Rajpura Arif
South Lancashire Health Authority, Grove House, Langton Brow, The Green, Eccleston, Lancashire, UK.
Burns. 2002 Mar;28(2):131-4. doi: 10.1016/s0305-4179(01)00086-9.
Prevention is by far the best strategy to minimise the burden of burns and smoke inhalation injuries on public health. However, it is inevitable that some injuries will occur despite the best attempts to prevent them. We must, therefore, optimise treatment in order to restore individuals to the best possible condition. Previous experience has shown that a wide range of specialties, many of which are untrained in burn care medicine, are involved in the care of inpatient burns/smoke inhalation victims in the UK. In light of this, a local review of which specialties care for such injuries was conducted for the population of Lancashire and South Cumbria in the north-west of England. Using population-based health authority data from 1997 to 1999, all Hospital Episodes relating to a primary diagnosis of burns or smoke inhalation were ascertained. The results showed that 41% of all burns episodes were treated by specialties other than burns/plastics. The short lengths of stay in non-plastics/burns specialties suggest that relatively minor injuries are being admitted to these units. Analysis of smoke inhalation injuries showed admission to various different specialties. Admission to burn services ensures that key specialties are available for the care of complex burn injuries. These multidisciplinary teams include burn nurses, burn surgeons and burn anaesthetists/intensivists. From the data available, it was not possible to assess the appropriateness of admission of burns and smoke inhalation injuries to the various branches of medicine. In order to assess appropriateness, we need information on severity of injury and outcome of treatment in each specialty. Further research in this area is required since it is concerning that many burns/smoke inhalation injuries are being treated by specialties with no formal training in burn care medicine. This may have major implications for service planning alongside changes in referral patterns.
预防是将烧伤和吸入性损伤对公众健康造成的负担降至最低的最佳策略。然而，尽管已竭尽全力预防，但仍不可避免会发生一些损伤。因此，我们必须优化治疗，以使患者恢复到尽可能好的状态。以往经验表明，在英国，众多专科参与了住院烧伤/吸入性损伤患者的护理工作，其中许多专科并未接受过烧伤护理医学方面的培训。鉴于此，针对英格兰西北部兰开夏郡和南坎布里亚郡的人群，对护理此类损伤的专科进行了一项本地调查。利用1997年至1999年基于人群的卫生当局数据，确定了所有与烧伤或吸入性损伤的初步诊断相关的医院诊疗记录。结果显示，所有烧伤病例中有41%是由烧伤/整形外科以外的专科治疗的。非整形外科/烧伤专科的住院时间较短，这表明相对较轻的损伤被收治到了这些科室。对吸入性损伤的分析表明患者被收治到了各种不同的专科。收治到烧伤专科服务机构可确保关键专科能够为复杂烧伤损伤的护理提供支持。这些多学科团队包括烧伤护士、烧伤外科医生和烧伤麻醉师/重症监护医生。根据现有数据，无法评估烧伤和吸入性损伤收治到各个医学分支科室的合理性。为了评估合理性，我们需要了解每个专科的损伤严重程度和治疗结果的信息。该领域需要进一步研究，因为令人担忧的是，许多烧伤/吸入性损伤正由未接受过烧伤护理医学正规培训的专科进行治疗。这可能会对服务规划以及转诊模式的变化产生重大影响。
