The evaluation of burn knowledge and burn management skills of resident doctors of emergency medicine, general surgery and plastic surgery

Yıl 2024, Cilt: 14 Sayı: 3, 152 - 157, 31.05.2024

Zafer Dolu , Ömer Jaradat , Yavuz Katırcı , Hacı Mehmet Çalışkan , Burak Şahin , Ahmet Burak Erdem

https://doi.org/10.16899/jcm.1466346

Öz

Abstract

Background/Aims:
Our study aimed to assess the abilities of emergency medicine, general surgery, and plastic surgery resident doctors in diagnosing, treating, and managing burn patients.

Methods:
We conducted a survey study between 04.05.2015 and 04.08.2015 at university hospitals and training and research hospitals in Ankara. We collected information on the age, gender, experience, and hospital of the doctors, as well as their training and approaches to treating burn cases. We evaluated their knowledge in various areas, including clinical approaches to 2nd and 3rd-degree burn cases, escharotomy localizations, intubation indications, bulla treatment, referral and hospitalization indications, identification of inhalation burns, and fluid resuscitation.

Results:
The average age of the participants was 29.3±2.4 years, and 65.7% were male. We found that doctors who had received advanced burn life support training had better approaches to burn cases (p<0.05). We also observed a positive correlation between age and approaches to cases, escharotomy localizations, and referral indications (p<0.05). Additionally, there was a positive correlation between the duration of residency and approaches to burn cases, clinical application to 2nd and 3rd-degree burn cases, escharotomy localization, intubation indications, indications of bulla treatment, referring indications, hospitalization indications, and approaches to inhalation burn (p<0.05).

Conclusions:
Our study revealed that doctors' knowledge about assisting burn patients was insufficient in the early stages of their training. However, this improved as the duration of their residency increased. We believe that burn training and advanced life support courses can facilitate the diagnosis and treatment of burn patients more effectively.

Anahtar Kelimeler

Burn, medical training, emergency medicine, general surgery, plastic surgery

Etik Beyan

The study was carried out with the permission of Ankara Training and Research Hospital Ethics Committee (Date: 29.04.2015, Decision No: 4886).

Destekleyen Kurum

None.

Acil tıp, genel cerrahi ve plastik cerrahi asistanlarının yanık bilgisi ve yönetim becerisinin değerlendirilmesi

Öz

Öz

Amaç: Biz bu çalışmada Ankara’daki acil tıp, genel cerrahi ve plastik cerrahi kliniklerindeki asistan doktorların, anket soruları ile yanık bilgilerinin ve yönetim becerilerinin değerlendirilmesini amaçladık.

Gereç ve Yöntem: Bu çalışma 04.05.2015- 04.08.2015 tarihleri arasında Ankara’daki üniversite ve eğitim ve araştırma hastanelerinde anket çalışması olarak yapıldı. Hekimlerin yaş, cinsiyet, hekimlik süresi, asistanlık süresi, çalıştıkları hastane, aldıkları eğitimler ve vakalara yaklaşımları belirlendi. Hekimlerin 2. ve 3. derece yanık vakalarındaki klinik uygulamalar, eskaratomi alanı, entübasyon endikasyonu, büllere müdahale, sevk ve yatış endikasyonları, inhalasyon yanığını tanıma, yanıkta sıvı resusitasyonu konusundaki bilgileri değerlendirildi.

Bulgular: Katılımcıların yaş ortalaması 29.3±2.4 yıl ve %65.7’si erkekti. İleri Yanık Yaşam Desteği eğitimi alan hekimlerin vakalara yaklaşım ve klinik bilgilerinin daha iyi olduğu saptandı (p<0.05). Yaş ile vakalara yaklaşım, eskaratomi lokalizasyonu ve sevk endikasyonu bilgisi arasında pozitif yönlü korelasyon saptandı (p<0.05). Asistanlık süresiyle; yanık vakalarına yaklaşım, 2. ve 3. derece yanık vakalarında klinik uygulama, eskarotomi lokalizasyonu, entübasyon endikasyonları, bül tedavi endikasyonları, sevk endikasyonları, yatış endikasyonları ve inhalasyon yanıklarına yaklaşım arasında pozitif yönlü korelasyon saptandı (p<0.05).

Sonuç: Çalışmamız hekimlerin yanık müdahalesi konusunda bilgilerinin yeterli olmadığını göstermiştir. Verilecek yanık eğitimleri ve ileri yaşam desteği kursları ile yanık hastalarında tanı ve tedavi süreci daha başarılı bir şekilde gerçekleştirilecektir.

Anahtar Kelimeler

Yanık, tıp eğitimi, acil tıp, genel cerrahi, plastik cerrahi

Kaynakça

• 1. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev, 2006;19(2):403-34.
• 2. Jeschke M, Williams FN, Gauglitz GG and Hemdon DN. Burns. In: Townsend Jr, Beauchamp D, Evers BM, Mattox KL, editors. Sabiston Text Book of Surgery: The Biological Basis of Modern Surgical Practice. Philadelphia: Saunders Elsevier; 2012. p. 521-47.
• 3. Latha B, Babu M. The involvement of free radicals in burn injury: a review. Burns, 2001;27(4):309-17.
• 4. Doğan F, Çoruh A, Kemaloğlu AC, Günay GK. Çocuk Hastalarda Yanık Travması ve Koruyucu Önlemler. Erciyes Tıp Dergisi 2011; 33(1):35-8.
• 5. Coban YK, Erkilic A, Analay H. Our 18-month experience at a new burn center in Gaziantep, Turkey. Ulus Travma Acil Cerrahi Derg, 2010;16(4):353-6.
• 6. Engin C, Çakar KS. An epidemiyologic evaluation of outpatient burn cases. Ulusal Travma Derg, 1996;2(2):208-211.
• 7. Sarı O, Onar T, Aydoğan Ü. Wound and burn management in primary care. Smyrna Tıp Dergisi, 2011;1:53-8.
• 8. Baker RH, Akhavani MA, Jallali N. Resuscitation of thermal injuries in the United Kingdom and Ireland. J Plast Reconstr Aesthet Surg. 2007;60(6):682-5.
• 9. Klein MB, Hayden D, Elson C et al. The association between fluid administration and outcome following major burn: a multicenter study. Ann Surg, 2007;245(4):622-8.
• 10. Breederveld RS, Nieuwenhuis MK, Tuinebreijer WE, Aardenburg B. Effect of training in the Emergency Management of Severe Burns on the knowledge and performance of emergency care workers as measured by an online simulated burn incident. Burns, 2011;37(2):281-7.
• 11. Smith JJ, Malyon AD, Scerri GV, Burge TS. A comparison of serial halving and the rule of nines as a pre-hospital assessment tool in burns. Br J Plast Surg, 2005;58(7):957-67.
• 12. Baartmans MG, van Baar ME, Boxma H, Dokter J, Tibboel D, Nieuwenhuis MK. Accuracy of burn size assessment prior to arrival in Dutch burn centres and its consequences in children: a nationwide evaluation. Injury, 2012;43(9):1451-6. 13. Freiburg C, Igneri P, Sartorelli K, Rogers F. Effects of differences in percent total body surface area estimation on fluid resuscitation of transferred burn patients. J Burn Care Res, 2007;28(1):42-8.
• 14. Lavrentieva A, Kontakiotis T, Lazaridis L, Tsotsolis N, Koumis J, Kyriazis G et al. Inflammatory markers in patients with severe burn injury. What is the best indicator of sepsis? Burns, 2007;33(2):189-94.
• 15. DeKoning EP. Thermal Burns. In: Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM, editors. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York: McGraw-Hill Education; 2016. p. 1398-405.
• 16. Tompkins D, Rossi LA; Nursing Committee of the International Society for Burn, Care of out patient burns. Burns, 2004;30(8):A7-9.
• 17. Herndon DN. Total Burn Care. 2nd ed. London: WB Saunders; 2002.
• 18. Mertens DM, Jenkins ME, Warden GD. Outpatient burn management. Nurs Clin North Am, 1997;32(2):343-64.
• 19. Carter JE, Neff LP, Holmes JH 4th. Adherence to burn center referral criteria: are patients appropriately being referred? J Burn Care Res, 2010;31(1):26-30.
• 20. Fathuldeen AA, Alduheim MA, Alqahtani AS, Alshammari KM, Alsamaan SS, Althagafi AH et al. Knowledge and Practice of Burn Management Among Physicians Using Burn Manikin in Ha'il, Kingdom of Saudi Arabia. Cureus, 2023;15(3):e36196.
• 21. Saffle JR, Davis B, Williams P. Recent outcomes in the treatment of burn injury in the United States: a report from the American Burn Association Patient Registry. J Burn Care Rehabil, 1995;16(3 Pt 1): 219–289.
• 22. Parks J, Foster T, Hickerson W. Burn care in emergency departments: A 3-year review. J Burn Care Res 2008; 29(Suppl 2): 155.
• 23. Bjur AJ, Blayney C, Zierler B, Whitney JD, Gibran NS. Prehospital burn resuscitation. J Burn Care Res 2009; 30(Suppl 2): 89.
• 24. Rogers AD, Allorto NL, Wallis LA, Rode H. The Emergency Management of Severe Burns course in South Africa. S Afr J Surg, 2013;51(1):38.
• 25. van Olden GD, et al. Clinical impact of advanced trauma life support. Am J Emerg Med, 2004;22(7):522-5.
• 26. van Olden GD, Meeuwis JD, Bolhuis HW, Boxma H, Goris RJ. Advanced trauma life support study: quality of diagnostic and therapeutic procedures. J Trauma, 2004;57(2):381-4
• 27. Smith KK, Gilcreast D, Pierce K. Evaluation of staff's retention of ACLS and BLS skills. Resuscitation, 2008;78(1):59-65.
• 28. Ramakrishnan KM. Advanced pediatric life support in burn injuries. Indian Journal of Burns, 2013;21(1):8.
• 29. Lam NN, Huong HTX, Tuan CA. Knowledge on emergency management for burn and mass burn injuries amongst physicians working in emergency and trauma departments. Ann Burns Fire Disasters, 2018;31(2):138-143.