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31. Bathing Related Scald Burns - A Pilot Study |
| N. Li MSW, C. Longden RN, P. W. Hyden MD, JD, N. Alden RN, A. Rabbitts RN, MS, P. Q. Bessey MD,
FACS, R. W. Yurt MD, FACS |
| New York Presbyterian Hospital-New York Weill Cornell Center, New York, NY. |
| Introduction: Bathing related scald burns from tap water cause significant injuries when water is 130°F or higher. The city requires water temperature control valves to be installed and set to a maximum of 120°F in all multi-unit dwellings constructed after 1997. Since then, the Burn Center has admitted 235 bathing related scald injuries.
Method: A review of medical records of all patients who sustained bathing related scald during the period of April - July, 2001 was performed. Age, % TBSA burned, ORs required, length of stay (LOS) and disposition were reviewed. A Jones liquid thermometer was used by the Fire Marshall to test the water temperature in the patients' homes at the following time intervals: 3, 5, 10, 20, 30 and 60 seconds.
Results: The Burn Center admitted 15 patients with bathing related injuries during the study period. The average age of children was 4 years old and 44.6 years old for adults. The average TBSA burned was 6.4 ± 3.6%. Three patients required skin grafting. The average LOS was 14.5 ± 9.0 days. The Fire Marshall tested the bath water temperature in 5 apartments. (Table 1)
Conclusion: Bathing related scald injuries are occurring at sites where water temperatures exceed maximum levels under the mandate. The excessive temperatures occurred within 3 seconds
of water turn on in one case and by 20 seconds in all cases. A study of apartments of Burn Center staff revealed no temperature related problems. Based in part on these findings, a leading law firm has offered to assist in legislation to address these issues. |
| Table 1: Water Temperature (°)F |
| Apartment # |
Test Date |
3 SEC |
5 SEC |
10 SEC |
20 SEC |
30 SEC |
60 SEC |
| 1 |
4/9/01 |
120 |
130 |
140 |
150 |
160 |
160 |
| 2 |
4/21/01 |
* |
* |
* |
* |
* |
* |
| 3 |
4/27101 |
140 |
140 |
140 |
140 |
140 |
140 |
| 4 |
6/4/01 |
120 |
120 |
120 |
130 |
130 |
130 |
| 5 |
6/4/01 |
120 |
120 |
140 |
140 |
140 |
140 |
| Control average (n=7) |
69 |
89 |
91 |
99 |
103 |
111 |
*Temperature valve installed by landlord prior to evaluation
|
| 32. Scald Injury Prevention Program for Asian Community |
| E. Combs, T. L. Palmieri MD,
FACS, D. G. Greenhalgh MD, FACS Shriners Hospitals for Children Northern California, Sacramento, CA. |
| Introduction: Cultural preferences, tendencies and mandates may create an environment conducive to scald injuries. In most Asian homes, the kitchen is a communal place. Crowded spaces, congestion and distraction can lead to serious scalds. The seriousness of these injuries is often compounded by a lack of knowledge of basic first aid, especially in homes populated by recent immigrants. Often there is a wariness and distrust of Western medicine and doctors. Shamans, healers and home remedies are often turned to first. This delay in seeking immediate medical attention may lead to life-threatening complications.
Methods: Utilizing the National TRACS/ABA Burn Registry database, statistics were gathered on 540 acute pediatric burn admissions from April 1997 to June 2001. Data was compared between Asian, Caucasian, Hispanic and African-American groups for cooking-related scald burns compared to all other types of burns.
Results: Cooking related scald burns accounted for 63% of Asian patients, 31% of Caucasian patients, 30% of Hispanic patients and 25% of African-American patients. Of the Asian group, 81% occurred to children 5 years of age or younger, 19% were ages 6 to 10; 59% were male, 41% were female; 16% suffered full-thickness burns; 89% had 0-25%
TBSA, 8% had 26-50% TBSA and 3% had 51-75% TBSA. Surgery was required on 27%, 30% required ICU care and 5% were on mechanical ventilation. Data showed that within the Asian group, acute burns were much more frequently the result of cooking-related scalds than from any other etiology. Based on this, an outreach scald injury prevention program was developed to target various Asian ethnic groups. A two-part survey was given to 69 participants in this outreach program. The pre-program survey showed that 26% of the respondents allowed their children to play in the kitchen while they were cooking. In the post-program survey, 100% of the respondents answered that they should keep their children out of the kitchen while they are cooking. The pre-program survey showed that 44% of the respondents treated burns with ice, butter, baking soda, aloe
vera, cream, ointments, Neosporin, Vaseline or Hmong herbs. In the post-program survey, 100% answered that they should cool the burn with cool water and call 911.
Conclusion: The implementation of a scald burn prevention program in the Asian community was effective in changing perceptions about scald burns. Continuing education and awareness are imperative for burn prevention and treatment. |
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S56 Burn Care & Rehabilitation
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