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Are Burn Unit Admissions Increased duringWeekends and Certain Holidays

01 Jan 2017-Vol. 2, Iss: 2
TL;DR: Burn unit admissions are more likely to occur on the Sundays and Mondays and least likely to occurs on Thursdays, and admissions occurring during July, November, and on Wednesdays are associated with overall smaller-size injuries.
Abstract: Background: Anecdotal evidence suggests an increased incidence of burn admissions during weekends and certain times of the year, particularly the summer holidays. We formally analyzed the timing of admissions to our burn unit as well as severity of injury by date to investigate more precisely the temporal patterns of burn injuries throughout the year. Materials and methods: A retrospective chart review was performed of all patients admitted to our burn center from 2006-2015. Date, day of the week, month, and season of admission were collected and analyzed. Type of burn injury and total body surface area (TBSA) were also noted for each admission from 2013-2015. Results: The majority of admissions occurred on Sundays (39 ± 4 compared to 30 ± 6, p=0.0009), the second most occurred on Mondays (36 ± 6, p=0.038), while the least occurred on Thursdays (24 ± 4, p=0.0169). Most admissions occurred in July compared to other months (22 ± 5 compared to 17 ± 2, p=0.017). Analysis by season revealed that most admissions occurred in the summer (60 ± 11 compared to 50 ± 3, p=0.0125). Scald injuries were most likely to occur in November (10 ± 9 compared to 7 ± 8, p=0.0055) and least likely to occur in February (4 ± 8, p=0.0388). Injuries occurring in July had the smallest total body surface area compared to other months (4 ± 2.5 compared to 8 ± 2.1, p<0.0001), and injuries in November were second smallest (5 ± 5.4, p=0.0147). Injuries occurring on Wednesdays were smaller than the other days of the week (2 ± 9 compared to 7 ± 3, p=0.0006). Conclusion: Burn unit admissions are more likely to occur on the Sundays and Mondays and least likely to occur on Thursdays. July and the summer also tend to have higher rates of admissions than the rest of the year. Scald injuries are most likely to occur in November and least likely to occur in February. Admissions occurring during July, November, and on Wednesdays are associated with overall smaller-size injuries.
Citations
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Journal ArticleDOI
TL;DR: Investigation of temporal variations in burn injuries in patients treated at a referral center for burns in northern Israel between 2017-2019 found a 66% decrease in the number of adult burn patients and no significant decrease was observed among the pediatric population.
Abstract: Coronavirus disease 2019 obliged many countries to apply lockdown policies to contain the spread of infection. The restrictions in Israel included limitations on movement, reduction of working capacity, and closure of the educational system. The present study focused on patients treated at a referral center for burns in northern Israel. Their goal was to investigate temporal variations in burn injuries during this period. Data were retrospectively extracted from the medical records of burn patients treated at our hospital between March 14, 2020 and April 20, 2020 (ie, the period of aggravated lockdown). Data from this period were compared with that from paralleling periods between 2017 and 2019. During the lockdown and paralleling periods, 178 patients were treated for burn injuries, of whom 44% were under 18. Although no restrictions were enforced during the virus outbreak period with regard to seeking medical care, we noticed a decrease in the number of patients admitted to the emergency room for all reasons. Of particular interest was a 66% decrease in the number of adult burn patients (P < .0001). Meanwhile, among the pediatric population, no significant decrease was observed. Nonetheless, subgroups with higher susceptibility to burn injuries included children aged 2 to 5 years (56.3% vs 23.8%, P = .016) and female patients from all pediatric age groups (57.1% vs 25%, P = .027). These findings may be explained by the presumably busier kitchen and dining areas during the lockdown. Overall, the study results can assist with building a stronger understanding of varying burn injuries and with developing educational and preventive strategies.

26 citations

Journal ArticleDOI
TL;DR: The study evaluated the effect of COVID-19 on the occurrence and patterns of burn injuries in Israel and found that scald injuries were the most common burn etiology and burn injuries occurred most often at home during the lockdown period.
Abstract: Abstract The coronavirus disease 2019 (COVID-19) pandemic forced many countries into lockdowns to limit the spread of infection. Israel’s containment measures included school closures, mobility restrictions, and workforce reductions. Our study evaluated the effect of COVID-19 on the occurrence and patterns of burn injuries. The study data was obtained via retrospective chart review of burn patients treated between March 15, 2020 and April 30, 2020, namely the period of strict national lockdown. This data was compared against data from paralleling periods between 2017 and 2019. A total of 686 patients were treated for burn injuries in the two study periods. Age group analysis revealed an increased ratio of pediatric patients aged 0–3 years during the lockdown (55.91% vs 40.79%, P = .002). In contrast, there were fewer patients presenting with burn injuries in the 7–16 and 17–29 age groups (9.66% vs 3.15%, P = .017; 16.46% vs 7.09%, P = .007, respectively). During both study periods, scald injuries were the most common burn etiology and burn injuries occurred most often at home. This predominance was further pronounced during the lockdown (71.65% vs 58.68%, P = .007; 90.55% vs 74.60%, P = .0001, respectively). The lockdown period underlined the danger faced by pediatric patients in their household environment. This danger was possibly compounded by an improper level of adult supervision as parents transitioned to remote work. These findings can educate us about factors that render burn injuries more likely not only during lockdowns, but also during regular times, thus shaping the development of burn prevention practices.

1 citations

Journal ArticleDOI
08 Jun 2023-PLOS ONE
TL;DR: In this article , a retrospective, cohort observational study of a single burn center from 7/1/2016 to 3/31/2021 was performed on all admissions to the burn surgery service.
Abstract: Background Variations in admission patterns have been previously identified in non-elective surgical services, but minimal data on the subject exists with respect to burn admissions. Improved understanding of the temporal pattern of burn admissions could inform resource utilization and clinical staffing. We hypothesize that burn admissions have a predictable temporal distribution with regard to the time of day, day of week, and season of year in which they present. Study design A retrospective, cohort observational study of a single burn center from 7/1/2016 to 3/31/2021 was performed on all admissions to the burn surgery service. Demographics, burn characteristics, and temporal data of burn admissions were collected. Bivariate absolute and relative frequency data was captured and plotted for all patients who met inclusion criteria. Heat-maps were created to visually represent the relative admission frequency by time of day and day of week. Frequency analysis grouped by total body surface area against time of day and relative encounters against day of year was performed. Results 2213 burn patient encounters were analyzed, averaging 1.28 burns per day. The nadir of burn admissions was from 07:00 and 08:00, with progressive increase in the rate of admissions over the day. Admissions peaked in the 15:00 hour and then plateaued until midnight (p<0.001). There was no association between day of week in the burn admission distribution (p>0.05), though weekend admissions skewed slightly later (p = 0.025). No annual, cyclical trend in burn admissions was identified, suggesting that there is no predictable seasonality to burn admissions, though individual holidays were not assessed. Conclusion Temporal variations in burn admissions exist, including a peak admission window late in the day. Furthermore, we did not find a predictable annual pattern to use in guiding staffing and resource allocation. This differs from findings in trauma, which identified admission peaks on the weekends and an annual cycle that peaks in spring and summer.
References
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Journal ArticleDOI
TL;DR: The success of this smoke detector giveaway program is notable in that it required the active participation of a high-risk population, and the population reached by this giveaway program a population at high risk from fire.
Abstract: Each year, 5,000 Americans die and 300,000 are hospitalized as a result of 2.8 million residential fires. Almost all house fires allow time for safe exit if an early warning is given. Smoke detectors are an effective, reliable, and inexpensive method of providing such warning. After an upsurge of deaths related to fires in 1982, Baltimore City gave away 3,720 smoke detectors to households that requested them. This study addressed two questions: (1) Did the households that received the smoke detectors install them? (2) Was the population reached by this giveaway program a population at high risk from fire? A survey of 231 randomly selected households among those requesting smoke detectors was conducted 8 to 10 months after the giveaway program. At that time, smoke detectors were installed in 92% (212/231) of the homes and 88% (187/212) of the installed smoke detectors were operational. Households requesting smoke detectors were in census tracts at higher risk from fire. The correlation coefficient between the rate of requesting a smoke detector and the risk of death or injury related to fires was r = .90, P less than .001. The 231 surveyed households had more personal fire risk factors than the general population. The success of this smoke detector giveaway program is notable in that it required the active participation of a high-risk population.

58 citations

Journal ArticleDOI
TL;DR: Analysis of the Grady Memorial Hospital Burn Center was conducted to examine the feasibility and savings if burns were managed locally with consultation as needed and major burns require burn center referral.
Abstract: Background Minor burns represent .96% to 1.5% of emergency department visits, yet burn center referral is common. Analysis of the Grady Memorial Hospital Burn Center was conducted to examine the feasibility and savings if burns were managed locally with consultation as needed. Methods Data on 776 consecutive admissions to Grady Memorial Hospital Burn Center between November 2005 and July 2007 were prospectively reviewed. National and international cohorts were compared. Results Patients' mean age was 31 years, 69.8% were male, and 87% were insured. Thirty-nine percent were transfers. Seventy-six percent of transfers (51% of air transfers) and 70% of all admissions were for ≤10% total body surface area burns. Helicopter transport cost $12,500 and averaged 48 miles. Eighty percent of burns were hot water (scald), grease, or flame burns, and 31% required skin grafting. Conclusions Most burns require assessment, debridement, and dressing changes. Grafting is rarely necessary. Patients are transferred because of a lack of training, and patients suffer economic burden and treatment delay. Savings could be realized were patients treated locally with select burn center referral. Video consultation and mentoring can help with triage and care of minor burns. Major burns require burn center referral. International practice reinforces these results.

32 citations

Journal ArticleDOI
TL;DR: Investigation of temporal variations in burn injuries in patients treated at a referral center for burns in northern Israel between 2017-2019 found a 66% decrease in the number of adult burn patients and no significant decrease was observed among the pediatric population.
Abstract: Coronavirus disease 2019 obliged many countries to apply lockdown policies to contain the spread of infection. The restrictions in Israel included limitations on movement, reduction of working capacity, and closure of the educational system. The present study focused on patients treated at a referral center for burns in northern Israel. Their goal was to investigate temporal variations in burn injuries during this period. Data were retrospectively extracted from the medical records of burn patients treated at our hospital between March 14, 2020 and April 20, 2020 (ie, the period of aggravated lockdown). Data from this period were compared with that from paralleling periods between 2017 and 2019. During the lockdown and paralleling periods, 178 patients were treated for burn injuries, of whom 44% were under 18. Although no restrictions were enforced during the virus outbreak period with regard to seeking medical care, we noticed a decrease in the number of patients admitted to the emergency room for all reasons. Of particular interest was a 66% decrease in the number of adult burn patients (P < .0001). Meanwhile, among the pediatric population, no significant decrease was observed. Nonetheless, subgroups with higher susceptibility to burn injuries included children aged 2 to 5 years (56.3% vs 23.8%, P = .016) and female patients from all pediatric age groups (57.1% vs 25%, P = .027). These findings may be explained by the presumably busier kitchen and dining areas during the lockdown. Overall, the study results can assist with building a stronger understanding of varying burn injuries and with developing educational and preventive strategies.

26 citations

Journal ArticleDOI
TL;DR: The month and day of the week of injury in common childhood activities using the National Electronic Injury Surveillance System database can be used to further guide childhood injury prevention programmes/campaigns and especially track improvements after targeted prevention programmes.
Abstract: BACKGROUND/PURPOSE: To investigate the month and day of the week of injury in common childhood activities using the National Electronic Injury Surveillance System database. METHODS: All emergency department visits 2002-2006 from bicycles/tricycles, scooters, playground equipment, swimming/water activities, skiing/snowboarding, trampolines, and skating were analysed. The NEISS weighted and stratified data set was analysed using SUDAAN software. Weekday and month of injury, gender, race, anatomical location of the injury, geographical location of injury, and disposition were tabulated. Simple variation by month or weekday was analysed using cosinor analysis; combined variation for both month and weekday was analysed by topographical analysis. RESULTS: There were an estimated 4.61 million emergency department visits for injuries from these activities in children in the United States. The average age was 9.5 years; there were 1.65 million girls (35.9%) and 2.97 boys (64.1%). Cosinor analysis demonstrated significant single peaks for month of injury for snow activities (January 27), trampolines (June 10), scooters (June 24), cycling (July 6), and water (July 12) activities. Double cosinor peaks were noted for skating (April 13 and September 12) and playground (April 22 and September 21) activities. Cosinor analyses demonstrated that the peak week days of injury were Monday for trampoline and snow activities, Saturday/Sunday for skating activities, Sunday for cycling, and Wednesday for playground equipment. There was no peak injury day for scooter or water activities. Topographical representation of paediatric injuries demonstrated that injuries from slides most frequently occurred April-May on Wednesdays and Saturdays, and those on swings April-May all days except Tuesday. Monkeybar injuries were bimodal, with the spring peak on Wednesday-Thursday in April/May and the fall peak Tuesday-Friday in September. Rollerblade injuries occurred Saturday-Sunday from March/April; rollerskates on Saturday-Sunday in January-April, and skateboards Saturday-Monday in August-October and Sundays in April. CONCLUSIONS: These findings can be used to further guide childhood injury prevention programmes/campaigns and especially track improvements after targeted prevention programmes. Public parks and schools should check/correct the status of playground landing surfaces just before the bimodal peaks. Education campaigns reinforcing the need for bicycle helmets could be concentrated immediately before the increase in cycling activity - March on weekends and April/May for weekdays. Language: en

24 citations

Journal ArticleDOI
TL;DR: These calendar-based patterns support the need for ongoing and future emergency leaders' collaborations in community-based care system redesign to meet the health care access needs of low-income persons.

23 citations