title: Burns caused by medical therapy.
abstract: A burn injury may occur as an unexpected consequence of medical treatment. We examined the burn prevention implications of injuries received in a medical treatment facility or as a direct result of medical care. The records of 4510 consecutive admissions to 1 burn center between January 1978 and July 1997 were retrospectively reviewed. A cohort of 54 patients burned as a result of medical therapy was identified and stratified by location (home vs medical facility) and by mechanism of injury. Twenty-two patients were burned in a medical treatment facility, including 12 patients who were burned as a result of careless or unsupervised use of tobacco products. Thirty-two patients were burned as a result of home medical therapy, including 9 patients who had scald injuries from vaporizers, 8 patients who were burned by simultaneous use of cigarettes and home nasal oxygen therapy, and 11 patients who were burned by therapeutic application of heat. In contrast to previous studies, no patient was burned by the use of medical laser devices. To further decrease burn risk from medical therapy we advocate the prohibition of cigarette smoking in any medical facility. Continued tobacco use may represent a contraindication to home oxygen therapy. Given the lack of proof of efficacy combined with the potential for burn injury, the use of vaporizers to treat upper respiratory symptoms should be discouraged. Patients with diminished sensation or altered mental status are at increased risk of burn injury from bathing or topical heat application and merit closer monitoring during these activities.
authors.affiliation: US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Barillo
authors.forename: E C
authors.initials: EC
authors.lastname: Coffey
authors.forename: K Z
authors.initials: KZ
authors.lastname: Shirani
authors.forename: C W
authors.initials: CW
authors.lastname: Goodwin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006268:Health Facilities; D006760:Hospitalization; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D007223:Infant; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010102:Oxygen Inhalation Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking