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The American Burn Association (ABA) reports that nearly half a million people suffer thermal burns each year in the United States.1 According to World Health Organization estimates, as many as 265,000 people worldwide die annually from thermal burns.2 The economic burden of thermal burn injury is also substantial: In the United States in 2000, the annual direct-care cost of treating pediatric burns alone was $211 million.2 This does not take into account the economic impact of rehabilitation and long-term disability. Although efforts to prevent thermal burns through regulation and public health initiatives have reduced the incidence in developed countries, burn injuries still account for approximately 0.5% of annual emergency department (ED) visits in the United States.3 This issue of Evidence-Based Urgent Care reviews the guidelines on assessment of burns, the latest evidence on burn wound care, pain control, and the criteria for referral to specialized care.
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Following are the most informative references cited in this paper, as determined by the authors.
1. American Burn Association. Burn Incidence Fact Sheet. 2016. Accessed June 10, 2022. (Website fact sheet)
2. World Health Organization. Burns. World Health Organization; 2018. Accessed June 10, 2022. (WHO website fact sheet)
3. United States Centers for Disease Control and Prevention. National Hospital Ambulatory Medical Care Survey: 2011 Emergency Department Summary Tables. Accessed June 10, 2022. (Government survey database)
5. * Rae L, Fidler P, Gibran N. The physiologic basis of burn shock and the need for aggressive fluid resuscitation. Crit Care Clin. 2016;32(4):491-505. (Review) DOI: 10.1016/j.ccc.2016.06.001
14. * Aziz Z, Abu SF, Chong NJ. A systematic review of silver-containing dressings and topical silver agents (used with dressings) for burn wounds. Burns. 2012;38(3):307-318. (Systematic review; 14 randomized controlled trials, 877 participants) DOI: 10.1016/j.burns.2011.09.020
35. * Magnette J, Kienzler JL, Alekxandrova I, et al. The efficacy and safety of low-dose diclofenac sodium 0.1% gel for the symptomatic relief of pain and erythema associated with superficial natural sunburn. Eur J Dermatol. 2004;14(4):238-246. (Randomized double-blind single-center trial; 172 patients) PMID: 15319157
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Keywords: burn, thermal burn, superficial, first-degree burn, partial-thickness burn, second-degree burn, deep partial-thickness burn, full-thickness burn, third-degree burn, cooling, total body surface area, TBSA, silver sulfadiazine, escharotomy, scald, nonaccidental trauma, intentional injury, sunburn, topical NSAIDs, aloe vera, honey, referral criteria, burn center
Keith Pochick, MD, FACEP
Attending Physician, Urgent Care
Steven S. Wright, MD, FACEP, MS
Optum Physician Partner, Prohealth Medical Management, LLC; Assistant Professor, Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
July 1, 2022
July 1, 2025
4 AMA PRA Category 1 Credits™. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits