LAUSR

Aims Analysis of paediatric burns, presentation, management and outcomes in an urban Accident and Emergency over the course of six months. Methods The audit was undertaken in partnership with the paediatric social work department. Data on all presentations in a six month period (1/10/2017–31/03/2018) with a discharge diagnosis of burn or scald were included in the study. Data was collected on time and date of presentation, outcome of presentation from both a medical and social work point of view, medical and social work follow up arrangements including tertiary plastic team referral. Results 70 cases were recorded. 66% (n=46) of patients were under the age of 5 years old, with a mean age of 4.6 years overall. 49% of cases presented between the hours of 6pm and 12am. In total 31 patients were referred to a tertiary centre for plastic surgery input: 24/31 (77%) were referred non-urgently for next morning review and 7/31 (23%) were transferred to the tertiary centre for same day review. 36/70 (51%) received treatment from a nurse lead dressing clinic. Of these 3 (4%) were subsequently referred onward for plastic surgery input. During the time of the audit, all children under the age of 5 years (n=46) were referred for social work review as a matter of routine. There were 52/70 (74%) referrals to the social work department in the hospital, but only one case was referred on to Child protection services and the police. Of these referrals, 7/52 (14%) had concern from a social protection point of view identified in the attendance documentation. In the equivalent six months of the previous year there was only a single case of a child presenting with a burn who was referred for initial social work review. Conclusion This audit demonstrated that the imposing a blanket referral policy to social work for children with burns will increase the awareness of risk factors for child protection and result in improved multiagency assessment.