Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA.
Am J Surg. 2011 Jan;201(1):91-6. doi: 10.1016/j.amjsurg.2009.12.023. Epub 2010 Jun 9.
minor burns represent .96% to 1.5% of emergency department visits, yet burn center referral is common. Analysis of the Grady Memorial Hospital Burn Center was conducted to examine the feasibility and savings if burns were managed locally with consultation as needed.
data on 776 consecutive admissions to Grady Memorial Hospital Burn Center between November 2005 and July 2007 were prospectively reviewed. National and international cohorts were compared.
patients' mean age was 31 years, 69.8% were male, and 87% were insured. Thirty-nine percent were transfers. Seventy-six percent of transfers (51% of air transfers) and 70% of all admissions were for ≤ 10% total body surface area burns. Helicopter transport cost $12,500 and averaged 48 miles. Eighty percent of burns were hot water (scald), grease, or flame burns, and 31% required skin grafting.
most burns require assessment, debridement, and dressing changes. Grafting is rarely necessary. Patients are transferred because of a lack of training, and patients suffer economic burden and treatment delay. Savings could be realized were patients treated locally with select burn center referral. Video consultation and mentoring can help with triage and care of minor burns. Major burns require burn center referral. International practice reinforces these results.
轻度烧伤占急诊就诊的 0.96%至 1.5%，但烧伤中心转诊很常见。对 Grady Memorial 医院烧伤中心进行了分析，以检查如果在当地进行管理并根据需要进行咨询，是否可行并可以节省费用。
对 2005 年 11 月至 2007 年 7 月期间连续入住 Grady Memorial 医院烧伤中心的 776 名患者的数据进行了前瞻性回顾。比较了国家和国际队列。
患者的平均年龄为 31 岁，69.8%为男性，87%有保险。39%为转院。76%的转院（51%为空运转院）和 70%的所有入院均为总体表面积≤10%的烧伤。直升机运输费用为 12500 美元，平均飞行 48 英里。80%的烧伤是热水（烫伤）、油脂或火焰烧伤，31%需要植皮。
大多数烧伤需要评估、清创和换药。很少需要植皮。患者转院是因为缺乏培训，而且患者承受经济负担和治疗延迟。如果患者在当地接受选择的烧伤中心转诊治疗，可以实现节省费用。视频咨询和指导可以帮助分诊和治疗轻度烧伤。严重烧伤需要烧伤中心转诊。国际实践证实了这些结果。
