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Published in: International Journal of Emergency Medicine 1/2017

Open Access 01-12-2017 | Original research

Operational demands on pre-hospital emergency care for burn injuries in a middle-income setting: a study in the Western Cape, South Africa

Authors: Rachel L. Allgaier, Lucie Laflamme, Lee A. Wallis

Published in: International Journal of Emergency Medicine | Issue 1/2017

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Abstract

Background

Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres, yet a well-developed pre-hospital system. This paper describes the burn cases from a viewpoint of operational factors important to pre-hospital emergency medical services.

Methods

A retrospective, cross-sectional study of administrative and patient records was conducted. Data were captured for all pre-hospital burn patients treated by public Emergency Medical Services over a continuous 12-month period. Data were captured separately at each site using a standardised data collection tool. Described categories included location (rural or urban), transport decision (transported or remained on scene), age (child or adult) and urgency (triage colour).

Results

EMS treated 1198 patients with confirmed burns representing 0.6% of the total EMS caseload; an additional 819 potential burn cases could not be confirmed. Of the confirmed cases, 625 (52.2%) were located outside the City of Cape Town and 1058 (88.3%) were transported to a medical facility. Patients from urban areas had longer mission times. Children accounted for 37.5% (n = 449) of all burns. The majority of transported patients that were triaged were yellow (n = 238, 41.6% rural and n = 182, 37.4% urban).

Conclusions

Burns make up a small portion of the EMS caseload. More burns occurred in areas far from urban hospitals and burn centres. The majority of burn cases met the burn centre referral criteria.
Literature
1.
go back to reference Goosen J, Bowley DM, Degiannis E, Plani F. Trauma care systems in South Africa. Injury. 2003;34(April):704–8.CrossRefPubMed Goosen J, Bowley DM, Degiannis E, Plani F. Trauma care systems in South Africa. Injury. 2003;34(April):704–8.CrossRefPubMed
2.
go back to reference World Health Assembly. Health systems: emergency-care systems. WHA60.22. Geneva: Sixtieth World Health Assembly; 2007 p. 21–3. World Health Assembly. Health systems: emergency-care systems. WHA60.22. Geneva: Sixtieth World Health Assembly; 2007 p. 21–3.
3.
go back to reference Mock C, Lormand J, Goosen J, Joshipura M, Peden M. Guidelines for essential trauma care. Geneva: World Health Organization; 2004. Mock C, Lormand J, Goosen J, Joshipura M, Peden M. Guidelines for essential trauma care. Geneva: World Health Organization; 2004.
4.
go back to reference Kobusingye OC, Hyder AA, Bishai D, Joshipura ERH, Mock C. Emergency medical services. In: Jamison D, Breman J, Measham A, et al., editors. Disease control priorities in developing countries. 2nd ed. Washington D.C: World Bank; 1996. p. 1261–79. Available from: http://www.ncbi.nlm.nih.gov/books/NBK11744/. Kobusingye OC, Hyder AA, Bishai D, Joshipura ERH, Mock C. Emergency medical services. In: Jamison D, Breman J, Measham A, et al., editors. Disease control priorities in developing countries. 2nd ed. Washington D.C: World Bank; 1996. p. 1261–79. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK11744/​.
5.
6.
go back to reference Western Cape Government: Health. Healthcare 2030: the road to wellness. Cape Town; 2013. Western Cape Government: Health. Healthcare 2030: the road to wellness. Cape Town; 2013.
7.
go back to reference World Health Organization. A WHO plan for burn prevention and care. Geneva: World Health Organization; 2008. World Health Organization. A WHO plan for burn prevention and care. Geneva: World Health Organization; 2008.
11.
go back to reference Blom L, van Niekerk A, Laflamme L. Epidemiology of fatal burns in rural South Africa: a mortuary register-based study from Mpumalanga Province. Burns. Elsevier Ltd and International Society of Burns Injuries; 2011;37(8):1394–402. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21855219. [cited 2014 Jul 20]. Blom L, van Niekerk A, Laflamme L. Epidemiology of fatal burns in rural South Africa: a mortuary register-based study from Mpumalanga Province. Burns. Elsevier Ltd and International Society of Burns Injuries; 2011;37(8):1394–402. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​21855219. [cited 2014 Jul 20].
14.
go back to reference Statistics South Africa. Census 2011 Municipal report-Western Cape. Pretoria: Statistics South Africa; 2012. Statistics South Africa. Census 2011 Municipal report-Western Cape. Pretoria: Statistics South Africa; 2012.
17.
go back to reference Wallis LA, Gottschalk SB, Wood D, Bruijns S, de Vries S, Balfour C. The Cape Triage Score—a triage system for South Africa. South African Med J. 2006;96(1):53–6. Wallis LA, Gottschalk SB, Wood D, Bruijns S, de Vries S, Balfour C. The Cape Triage Score—a triage system for South Africa. South African Med J. 2006;96(1):53–6.
20.
go back to reference Maritz D, Wallis L, Van Der Merwe E, Nel D. The aetiology of adult burns in the Western Cape, South Africa. Burns. 2012;38:120–7.CrossRefPubMed Maritz D, Wallis L, Van Der Merwe E, Nel D. The aetiology of adult burns in the Western Cape, South Africa. Burns. 2012;38:120–7.CrossRefPubMed
21.
go back to reference Rogers AD, Allorto NL, Adams S, Adams KG, Hudson DA, Rode H. Isn’t it time for a cadaver skin bank in South Africa? Ann Burns Fire Disasters.2013;XXVI(3):142–6. Rogers AD, Allorto NL, Adams S, Adams KG, Hudson DA, Rode H. Isn’t it time for a cadaver skin bank in South Africa? Ann Burns Fire Disasters.2013;XXVI(3):142–6.
22.
go back to reference MacFarlane C, Benn C. Evaluation of emergency medical services systems: a classification to assist in determination of indicators. Emerg Med J. 2003;20:188–91.CrossRefPubMedPubMedCentral MacFarlane C, Benn C. Evaluation of emergency medical services systems: a classification to assist in determination of indicators. Emerg Med J. 2003;20:188–91.CrossRefPubMedPubMedCentral
23.
go back to reference Stein C, Wallis L, Adetunji O. Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: more ambulances won’t help. South African Med J. 2015;105(10):840–4.CrossRef Stein C, Wallis L, Adetunji O. Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: more ambulances won’t help. South African Med J. 2015;105(10):840–4.CrossRef
24.
go back to reference Chopra M, Kettle H, Wilkinson D, Stirling S. Paediatric burns in a rural South African district hospital. South African Med J. 1997;87(May):600–3. Chopra M, Kettle H, Wilkinson D, Stirling S. Paediatric burns in a rural South African district hospital. South African Med J. 1997;87(May):600–3.
25.
go back to reference Sampalis J, Lavoie A, Williams J, Mulder D, Kalina M. Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients. J Truama. 1993;32(2):252–61.CrossRef Sampalis J, Lavoie A, Williams J, Mulder D, Kalina M. Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients. J Truama. 1993;32(2):252–61.CrossRef
26.
go back to reference Suffla S, Van Niekerk A, Duncan N. Crime, violence and injury prevention in South Africa: developments and challenges. 2004. p. 2–6. Suffla S, Van Niekerk A, Duncan N. Crime, violence and injury prevention in South Africa: developments and challenges. 2004. p. 2–6.
28.
go back to reference Bell N, Simons R, Hameed SM, Schuurman N, Wheeler S. Does direct transport to provincial burn centres improve outcomes? A spatial epidemiology of severe burn injury in British Columbia, 2001–2006. Can J Surg. 2012;55(2):110–6.CrossRefPubMedCentral Bell N, Simons R, Hameed SM, Schuurman N, Wheeler S. Does direct transport to provincial burn centres improve outcomes? A spatial epidemiology of severe burn injury in British Columbia, 2001–2006. Can J Surg. 2012;55(2):110–6.CrossRefPubMedCentral
Metadata
Title
Operational demands on pre-hospital emergency care for burn injuries in a middle-income setting: a study in the Western Cape, South Africa
Authors
Rachel L. Allgaier
Lucie Laflamme
Lee A. Wallis
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 1/2017
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1186/s12245-017-0128-9

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