Chan Rayleigh, Van Slyke Aaron C, Bucevska Marija, Verchere Cynthia
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Co-First Authors, contributed equally to this work.
Plast Surg (Oakv). 2019 Nov;27(4):305-310. doi: 10.1177/2292550319876663. Epub 2019 Sep 22.
The burn treatment room at our tertiary-care centre is run by a multidisciplinary team, providing care to primarily burn patients who require moderate to deep sedation to undergo dressing changes in a monitored setting outside the operating room. There is little literature on the safety, efficacy, and logistics of treating outpatient pediatric burn patients in this manner. This study reviews the safety of deep sedation in the burn treatment room.
A retrospective chart review of patients with burns treated in the burn treatment room from 2013 to 2015 was conducted. Patient demographics, diagnosis, procedure details, sedation, and adverse events were recorded. Data were analyzed descriptively.
Sevety-four patients with burns had a total of 308 visits in the burn treatment room for burn bath and/or dressing changes. Scald burns were the most common mechanism of injury (n = 56). Most burns were superficial and mid-dermal (54%), initially estimated at 5% to 10% TBSA (50%). Of the 308 visits, 304 required sedation. Adverse events were recorded in 11 (3.6%) of 304 sedated procedures. None of these events were critical: 7 patients required intravenous conversion due to inadequate oral sedation, 2 experienced brief apnea episodes but recovered spontaneously, and 2 had delayed discharge of more than 2 hours due to residual sedation.
The burn treatment room is a safe and effective setting for treating pediatric burn patients, bypassing what might historically require operating suite inpatient management.
我们三级护理中心的烧伤治疗室由一个多学科团队管理，主要为那些需要中度至深度镇静以便在手术室以外的监测环境中进行换药的烧伤患者提供护理。关于以这种方式治疗门诊儿科烧伤患者的安全性、有效性和后勤保障方面的文献很少。本研究回顾了烧伤治疗室中深度镇静的安全性。
对2013年至2015年在烧伤治疗室接受治疗的烧伤患者进行回顾性病历审查。记录患者的人口统计学资料、诊断、操作细节、镇静情况和不良事件。对数据进行描述性分析。
74例烧伤患者在烧伤治疗室共接受了308次烧伤浴和/或换药。烫伤是最常见的受伤机制（n = 56）。大多数烧伤为浅度和中深度（54%），最初估计体表面积为5%至10%（50%）。在308次就诊中，304次需要镇静。在304次镇静操作中，有11次（3.6%）记录到不良事件。这些事件均不严重：7例患者因口服镇静不足需要改为静脉给药，2例出现短暂呼吸暂停发作但自行恢复，2例因镇静残留导致出院延迟超过2小时。
烧伤治疗室是治疗儿科烧伤患者的一个安全有效的场所，无需像以往那样在手术室进行住院管理。
