Institutional Experience Using a Treatment Algorithm for Electrical Injury.

MedStar author(s):
Citation: Journal of Burn Care & Research. 42(3):351-356, 2021 05 07.PMID: 33530107Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Firefighters' Burn and Surgical Research Laboratory | MedStar Health Research Institut | Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Algorithms | *Burns, Electric/th [Therapy] | *Outcome Assessment, Health Care | Adult | Biomarkers/me [Metabolism] | Burn Units | Burns, Electric/mo [Mortality] | Female | Health Care Costs | Hospital Mortality | Humans | Intensive Care Units/sn [Statistics & Numerical Data] | Length of Stay/sn [Statistics & Numerical Data] | Male | Patient Readmission/sn [Statistics & Numerical Data] | Retrospective Studies | Telemetry | TriageYear: 2021Local holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - presentISSN:
  • 1559-047X
Name of journal: Journal of burn care & research : official publication of the American Burn AssociationAbstract: Electrical injury has low incidence but is associated with high morbidity and mortality. Variability in diagnosis and management among clinicians can lead to unnecessary testing. This study examines the utility of an electrical injury treatment algorithm by comparing the incidence of testing done on a cohort of patients before and after implementation. Demographics, injury characteristics, and treatment information were collected for patients arriving to a regional burn center with the diagnosis of electrical injury from January 2013 to September 2018. Results were compared for patients admitted before and after the implementation of an electrical injury treatment algorithm in July 2015. There were 56 patients in the pre-algorithm cohort and 38 in the post-algorithm cohort who were of similar demographics. The proportion of creatine kinase (82% vs. 47%, p<0.0006), troponin (79% vs. 34%, p<0.0001), and urinary myoglobin (80% vs. 45%, p<0.0007) testing in the pre-algorithm cohort was significantly higher compared to post-algorithm cohort. There were more days of telemetry monitoring (median (IQR), 1 (1-5) vs. 1 (1-1) days, p=0.009) and greater ICU length of stays (4 (1-5) vs. 1 (1-1) days, p=0.009), prior to algorithm implementation. There were no significant differences in total hospital lengths of stay, incidence of ICU admissions, in-hospital mortality, or 30-day readmissions. This study demonstrates an electrical injury evaluation and treatment algorithm suggests a mode of triage to cardiac monitoring and hospital admission where necessary. Use of this algorithm allowed for reduction in testing and health care costs without increasing mortality or readmission rates. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].All authors: Johnson LS, Keyloun JW, Kolachana S, McLawhorn MM, Moffatt LT, Nisar S, Shupp JW, Travis TEOriginally published: Journal of Burn Care & Research. 2021 Feb 02Fiscal year: FY2021Fiscal year of original publication: FY2021Digital Object Identifier: Date added to catalog: 2021-02-18
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33530107 Available 33530107

Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present

Electrical injury has low incidence but is associated with high morbidity and mortality. Variability in diagnosis and management among clinicians can lead to unnecessary testing. This study examines the utility of an electrical injury treatment algorithm by comparing the incidence of testing done on a cohort of patients before and after implementation. Demographics, injury characteristics, and treatment information were collected for patients arriving to a regional burn center with the diagnosis of electrical injury from January 2013 to September 2018. Results were compared for patients admitted before and after the implementation of an electrical injury treatment algorithm in July 2015. There were 56 patients in the pre-algorithm cohort and 38 in the post-algorithm cohort who were of similar demographics. The proportion of creatine kinase (82% vs. 47%, p<0.0006), troponin (79% vs. 34%, p<0.0001), and urinary myoglobin (80% vs. 45%, p<0.0007) testing in the pre-algorithm cohort was significantly higher compared to post-algorithm cohort. There were more days of telemetry monitoring (median (IQR), 1 (1-5) vs. 1 (1-1) days, p=0.009) and greater ICU length of stays (4 (1-5) vs. 1 (1-1) days, p=0.009), prior to algorithm implementation. There were no significant differences in total hospital lengths of stay, incidence of ICU admissions, in-hospital mortality, or 30-day readmissions. This study demonstrates an electrical injury evaluation and treatment algorithm suggests a mode of triage to cardiac monitoring and hospital admission where necessary. Use of this algorithm allowed for reduction in testing and health care costs without increasing mortality or readmission rates. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].

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