management until the patient is transferred to a burn center affect mortality and morbidity. Therefore, adherence to the developed algorithms is an important issue. This study aimed to determine deficiencies in different aspects of the implementation of these algorithms during the pre-admission diagnosis and treatment processes of patients referred to our burn center. This study involved a four-year review of patients referred to our burn center. 170 burn cases admitted by referral were enrolled in the study. Adequacy of resuscitation within the first 24 hours, adherence to guidlines, and mortality were investigated. Resuscitation performed within the first 24 hours was found to be inadequate in 88 patients (51.8%). When the burned surface area percentages were evaluated all percentages were calculated higher before arrival. There were 78 major burn cases (45.9%), and the frequency of inhalation burns, intubation requirements and renal failure were more common in this group compared to the minor burn group (p<0.001). The frequency of intubation without accurate indications was found to be 70.58% . Inadequate escharotomy was detected at a rate of 52.9% , and inadequate fasciotomy at a rate of 66.6% . The mortality rate was 22.4% among all patients. Interventions undertaken during the period until the patients’ referral to these centers affect mortality and morbidity. In this study, it was found that the pre-hopital applications generated were insufficient, and it was proposed that burn patient care algorithms be developed with in-service training throughout the country.