Burn care in the philippines

TEODORO J. HERBOSA, MD

Undersecretary

BURN INJURIES:

A SERIOUS PUBLIC HEALTH PROBLEM

• Globally a serious public health problem

• devastating injury

• the 4th most common type of injury worldwide

• over 195,000 deaths yearly from fires alone

• more deaths from scald, electrical burns, and other

forms of burns

• global data are not available

• Fire-related deaths rank

among the 15 leading causes

of death among children &

young adults 5-29 yrs

• > 95% of fatal burns occur in

low/middle-income countries

• < 5 yrs and elderly (> 70 yrs)

- highest mortality rates

• millions left with

disabilities &

disfigurement resulting

in stigma

• more tragic as burns

are so eminently

preventable

Source: Online Electronic Injury Surveillance System (ONEISS)

Department of Health, Philippines

Burn Injuries in 2011 peaked during the 1st Quarter of the

year and descended at the latter months

Burn injury cases peaked during months of

April to June 2012

• Significant increase in burn injury cases can be observed during the months of March and April

• significant decrease can be plotted during the months of September, October and November

Region III has the highest reported burn injury

cases followed by NCR and CAR

Most of burn injuries occur in the morning

(8AM- 12NN) and also during in the late

afternoon (4PM- 7:59PM)

Most burn injuries happens AT HOME…

Most burn injuries are unintentional/ accidental.

A higher incidence of burn injuries occur

in males than females.

Children ages 1-9 years old are more at risk to

acquire burn injuries

Hospitals with

Burn Units/ Centers

• 1. Philippine General Hospital

• 2. Jose Reyes Memorial Medical Center

• 3. East Avenue Medical Center

• 4. Southern Philippines Medical Center

• 5. Quirino Memorial Medical Center

A great number of patients who had burn injuries

were alive upon reaching the hospital

Most patients with burn injuries are treated and

sent home while some are being admitted

Most burn patients improved after treatment.

JRMMC Burn Unit Experience

• A 7-bed specialized critical care unit dedicated to

patients with acute burn injuries

• Supervised by a Burn Unit Chief who is directly

under the Chief of Section of Plastic and

Reconstructive Surgery with a Head Nurse, four

staff nurses, two nursing assistants, a plastic and

reconstructive surgery fellow and two surgical

residents

• The unit was equipped with 2 cribs, 1

bassinet for Pediatric patients and 4 adult

beds

• Baseline xrays, hematologic and chemistry

laboratory tests are done upon admission

• Close of monitoring of vital signs and fluid

balance are vital in the overall management

of patients

• Hydration and stabilization of the acutely

burned is the first priority

• Daily bedside debridements and regular

dressing changes are done within the unit

• Patients who necessitate formal

debridements under anesthesia are brought

to the Operating Room as required

• Topical skin and wound care is addressed by

application of silver sulfadiazine

(Flammazine) cream or cerium nitrate- silver

sulfadiazine and MEBO (moist exposed burn

ointment)

BURN TREATMENT • The nature and complexity of severe burn injury requires a

collaborative approach to patient care. This is provided by

a multi-disciplinary team with expertise in the management

of severe burns in a Burn Unit with supporting services

such as: critical care, surgery, reconstruction and

rehabilitation.

• Bringing together the expertise required to

coordinate clinical services across the continuum

of care - from initial hospital admission through to

hospital discharge, rehabilitation and ongoing

care.

• Sharing clinical expertise

• Developing standardized clinical practice

guidelines for patient care

• Increasing the focus on prevention, improving

links to community outreach services for patients

and undertaking research to improve patient care

END