New Report Calls for Major Change in Approach to Pre-Hospital Burn Care
Saving Lives is Not Enough: A casualty-centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors
A new report calling for major changes in the way in which the emergency services handle pre-hospital burn care was launched today at The Emergency Services Show at the NEC in Birmingham. Co-authors of the report, Saving Lives is Not Enough – David Wales, International Research Lead for the National Fire Chiefs Council and Kristina Stiles, Head of Clinical Services, The Katie Piper Foundation – presented their recommendations to an audience of emergency responders in the Lessons Learnt seminar theatre at the Show.
The Saving Lives is Not Enough report identifies that 999 call handlers and fire fighters are ideally placed to play a crucial part in the early management of burn-injured casualties and sets out ten recommendations for improving their pre-hospital care, experience and outcomes.
David Wales explained: “The Fire and Rescue Service (FRS) has a long and proud tradition of saving lives from the risk of harm posed by fire. Traditionally, its role has been to remove casualties from a fire scene and then, as soon as possible, hand them over to the Ambulance Service or other first responders to administer medical care whilst FRS resources return to fire- fighting in order to limit property damage.
“This is clearly an essential and valuable contribution but, arguably, has encouraged greater attention on property rather than people, whereas the opposite approach is taken to Road Traffic Collisions. It could also be considered as a narrow interpretation of what ‘saving lives’ means, in that it does not fully recognise potential long-term risks and consequences.”
Kristina Stiles said that the report aimed to build a complete end-to-end picture of the burn survivor experience and enhance collaboration between all agencies involved: “The burn survivor’s journey begins at the time of injury. Each service, each point of contact, each intervention leaves a trace on the burn survivor that will only become evident hours, days or even months later. Each action and inaction have the potential to make a difference and will directly impact burn survivor’s outcome and quality of life.
“Survival following burn injury has significantly improved, particularly in first world regions like the UK, and it is timely that attention needs to turn outwards to focus on quality of life outcomes following survival. For many years the business sector has understood the importance of ‘customer experience’. Co-design approaches originated from the business world are now finding their way into all walks of life, including health. Stakeholder groups responsible for the care of the burn injured at various stages of their journey are called upon to join together to share knowledge, overcome barriers that affect the movement of knowledge across and between professional groups, and innovate.”
Recommendations in the report focus on the following elements:
- Use the 999 call to manage casualties during the pre-attendance period
- Use an evidence-based model to improve search and rescue tactics
- Develop the ability to protect casualties from first contact
- Recognise that age matters
- Assess the benefit of fully cooling burns prior to removal from fire ground
- Develop a water strategy for the optimal cooling of burns
- Attend burn and scald only incidents to provide first aid
- Communicate circumstances of burn injury to clinical care providers
- Assess the influence of FRS actions and terminology on psychosocial recovery
- Introduce a customer reported experience and outcome framework
The full report can be downloaded here.