Twenty minutes of cool running water burn first aid: a systematic review and meta analysis.

Bronwyn Griffin¹, Cara Joyce Caliban³, Grace Xu¹, Bassel Ayoub⁵, Roy Kimble^1,2, Tina Palmieri⁴, Yvonne Singer⁶,
¹Griffith University, South Brisbane, Qld, Australia
²Queensland Children’s Hospital, Brisbane, QLD, Australia
³Princess Alexandra Hospital, Brisbane, Queensland, Australia
⁴UC Davis, Sacramento, California, United States
⁵Mildura Hospital, Mildura, Victoria, Australia
⁶Alfred Hospital, Melbourne, Victoria, Australia

Abstract

Introduction
Burn injuries are a leading cause of morbidity that can result in devastating disability and poor quality of life for survivors. This systematic review aimed to synthesise evidence regarding the effect of 20 minutes of cool running water within three hours of injury (20CRW) on outcomes of patients with thermal burn injuries.

Methods:
This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Multiple databases and the Australia New Zealand Clinical Trial Registry were searched for eligible studies published in English and Chinese, without date restriction. Meta-analyses were undertaken. Methodological quality of studies was assessed using Downs and Black Checklist.

Results:
Of 323 records, seven studies were included, with a combined study population of 11,383 patients. The majority (67%) of studies were conducted in Australia and New Zealand. The methodological quality was ranked between ‘fair’ and ‘good’. Approximately half of the population (n=5782 [50.8%]) received (20CRW). Patients who received (20CRW) had significantly decreased odds of requiring skin grafting or other surgical intervention when compared to patients who did not receive 20CRW.

Conclusions:
There is considerable evidence demonstrating the association between the application of 20CRW and improved outcomes for patients with burn injury. Burns first aid guidelines needs global standardisations. Greater understanding of the barriers and enablers to translating 20CRW evidence into clinical practice is required. Clinical decisions are influenced by knowledge and skills, but also organisational, environmental and situational conditions clinicians work in.

Biography

Bron is an Associate Professor with the School of Nursing and Midwifery at Griffith University and the Pegg Leditschke Children’s Burn Centre at Queensland Children’s Hospital. With clinical experience across multiple Australian paediatric hospitals, she focuses her research on generating evidence-based practice and knowledge translation. Most recently she has been awarded a US Department of Defense and NHMRC Partnership Project translating evidence-based practice into routine care.