Management of COVID-19 in burns patients: The experience of a UK burn centre

Abstract

During the onslaught of the SARS-Cov-2 (COVID-19) pandemic, majority of healthcare systems focused their approach towards disease containment. The main strategies involved measures to prevent disease spread through social distancing; shielding and use of personal protective equipment (PPE); testing and quarantine of infected cases; and rationalising health care [ 1 2 _ T D $ D I F F ] services to prioritise intensive care (ICU) resources.These measures have had a significant impact on Burns services worldwide. Instigating infection control measures to protect Burn and non-Burn injured patients as well as healthcare staff, create complex logistical arrangements considering the potential risks of transmitting COVID-19 whilst delivering care on the ward and in theatres amidst shortages of PPE [1,2]. There is a reliance on planning discharge of care and patient isolation (suspected or proven COVID-19 = RED area; unsuspected COVID-19 = GREEN area) based on the outcome of the patients' test [3]; particularly oro-and nasopharyngeal (ONP) RT-PCR swabs despite uncertainties on the validity of the results.

Impact of COVID-19 on Patient Trends and Outcome: Results from a Tertiary Care Burn and Plastic Unit in Northern India

“…It has been seen that sensitivity of RT-PCR is less than 70% and it also depends on the sampling technique. 15 Instead, baseline chest computed tomography (CT) with RT-PCR COVID testing serves as a better and more reliable indicator of the pathology. 5 Due to our center limitations, CT could not be done for all patients.…”

Burn Care in Kirtipur Hospital before and during COVID 19 Pandemic: Survey of Psychological Issues and Practice Behaviours of Burn Care Personnel

“…Given that burn patients can also have or acquire asymptomatic COVID 19 infection treating patients based on an initial negative test result without proper protection can risk both patients and staff. Significant presence of false negative tests should always be taken into consideration and universal protective measures should be taken 12,13 . High risk procedures in suspected COVID 19 burn patients include establishing intravenous access, endotracheal intubation or tracheostomy, wound treatment, and surgery.…”

Efectos del confinamiento por COVID-19 en la demanda de atención de niñas, niños y adolescentes con quemaduras

“…Cabe señalar que en estos reportes internacionales las cifras de atendidos son de poca magnitud y con períodos de observación de 1 a 3 meses [13][14][18][19][20][21]24,[26][27][28][29][30] . Hay más concordancia en la literatura en que los casos leves y los secundarios a contacto con objetos calientes han disminuido 20,28,30,31 , y que algunos pacientes con quemaduras de mayor gravedad han consultado con retraso 29,31 .…”

“…Lo anterior, llevó a la Corporación de Ayuda al Niño Quemado (COANIQUEM) a realizar una intensa campaña de prevención de quemaduras por redes sociales para advertir a la población de los mecanismos más frecuentes que provocan estas lesiones. Diversos centros de atención de pacientes con quemaduras a nivel mundial, en un tiempo acotado al inicio de la pandemia, han dado a conocer su experiencia en relación al funcionamiento y manejo [13][14][15][16][17][18][19] , cambios epidemiológicos 20,21 , llamados a la comunidad 22,23 o estudios sobre consultas, hospitalizaciones y duración del período de estadía hospitalaria 24 .…”