Dinesh Anant, Polanco Thais, Khan Khuram, Ramcharan Alexius, Engdahl Ryan
Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York.
Department of Surgery, Division of Plastic and Reconstructive Surgery, Harlem Hospital Center, Columbia University, New York, New York.
J Burn Care Res. 2018 Oct 23;39(6):995-999. doi: 10.1093/jbcr/iry026.
Pediatric burns in the urban environment present special problems. Communities in the inner-city may be unique with hardships due to various socioeconomic factors. Few, if any, papers have specifically sought to analyze pediatric burns in the inner-city, and there has been no report to date reviewing Harlem New York City, one of the most challenged areas in the nation. The aim of this study is to understand the prehospital circumstances and socioeconomic factors of affected patients, hospital care, and management of pediatric patients admitted with burns in Harlem. A retrospective review was performed of all the patients aged 0 to 18 years old admitted to the burn care unit from January 2006 to May 2017. Data collected included age, gender, ethnicity, burn mechanism, total burn surface area, first aid and management, socioeconomic factors including parental supervision, single or binary parenting, caregiver financial and employment status, New York City Administration for Children's Services (ACS) child protective services reporting for child abuse or neglect. Analysis was done using Microsoft Excel 2016 and SPSS statistics v23. A total of 177 pediatric burn patient admissions were included. The majority of the patients were toddlers (1-5 years of age). The most common type was scald burns. The average TBSA burnt was approximately 9%. Nearly all the injuries occurred at home with more being during winter months. Strikingly, the majority of patients, over 75%, did not receive appropriate first aid measures. Moreover, socioeconomic issues were significant with 60% of patients having single parents, approximately 35% with lack of supervision and neglect or abuse reported in 25% of these cases. Unemployment rate of the caregiver was high, with 50% unemployed or in between jobs. In 73% of the patients, their parents were receiving some form of social aid for childcare and sustenance of family needs. Pediatric burns are a major public health issue. An understanding of community variations with these injuries is essential taking into account socioeconomic challenges that these children face. Our inner-city hospital pediatric burn admissions have substantial caregiver and socioeconomic challenges in excess of traditionally reported in the literature. Most injuries occurred at home and the majority lacked proper prehospital first aid care. This analysis is informative, providing professionals and caregivers topics of consideration regarding safe practices at home, appropriate first aid measures, prevalent socioeconomic issues in our community in Harlem. There is a need to address socioeconomic factors which may potentially prevent pediatric burn admissions in these inner-city communities.
城市环境中的小儿烧伤存在特殊问题。市中心的社区可能因各种社会经济因素而面临独特的困难。很少有论文专门分析市中心的小儿烧伤情况，迄今为止也没有关于纽约市哈莱姆区（美国最具挑战性的地区之一）的相关报告。本研究的目的是了解哈莱姆区烧伤患儿的院前情况、社会经济因素、医院护理及管理情况。对2006年1月至2017年5月间收治于烧伤护理病房的所有0至18岁患者进行了回顾性研究。收集的数据包括年龄、性别、种族、烧伤机制、烧伤总面积、急救与处理情况、社会经济因素，如父母监管情况、单亲或双亲养育情况、照顾者的经济和就业状况、纽约市儿童服务管理局（ACS）关于虐待或忽视儿童的儿童保护服务报告。使用Microsoft Excel 2016和SPSS统计软件v23进行分析。共纳入177例小儿烧伤患者。大多数患者为幼儿（1至5岁）。最常见的烧伤类型是烫伤。平均烧伤总面积约为9%。几乎所有损伤都发生在家中，且更多发生在冬季。令人惊讶的是，超过75%的患者未接受适当的急救措施。此外，社会经济问题显著，60%的患者为单亲家庭，约35%的患者缺乏监管，其中25%的病例报告存在忽视或虐待情况。照顾者的失业率很高，50%处于失业状态或处于工作转换期间。73%的患者父母接受某种形式的社会援助以照顾孩子和维持家庭需求。小儿烧伤是一个重大的公共卫生问题。考虑到这些儿童面临的社会经济挑战，了解这些损伤在社区中的差异至关重要。我们市中心医院收治的小儿烧伤患者在照顾者和社会经济方面面临的挑战远超传统文献报道。大多数损伤发生在家中，且大多数患者缺乏适当的院前急救护理。该分析提供了有用信息，为专业人员和照顾者提供了关于家庭安全做法、适当急救措施以及我们哈莱姆社区普遍存在的社会经济问题等方面的思考主题。有必要解决可能潜在预防这些市中心社区小儿烧伤入院的社会经济因素。
