Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA.
Am J Surg. 2011 Dec;202(6):802-8; discussion 808-9. doi: 10.1016/j.amjsurg.2011.06.036. Epub 2011 Oct 10.
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 examined the feasibility and savings if pediatric burns were managed locally with as-needed consultation.
Prospective data on 219 consecutive admissions to Grady Memorial Hospital Burn Center between December 2008 and September 2010 were reviewed. National and international cohorts were compared.
Sixty-six percent of patients were male, the mean age was 6.1 years, and 92% were insured. The most common mechanism of burning was liquid scalding (40%). Seventy percent had burns over <10% of the total body surface area, and 73% of all pediatric admissions healed without surgery. Thirty-six percent were discharged within 24 hours of admission. Forty-five percent of patients transferred from other facilities were discharged within 24 hours. Fifteen percent were transported by helicopter; of those, 37% were discharged within 24 hours. Helicopter transport cost $12,500 and averaged 45 miles.
Pediatric 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.
轻度烧伤占急诊就诊人数的 0.96%至 1.5%，但烧伤中心转诊很常见。对 Grady Memorial 医院烧伤中心的分析研究了如果对儿科烧伤进行局部处理并按需咨询，是否可行以及是否可以节省费用。
对 2008 年 12 月至 2010 年 9 月期间 Grady Memorial 医院烧伤中心连续收治的 219 例患者进行了前瞻性数据分析。比较了国内和国际队列。
66%的患者为男性，平均年龄为 6.1 岁，92%有保险。最常见的烧伤原因是液体烫伤（40%）。70%的患者烧伤面积小于 10%的总体表面积，73%的所有儿科患者无需手术即可治愈。36%的患者在入院 24 小时内出院。从其他机构转来的 45%的患者在 24 小时内出院。15%的患者用直升机运送；其中 37%的患者在 24 小时内出院。直升机运送费用为 12500 美元，平均距离为 45 英里。
儿科烧伤需要评估、清创和换药。植皮很少需要。患者转院是因为缺乏培训，患者遭受经济负担和治疗延迟。如果选择烧伤中心转诊，对患者进行局部治疗，可以节省费用。
