Annals of burns and fire disasters最新文献

This paper takes the form of a case study of forest fires that occurred in Indonesia from 2014 to 2019 and were reported on the social media of Twitter. The study was a corpus-assisted discourse study (CADS) using data scraping or text mining on Twitter based on the keyword "kebakaran hutan" [forest fire] and discourse analysis. The actor-network theory was used to map the actors involved. This study concludes that five discourses show a consistently large pattern of Twitter users responding to the problem of forest fires in Indonesia. Regarding the actors, the government takes an essential role of leadership and information arbitrage on Twitter. Seeing as it is the state's responsibility to ensure the safety of all people, the government must appear to be the main holder of control in managing disaster information traffic to avoid irresponsible information or hoaxes disseminated by parties or actors. These results indicate that the availability of information obtained from every conversation of Twitter users can be used as a study or input in the formulation of evidence-based policy about forest fires. It should be given more attention as an alternative means of solving the issue of forest fires, which has become an annual problem in Indonesia.

Fire-related burns contribute significantly to the global burden of burn injury and mortality. Alcohol and/or drug intoxication poses a risk to burn and fire-related injury, whether intentional or unintentional, but such evidence is scarce in the African context. This review aimed to fill the knowledge gap on health determinants of fire-related morbidity and mortality regionally by investigating the role of alcohol and drug intoxication in such events. Using key concepts, an extensive search was performed on 25 databases for relevant publications. Eligible articles were critically appraised using the appraisal tool for cross-sectional studies (AXIS tool), adapted to the review's objectives and outcomes. A total of 42 articles were included, of which less than half were solely investigating burn/fire-related events. Others indirectly mentioned burn injuries as part of larger health burdens such as injury, trauma, violence and other diseases. The measurement of alcohol and/or drug intoxication was inconsistent between studies with varying results. Alcohol and drug impairment in burn incidents in Africa requires evidence-based epidemiological research, and this review illustrated the limited scope of this topic in current literature. Routine toxicological results from post-mortem examinations were identified as important data sources and several research recommendations were provided.

When their treatment is not optimal, deep cervical burns often develop retractions, ranging between simple vertical retractions to major global ones. They generate functional, aesthetic and psychological sequelae. Surgical treatment, adapted to both the patient and the type of retraction, has several goals including restoring the neck-chin angle, restoring a correct aesthetic aspect, and allowing social rehabilitation. In our unit, we managed 47 patients (mean age 22) with neck contractures over 8 years, from 2012-2020. Scald is more frequent in children while flame burns prevail in adults. Most (58%) patients healed spontaneously. Moderate and severe contractures (Achauer's classification) accounted for 30.6 and 38.8% respectively. In most (94%) patients, the contracture leads to a distortion of the neck-chin angle and limits the extension of the neck. Surgery techniques were skin grafts (67.3%), local plasties (24.5%) and flaps (8.2%). During the follow-up, results were considered as good in 83%, acceptable in 8.5%, while 8.5% needed another surgery. Plasties (Z, IC, VY…) and local flaps (with or without skin expansions) are indicated in minor contractures. Authors still debate on the best technique (graft or flap) for severe and major ones. Post-operative rehabilitation is a cornerstone for good results.

The aims of this study were to investigate the profile of serum triglyceride level and its influence on outcomes in adult patients with severe burns. An observational study was conducted on 62 patients with burn extent from and over 20% TBSA. Results indicated that serum triglyceride level steadily increased from 1.9mmo/l on the 3rd day to 2.5 mmol/l on the 14th day before reducing on the 21st day after burn. Remarkably higher triglyceride level was seen in patients with full thickness burn area >20% TBSA and in inhalation injury (p < .05). Liver size significantly increased over time and was greater in increased triglyceride patients, but the difference was not significant (p > .05). In addition, patients with elevated serum triglyceride level had significantly higher rates of multiple organ failure and death compared with the remaining group. Further studies need to be conducted to understand and determine intervention for increased plasma triglyceride levels in severely burned patients.

The pathogenesis of coronavirus disease 2019 (COVID-19) involves a prominent innate immune response to SARS-CoV-2 infection, including inflammatory cytokines, chemokines, the complement system and acute phase proteins. This hyperinflammatory response predisposes patients to thromboembolic disease, acute lung injury, acute respiratory distress syndrome and multiple organ dysfunction syndrome. In burn injuries, damaged tissues induce a local and systemic inflammatory response through pathways associated to COVID-19. As such, a COVID-19 positive patient sustaining burn injuries may have an amplified response to the burn insult due to their baseline hyperinflammatory and hypercoagulable states. Burn patients may have compromised physiological reserve to withstand the insult of surgical intervention before reaching clinical instability. The concurrent pathogenesis of COVID-19 and the inflammatory response in burn injury have serious implications on the management of burn patients.

The importance of tissue damage secondary to high voltage electrical injury to the limbs often makes the management of this kind of burn very difficult. Repair interventions are sometimes ineffective and amputations are then unavoidable. We report the case of a young patient suffering electrical injury to both upper limbs caused by a high voltage current, whose evolution was dramatically marked by bilateral disarticulation of both shoulders.

Our aims were to evaluate resources and the preparedness of the health care facilities to respond to mass burn injuries in Vietnam. A survey was conducted in 19 provincial and central/regional hospitals using a questionnaire. The contents of the survey included infrastructure, human resources, medical equipment for burn care, and preparedness of hospitals for mass burn injuries. Results indicated that a variety of burn care facilities were set up, from separate burn departments (42.1%) to burn units (15.8%) or burn beds (42.1%) inside trauma or surgical departments. Medical staff/burn bed ratio was .7 and nurse/physician ratio was 1.7, with 52.7% of nurses having more than 5 years' experience. Infrastructure and medical equipment for burn facilities were limited, with just under half of the hospitals equipped with an air conditioner and heater. Bronchoscopy for diagnosis and management of inhalation injury was available in 6 (31.6%) hospitals. Few health facilities had a mechanical ventilator, fluid warmer, hemofiltration machine, burn theater, electro-dermatome or skin mesher. Only 26.3% hospitals had a plan for the management of mass burn injuries. A burn specialist was a member of the hospital's emergency medical team in 36.8% of the hospitals. Guidelines for burn emergency care were available in 63.2% hospitals. In the last 5 years, 21.1% of health facilities had conducted a drill for mass casualty incident management, but only 1 (5.3%) hospital had conducted a drill for MBI management. In conclusion, facilities, equipment, human resources for burn care and preparedness to manage mass burn injuries in Vietnam are still limited and need to be improved.

Severe burn is a circumstantial pathology, most often accidental but more and more caused by voluntary acts. In the initial phase, the failures encountered are essentially hemodynamic, respiratory and metabolic, placing the emergency physician and the intensivist at the centre of medical care. The role of the pre-hospital physician is essential but often difficult due to the circumstances of intervention. First actions and treatments initiated as well as the evaluation of gravity can favorably modify the prognosis when they are well carried out. In view of this, we will unfold the different stages of pre-hospital care to implement in the event of severe burn.

A descriptive study was conducted on 135 adult severe burn patients treated at the Burn ICU, National Institute of Burns from 1/2017 to 12/2017. Hypernatremia was defined as increased plasma sodium ≥ 146 mmol/l. It was recorded in 24.4% of total patients with onset time of 8.3 ± 4.8 days, ranging from the 5th to 21st day postburn. Moderate and severe hypernatremia was recorded in 16 (54.5%) patients. Multivariate logistic analysis indicated that increased age, burn extent, mechanical ventilation and ventilation duration were independent predictive factors for the development of hypernatremia. Significantly higher mortality rate (59.5% vs. 40.5% respectively; p = .001) and longer duration of stay in the ICU (23.2 ± 15.4 days vs. 16.2 ± 11.6; p = .01) and in the hospital (74.4 ± 43.7 days vs. 37.9 ± 22.9; p = .002) were seen in the hypernatremia group compared to normonatremic patients. It is necessary to find further effective interventions for the prevention and treatment of this fatal complication among severe burn patients.