Assessment of extra-hospital care in accident victims referred to a severe burns unit

Cester Martínez A, Molina Sánchez MA, Gracia Sos C, Marín Risco M, González Peirona E, Gondra Elguzábal A

Background and aims: We have analysed a number of aspects of

the in situ management and care and eventual medicalised

transportation of severely burned accident victims, comparing a

number of in-hospital and out-of-hospital variables so that, through their

analysis, a better care may be established for these patients in the extrahospitalary

environment.

Methods: Retrospective descriptive study of 60 severe burns cases initially

assisted by an extrahospitalary emergency service and who were

then referred to a specialised centre over a period of 14 years.

Results: In the comparison of variables assessed both out of and

in the hospital a very high correlation was observed (Pearson’s ñ

= 0.940) between the out-of-hospital and in-hospital calculation of

the percentage of body surface area burned, with no significant

differences (p <0.05). As for respiratory and circulatory support and analgesia there was therapeutic similarity and continuity between out-of-hospital and in-hospital assistance. The burns were systematically cooled with hydrogel dressings with no cases of hypothermia, although it should be stressed that preventive passive external and active internal re-warming measures were taken in all cases. Conclusions: Joint protocols must be established between the out-ofhospital and in-hospital teams for assistance to severely burned patients so as to achieve a more integrated and adequate therapeutic approach to these patients. The measures taken should be studied and assessed in order to decide on their maintenance, modification or rejection and a hyerarchical order of application should be established in order to reduce moribimortality in these cases.

Cester Martínez A, Gondra Elguzábal A, González Peirona E, Gracia Sos C, Marín Risco M, Molina Sánchez MA