Burns demography and management during COVID-19 pandemic-A descriptive study

ABSTRACT

Introduction: The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus has affected many people in India in 2020. This has put a huge strain on hospitals and healthcare workers. Burn patients usually require hospitalisation and surgery, which adds to the burden of care provided by healthcare workers. Modifications in management protocol during a pandemic are of utmost importance to prevent transmission of Coronavirus Disease-2019 (COVID-19) while simultaneously treating burn patients. Aim: To study burn demography and describe changes in burn management protocol during COVID-19 pandemic. Materials and Methods: This descriptive study was done from March to July 2020, during the COVID-19 pandemic’s initial stages in India, at a tertiary care hospital in Southern India. During these months, screening protocol and guidelines for admission and testing of patients for COVID-19 were followed as given by Indian Council of Medical Research (ICMR). All burn patients who visited the hospital’s Emergency Room (ER) during this period were included in the study. Those patients whose records were incomplete were excluded from the study. Detailed documentation was done of patient’s burn history, travel history and contact history by healthcare workers wearing level 1 Personal Protection Equipment (PPE). Demographic details were collected and entered into Microsoft excel spread sheet and the percentages were calculated. Results: A total of 77 burn patients visited the ER and 44 patients required admission. A total of 22 (50%) of the admissions were children. A total of 45 patients (58.44%) had sustained scald burns, 23 patients (29.87%) sustained flame burns and nine patients (11.69%) sustained electric burns. Thirty two patients sustained burns upto 20% and 12 patients had major burns (>20%). Nine patients underwent surgery. There were two fatalities. All patients were seen by healthcare workers wearing level 1 PPE. No COVID-19 positive patient was reported during our study period. Conclusion: There was an increase in paediatric burn accidents during the COVID-19 pandemic in India due to crowded and congested homes and a lack of continuous supervision from adults otherwise occupied with work done remotely from home. It is routine practice to admit only critical burn patients or in situations where home care is not possible. Minor burns dressing must be done at home instead of;at Out Patient Department (OPD) visit. Lifesaving surgeries in children were done using live skin donor. Diagnosis, treatment, physiotherapy and follow-up of patients through tele-consultation to avoid spread of COVID-19 virus was encouraged.