Audit of protocols for treatment of paediatric burns in emergency departments in the Île de France.
BACKGROUND
The main purpose of this study was to establish the existence and accuracy of protocols for treatment of children with burns in emergency departments (EDs) across the Île de France. In addition, we also analysed the incidence of paediatric burns.


METHODS
A postal questionnaire was sent to 91 EDs in the Île de France. Data collected were: number of children with burns in 2005, the absence or presence of specific written protocols. The ED was asked to send a copy of the protocol for analysis.


RESULTS
Forty-six EDs (50.5%) replied to the questionnaire. These EDs treated a total of 3258 children with burns, corresponding to 0.63% of paediatric pathologies in EDs. Amongst responding EDs, 48% had specific written protocols for the management of children with burns (but only in the larger EDs: >10000 patient visits/year). A written protocol for managing pain in children was present in 65% of cases. For analgesia, 80% used oxygen/nitrous oxide. Concerning second-step analgesics, six EDs 67% used a combination of paracetamol/codeine and only 22% used non-steroidal antiflammatory drug. Regarding third-step analgesics, 67% used nalbuphine while only 43% used morphine.


CONCLUSIONS
3,200 children were registered with burns in half of the region's EDs during 2005 (0.63% of paediatric consultations). The larger the ED the higher was the availability of specific written protocols. International recommendations appeared to be respected concerning dressings, management of pain being marked by an under-utilisation of morphine.
Tourtier
J-P
JP
Military Hospital VAL-DE-GRACE, Department of Anesthesia and Intensive Care, 74 boulevard port royal, Paris 75005, France. jeanpierre.tourtier@free.fr
Raynaud
L
L
Murat
I
I
Gall
O
O
D002056:Burns / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D054869:Clinical Audit; D002985:Clinical Protocols; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D019035:Rural Health Services / Q000592:standards; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000592:standards