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First aid for burns: too little, too late and often wrong

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To the Editor: The Australian and New Zealand Burns Association (ANZBA) defines adequate first aid for acute burns as 20 minutes of cold running water within the first 3 hours of a burn injury.1 Despite first aid campaigns, inappropriate and inadequate first aid treatment for burns continues to occur.2

Following Sydney Children’s Hospitals Network Human Research Ethics Committee approval, we performed a retrospective analysis of the first aid received by 4368 children who presented to the Burns Unit at The Children’s Hospital at Westmead between 1 January 2008 and 31 December 2012.

Nearly a third of children (34% of inpatients and 30% of outpatients) received inadequate, inappropriate or no first aid, irrespective of the size of the burn. Inadequate first aid included cold compresses or wet wraps in 414 children (9.5%) and Burnaid (Rye Pharmaceuticals) in 238 (5.4%). Inappropriate first aid included ice in 227 children (5.2%), with a wide range of bathroom products, foods, creams and oils used in most of the remaining patients. In 144 children (3.3%), the first aid received was not documented.