Wilson J J, Awad L, Allison K
James Cook University Hospital, Middlesbrough, UK.
Ann Burns Fire Disasters. 2023 Dec 31;36(4):276-280. eCollection 2023 Dec.
A review of paediatric burns in our burns facility in the United Kingdom demonstrated variable accuracy of size, and a majority documented as <1% total body surface area (TBSA). Accurate assessment is important for medical records, clinical management and non-accidental injuries. We propose to assess burn size with a coin-based system, where small burns are described by single/multiple sterling coins. Participants were asked about their confidence in evaluating small paediatric burns. Participants were given ten scenarios which included photographs of paediatric patients with small burns. They were asked to assess burn size in their normal manner (TBSA, measurement) and with a coin-based system. The 'burns' were drawn on children based on a given coin size and percentage so that the accuracy of the participant's answer was quantifiable. Participants provided qualitative feedback in a questionnaire on the coin-based system. Thirty nurses and medical staff of varying seniority actively involved in referral/management of paediatric burns took part, creating over 300 responses. In preliminary questions, 66% of participants did not feel confident in estimating paediatric burns and 83% needed to refer to a paediatric burns chart. Accuracy of burn size using TBSA and the coin-based system was 45% and 67%, respectively. The majority (97%) stated estimating size was easier, and 93% found it more accurate. A total of 87% found communication between colleagues easier. Results highlight the improved assessment of small burns in our hospital using a coin-based approach in comparison to TBSA, and could facilitate accurate communication between health care professionals.
对英国我们烧伤治疗机构的小儿烧伤情况进行的一项回顾显示，烧伤面积评估的准确性参差不齐，大多数记录的烧伤面积小于总体表面积（TBSA）的1%。准确评估对于医疗记录、临床管理以及判断非意外伤害至关重要。我们建议采用一种基于硬币的系统来评估烧伤面积，其中小面积烧伤用单枚/多枚英镑硬币来描述。研究人员询问了参与者对评估小儿小面积烧伤的信心。向参与者展示了十个场景，其中包括小儿小面积烧伤患者的照片。要求他们以常规方式（TBSA、测量）以及基于硬币的系统来评估烧伤面积。根据给定的硬币尺寸和百分比在儿童身上绘制“烧伤”情况，以便能够量化参与者答案的准确性。参与者通过一份关于基于硬币系统的问卷提供了定性反馈。30名不同资历、积极参与小儿烧伤转诊/管理工作的护士和医务人员参与了研究，共产生了300多个回复。在初步问题中，66%的参与者对估计小儿烧伤面积没有信心，83%的人需要参考小儿烧伤图表。使用TBSA和基于硬币的系统评估烧伤面积的准确率分别为45%和67%。大多数人（97%）表示估计面积更容易，93%的人认为这样更准确。共有87%的人发现与同事之间的沟通更容易了。结果表明，与TBSA相比，我们医院采用基于硬币的方法对小面积烧伤的评估有所改进，并且有助于医护人员之间进行准确的沟通。
