G314(P) First aid for children’s burns in the US and UK: an urgent call to establish and promote international standards

Introduction Appropriate first aid can reduce morbidity in burn. However, there is considerable variation between the international first aid recommendations. We aim to identify, and compare, first aid practices in children who present to Emergency Departments (ED) with a burn. Methods A prospective cross-sectional study in two paediatric EDs; one in the UK (Cardiff) and one in the USA (Denver, Colorado), (2015–17). Data regarding first aid practices were collected from 500 children and young people (0–16 completed years) who attended with a burn in each centre. Results Children attending hospital with a burn in Cardiff were 1.47 times more likely (RR 1.47; CI 1.36, 1.58), to have had some form of first aid than those in Denver. Denver patients were 4.7 time more likely to use a dressing and twice as likely to apply ointment/gel/aloe vera than the Cardiff cohort. 14% (72/500) of children in Cardiff and 6% (31/500) of children in Denver, received first aid consistent with their local recommendations. 27% of patients in Cardiff and 20% in Denver received potentially harmful first aid e.g. application of food, oil, toothpaste, shampoo or ice. Conclusion A very low number of children had received optimal burns first aid with potentially harmful methods applied in a considerable proportion of cases. There is an urgent need for internationally agreed, evidence-based burns first aid recommendations.