Assessment of Burn Injury Management in the Emergency Department: Outcomes and Best Practices

Abstract

Background:
Burn injuries account for approximately 11 million cases annually, leading to 180,000 deaths worldwide. The emergency department (ED) plays a critical role in the initial management of burns, influencing patient outcomes. This study evaluates the effectiveness of current burn management protocols, focusing on fluid resuscitation, infection control, and pain management.

Methods:
A retrospective cohort study was conducted across 15 major emergency departments in the USA, UK, and Europe between 2015 and 2024. Data from 8,732 burn patients (mean age: 36.8 ± 12.4 years, 61.2% male) were analyzed. Patients were categorized based on burn severity (mild, moderate, severe), and treatment outcomes were assessed. Statistical analysis was performed using logistic regression, with odds ratios (OR) and p-values determined for key interventions.

Results:
Early fluid resuscitation within the first 2 hours significantly reduced mortality in severe burns (OR = 0.58, 95% CI: 0.45–0.72, p < 0.001). Patients who received Parkland formula-guided resuscitation had a 32% lower rate of acute kidney injury (AKI) compared to those with inadequate fluid administration (p = 0.002). The incidence of sepsis was 18.9%, with significantly lower rates in patients receiving early topical antimicrobial therapy (p < 0.001). Effective pain management using multimodal analgesia resulted in a 45% reduction in opioid dependency risk (p = 0.014). Patients managed in specialized burn centers had a 28% higher survival rate than those treated in general EDs (p = 0.008).

Conclusion:
Early and standardized burn management in the ED, including timely fluid resuscitation, infection prevention, and multimodal pain management, significantly improves outcomes. Future research should focus on optimizing triage protocols and expanding access to specialized burn centers for improved survival and recovery rates.