Translating science into burns first aid practices:
“Sometimes I have believed as many as six impossible things before breakfast”

Yvonne Singer^1,2, Victor Joe⁴, Tina Palmieri³, Maleea Holbert², Kevin Mackey⁵, Roy Kimble⁷, John Rose⁶, Bronwyn Griffin²,
¹Victorian Adult Burn Service, Prahran, Victoria , Australia
²Griffith University, Nathan, Queensland, Australia
³Firefighters Burn Institute Burn Center at the University of California Davis, Davis, California, United States
⁴UC Irvine Health Regional Burn Center, Orange, California, United States
⁵Sacramento Fire Department, Sacramento, California, United States
⁶Emergency Dept, UC Davis Medical Centre, Davis, California, United States
⁷Burns and Trauma at the Queensland Children’s Hospital., Brisbane, Queensland, Australia

Abstract

There is substantial evidence demonstrating 20 minutes of cool running water applied within three hours of burn injury (20CRW) improves patient outcomes including reduced time to wound re-epithelialisation and odds of requiring skin grafting or hospitalisation. The real-world advantages of 20CRW are that’s it’s largely accessible, cost effective, and in and of itself, simple to administer.

So, why don’t clinicians and the public administer 20CRW first aid as much as the professional burns’ community want them to? Gaps in knowledge and lack of consensus regarding burns first aid recommendations are well described in the literature. Improving knowledge of 20CRW evidence and/or embedding it into organisational protocols seems not enough to change practices.

This challenge is not unique to burns care. The 17-year translation ‘gap’ between scientific discoveries and patient care is widely acknowledged. Much scientific research remains relegated to the “valley of death” and only a small percentage of evidence finds its way to the patient. This presentation takes a multidimensional view of 20CRW at the intersection of patient care, traditional, implementation and complexity sciences. It unpacks the interconnected and complex human, social, environmental and organisational factors that influence human decisions about burns first aid. These include access to water, cultural beliefs, the environments where people are injured, and the complexity of health systems that treat them. All are unique to each setting. Even the pickle juice….

This presentation may broaden perspectives and possibilities about ways we can facilitate the sustainable uptake of 20CRW evidence into burns first aid practices.

Biography

Yvonne works part time as the Quality Program Coordinator at the Victorian Adult Burn Service, and is completing her PhD through Griffith University. Yvonne’s PhD research work will contribute to an implementation science research project funded by the US Department of Defence to translate 20 minutes of cool running water (within three hours of injury) scientific evidence into clinical practices of Sacramento County Emergency Medical Services and the UC Davis Medical Centre Emergency Department.