Multidisciplinary management of the burn injured patient during a pandemic – The role of telemedicine

Sharaf, Amal; Muthayya, Preetha

doi:10.1016/j.burns.2020.04.028

Cited by 8 publications

(6 citation statements)

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“…Senior consultant input and reviews based on telemedicine photographs or acute burns clinic review as ward attenders ensured appropriate direction in patient management. 9 …”

Section: Discussionmentioning

confidence: 99%

“…Senior consultant input and reviews based on telemedicine photographs or acute burns clinic review as ward attenders ensured appropriate direction in patient management. 9 The initial assessment and further communication with telemedicine via emails or phone calls determined the nature of follow-up for these small burns. The challenges set by patients and burn factors may have led to more than one visit to ensure optimal care was provided.…”

Section: Discussionmentioning

confidence: 99%

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Management of minor burns during the COVID-19 pandemic: A patient-centred approach

Farid

Omran

Lewis

et al. 2021

Scars, Burns & Healing

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Introduction: The UK government introduced lockdown measures on 23 March 2020 due to the first wave of the COVID-19 pandemic. A restructuring of clinical services was necessary to accommodate mandatory changes while also maintaining the best possible standards for patient care. The present study explored the initial management, follow-up and patient-reported outcomes of burn injuries <15% total body surface area (TBSA) during the height of the COVID-19 lockdown at a tertiary burns centre. Methods: A retrospective review of all adult patients with burns <15% TBSA during the national lockdown (23 March 2020 to 10 May 2020) was undertaken at The Queen Elizabeth Hospital Birmingham (QEHB), UK. All referrals from non-QEHB telemedicine (external) or QEHB emergency (internal) departments were reviewed for management, length of hospital stay and pattern of follow-up (ward attender, self-care, community or outreach nurses). A telephone survey based on a structured questionnaire was conducted to establish patients’ satisfaction. Results: A total of 84 burn patients were included in the study. The mean age was 39 years (age range = 19–91 years) and the male:female ratio was 4:1. Patients were managed non-operatively (n = 69, 82%) or operatively (n = 15, 18%). Patients attended the ward attender acute burns clinic only once (n = 36, 61%). The telephone survey captured 70% (n = 59) of the study population and 57 patients (97% of respondents) were pleased with the ongoing care and burn healing. Conclusion: The integration of patient led self-care, reduction in admissions, minimal clinics attendance and a telemedicine follow-up is an effective model for small burns management during the COVID-19 pandemic. A high degree of patient satisfaction was achieved with continuous and approachable communication channels with the burn multidisciplinary team. We continue to implement this effective model of burns management throughout the COVID-19 pandemic and the subsequent period. Lay Summary The lockdown measures due to the first wave of COVID-19 pandemic affected the way we manage all medical emergencies including burns. The initial management, follow-up and patient satisfaction for small burn injuries during lockdown has not been reported previously. The aim of this study is to examine the outcome in terms of small burn management, hospital stay, number of clinic reviews, healing and patient satisfaction during the lockdown period in a burn centre in the UK. This would look at the need for operations and whether patients stayed longer if they required an intervention. We reviewed adult patients with small burns during the national lockdown (23 March 2020 to 10 May 2020) at The Queen Elizabeth Hospital Birmingham (QEHB). All referrals from telemedicine, referral system (external) or QEHB (internal) were reviewed for management, length of hospital stay and pattern of follow-up. Patients were reviewed in the acute burns clinic and given advice for burn management and dressing for self-care. Follow-up was mostly via email (telemedicine) A telephone survey based on a structured questionnaire was conducted to find out patients’ satisfaction. Four times more men than women had small burns during the lockdown period. The average age was 39 years. The majority were managed conservatively with dressings (82%) and a small proportion required an operation (18%). Most patients attended the acute burns clinic only once (61%) for initial assessment and management. The telephone survey captured 70% of patient and 97% of respondents were pleased with the care and burn healing. The integration of patient-led self-care, reduction in admissions, minimal clinics attendance and a telemedicine follow-up is an effective model for burns management during the COVID-19 pandemic. A high degree of patient satisfaction was achieved with continuous and approachable communication channels with burn multidisciplinary team. We continue to implement this effective model of burns management throughout the COVID-19 pandemic and the subsequent period.

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“…Senior consultant input and reviews based on telemedicine photographs or acute burns clinic review as ward attenders ensured appropriate direction in patient management. 9 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management of minor burns during the COVID-19 pandemic: A patient-centred approach

Farid

Omran

Lewis

et al. 2021

Scars, Burns & Healing

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“…Burns services globally describe an integration of telemedicine into their day to day work 22 in some cases allowing entirely remote patient management. 23 Better patient education and access to burns advice, improved remote communication and shifts to community-based dressings resulted in the majority of sites reporting more efficient wound care follow-up as a result of the pandemic. Telemedicine requires high-quality platforms, developed to allow accurate burns assessment.…”

Section: Discussionmentioning

confidence: 99%

RSTNCOVID Burns: A multi-centre service evaluation and stakeholder survey of the impact of COVID-19 on burns care in England, Wales and Northern Ireland

Phillips

Wormald

Yoshimura

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…response to a global need for continued rehabilitative care for burn survivors following discharge (14). The telehealth component which re ects the changing nature of healthcare particularly as the world is still navigating through the coronavirus pandemic implies that burn survivors will continue to receive professional support at a distance highlighting the potential bene ts of the 4Cs-TBuRP (53,54).…”

Section: Declarations Trial Statusmentioning

confidence: 99%

Effects of A Nurse-Led Transitional Burns Rehabilitation Programme (4Cs-TBuRP) For Adult Burn Survivors: Protocol for a Randomised Control Trial

Bayuo

Wong

Chung

2021

Preprint

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Background: Transitioning from the burn unit to the home/ community can be chaotic with limited professional support. Some adult burn survivors may face varied concerns leading to poor outcomes in the early post-discharge period with limited access to professional help. Based on these, a nurse-led transitional burns rehabilitation programme has been developed and the current trial aims to ascertain its effects as well as explore the implementation process. Methods: A single-centre, double-arm randomised controlled trial with a process evaluation phase will be utilised for this study. All adult burn survivors aged ≥18 years with burn size ≥10% total burn surface area at the site during the study period will be screened for eligibility at least 72hours to discharge. A sample size of 150 will be block randomised to treatment (receiving the nurse-led transitional care programme and routine post-discharge service) and control groups (receiving routine post-discharge service). The nurse-led transitional care programme comprises of predischarge and follow-up phases with the delivery of bundle of holistic interventions lasting for 8 weeks. There are three timelines for data collection: baseline, immediate post-intervention, 4 weeks post-intervention. Discussion: The findings from this study can potentially inform the development and organisation of post-discharge care and affirm the need for ongoing comprehensive home-based care for burn survivors and their families. Trial registration: ClinicalTrials.gov Trial Registry approved the prospective registration on 20 th August 2020. Registration details can be viewed on https://clinicaltrials.gov/ct2/show/record/NCT04517721 .

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Multidisciplinary management of the burn injured patient during a pandemic – The role of telemedicine

Cited by 8 publications

References 0 publications

Management of minor burns during the COVID-19 pandemic: A patient-centred approach

Management of minor burns during the COVID-19 pandemic: A patient-centred approach

RSTNCOVID Burns: A multi-centre service evaluation and stakeholder survey of the impact of COVID-19 on burns care in England, Wales and Northern Ireland

Effects of A Nurse-Led Transitional Burns Rehabilitation Programme (4Cs-TBuRP) For Adult Burn Survivors: Protocol for a Randomised Control Trial

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