title: Disposition of children with burns in emergency departments in Île de France.
abstract: The majority of burn injuries are managed by emergency departments (EDs), which are the pivotal axis in patient assessment. The aim of this study was to investigate the discharge destination of children with burn injuries presenting to EDs in Île de France. Therefore, a postal questionnaire was sent to 91 EDs. The number of children with burns and their discharge status after passing through the ED in 2005, as well as the clinical positions of practitioners involved, the discharge destination of children, and the conditions resulting in a transfer to a burn center were assessed. Forty-six EDs replied to the questionnaire. Pediatric burns corresponded to 0.63% of pediatric visits in EDs. The rates of admission (7.8%) and transfer (1.9%) were low. Larger EDs had a higher admission rate and a lower rate of transfer. The need for advice from a burn center remained constant as well as the transfer rate to a burn center (both around 14%), irrespective of the size of the ED. Reasons for transfer agreed with data in the literature. More than 3200 children were registered with burns in half of the region's EDs during 2005. The majority of burns were not severe, as demonstrated by the low number of admissions and transfers, and most children were cared for locally in nonspecialized settings. Nevertheless, the relationship between burn centers and all EDs, not just the large one, needs to be strengthened to improve the quality of care given to these children.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées du Val de Grâce, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Tourtier
authors.forename: Laurent
authors.initials: L
authors.lastname: Raynaud
authors.forename: Olivier
authors.initials: O
authors.lastname: Gall
authors.forename: Isabelle
authors.initials: I
authors.lastname: Murat
mesh_terms: D000367:Age Factors; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004638:Emergency Treatment; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D020380:Needs Assessment; D010343:Patient Admission / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000458:organization & administration; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data; D058996:Quality Improvement; D018570:Risk Assessment; D011795:Surveys and Questionnaires