Hearing the signs – A multi-disciplinary approach to a 10% TBSA burn in a hearing-impaired child.
Sarah Huang1, Deborah Maze1, Ling Hoon1, Torey Lawrence1, 1Children’s Hospital Westmead, Sydney, NSW, Australia
Abstract
This presentation outlines the management of a 10-year-old girl who was admitted to the Children’s Hospital Westmead Burns service with significant flame burns of TBSA 10% to her face, airway, neck, and bilateral corneas post-exposure to accelerant in a bin fire.
Extensive communication challenges were encountered because of this child’s complex past medical background, including profound sensorineural hearing loss, cochlear implant, and mutism. This, coupled with visual impairment from her corneal burn injury, required clinicians to alter their approach to care significantly. Her usual communication strategies, such as sign language, visual aids, and her cochlear implant, could not be utilised because of her burn injury. This led to much frustration from the patient, who occasionally had to resort to aggression to communicate her needs.
During her prolonged admission of 4 months, the team faced a range of challenges across multiple domains in her care, from managing her airway burns in ICU to ongoing wound management and engagement with allied health services. To provide holistic and effective care, a collaborative and coordinated approach had to be adopted by the multi-disciplinary team, consisting of medical (burns, otolaryngology, ophthalmology, intensive care, pain service), nursing and allied health professionals. This presentation aims to summarise the numerous learning points derived from this experience, which would also be applicable to other burn patients with complex needs.
Biography
Dr Sarah Huang is a burns and plastics surgery registrar in Sydney.