Background: The extent of pre-hospital medical care (PHMC) given to burned patients affects both the patient's condition and the effectiveness of treatment.
Objectives: To improve the quality of PHMC of burns in children, based upon an analysis of the selected parts of pre-hospital medical records, with particular emphasis on analgesia.
Material and methods: Medical records were used to analyze how PHMC was given to 117 burned children aged 0-18 years, treated at the Pediatric Surgery Ward between January 1, 2014 and December 31, 2017.
Results: In 41/85 cases, PHMC was delivered by Emergency Medical Teams (EMTs), in 42 in Emergency/Admission Rooms (ARs) and in 2 by Primary Health Care (PHC). Monotherapy was predominant. Medical records from ARs included the following information: the administration of analgesics with the name in 95% (21) of the cases, the route of drug administration in 45% (10), insertion of intravenous access and dressing in 33% (14), and fluid transfusion in 43% (6) cases. The way in which the EMTs provided assistance was described in 34% (14/41) of medical records, the administration of analgesics in 86% (12) cases, cooling and dressing in 43% (6), and the establishment of intravenous access with fluid transfusion in 36% (5) cases.
Conclusion: In burned children, access to analgesic and combined pain therapy is still random, limited and deviates from current recommendations. Prior to the admission to the ward, pain relief with 1 agent administered rectally prevails. There is a need to standardize the procedures for pre-hospital medical assistance provided to burned children, including the method of pain management in line with the Polish recommendations. It is necessary to make the medical staff aware of the obligation to keep medical records in a reliable and legal manner.
Keywords: burn; child; pain; pre-hospital care.