Ross Erin E, Coulourides Kogan Alexis, Johnson Maxwell B, Yenikomshian Haig A
Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Department of Gerontology, University of Southern California, Los Angeles, CA 90033, USA.
J Burn Care Res. 2025 Mar 4;46(2):425-429. doi: 10.1093/jbcr/irae183.
People experiencing homelessness are at increased risk for serious burn injuries and face additional barriers to care such as inability to perform wound care and difficulty with follow-up. Although not burn-specific, street medicine (SM) programs provide direct medical care to people experiencing unsheltered homelessness in their own environment and may be well positioned to bridge this gap in burn care for this population. We conducted a cross-sectional survey to characterize the burn care experience of SM teams with providing burn care for people experiencing homelessness. The 60 respondents included 18 (30%) physicians, 15 (25%) nurse practitioners or physician assistants, 15 (25%) registered nurses, 6 (10%) medical students, and 6 (10%) other team members. The most common reported barriers to care were prior negative experiences with emergency departments, and transportation to burn centers. There was regional variability in frequency of providing burn care, which was reflected in respondent comfort with assessing and treating burns. Burns were most often dressed with daily dressings such as a non-adherent dressing over silver sulfadiazine or bacitracin. Silver-based contact dressings were rarely used. Street medicine teams in the United States are treating burn injuries among people experiencing homelessness, though management practices and experience treating burns was variable. As SM programs continue to grow, burn-related education, training, and connections to local burn centers for team members is important. Through strengthened partnerships between burn centers and street medicine teams, these programs may be well positioned to bridge the gap in burn care for people experiencing homelessness.
无家可归者遭受严重烧伤的风险增加，并且在获得治疗方面面临额外障碍，例如无法进行伤口护理以及难以进行后续跟进。虽然并非专门针对烧伤治疗，但街头医学（SM）项目在无家可归者所处的自身环境中为他们提供直接医疗服务，可能非常适合弥补这一人群在烧伤护理方面的差距。我们开展了一项横断面调查，以描述SM团队为无家可归者提供烧伤护理的经历。60名受访者包括18名（30%）医生、15名（25%）执业护士或医师助理、15名（25%）注册护士、6名（10%）医学生以及6名（10%）其他团队成员。报告中最常见的护理障碍是既往在急诊科的负面经历以及前往烧伤中心的交通问题。提供烧伤护理的频率存在地区差异，这反映在受访者对评估和治疗烧伤的舒适度上。烧伤最常采用每日换药的方式，例如在磺胺嘧啶银或杆菌肽上覆盖一层不粘连敷料。很少使用含银接触敷料。美国的街头医学团队正在治疗无家可归者中的烧伤患者，不过烧伤管理实践和治疗经验存在差异。随着SM项目的不断发展，为团队成员提供与烧伤相关的教育、培训以及与当地烧伤中心建立联系非常重要。通过加强烧伤中心与街头医学团队之间的伙伴关系，这些项目可能非常适合弥补无家可归者在烧伤护理方面的差距。
