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Background: Worldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pan-demic, and whether country acute accent s income, geographical location, COVID-19-transmission pat-tern, and levels of specialization of the burn units affected reallocation of resources and access to burn care.Methods: The Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, chi 2 or Fishers exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic.Results: The survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedi-cated nursing staff was reduced (< 0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration be-tween burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors.Conclusions: During the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.(c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: It is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28). Methods: This is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume (V-T) was defined as V-T = 5 cmH(2)O; 80% of patients had maximum airway pressures Funding Agencies|Nederlandse Brandwonden Stichting (the Dutch Burn Association, Beverwijk, The Netherlands)Netherlands Government

Background: It is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28). Methods: This is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume (V-T) was defined as V-T = 5 cmH(2)O; 80% of patients had maximum airway pressures

Analgesia, sedation and delirium management in adult critically ill burns: a surveyObjectivesThis study aims to assess the current practices of analgesia, sedation and delirium monitoring and treatment strategies in burn ICUs.MethodsWe designed a web survey consisting of four parts: physician and institutional demographics, management of pain, sedation and delirium in burn patients. The questionnaire was distributed by email to 230 burn specialists worldwide.ResultsPhysician and Institutional demographics.A total of 40 respondents worldwide submitted valuable data in the 2 months period, equivalent to a response rate of 16%.Of all respondents, 20 (50%) were from Europe, 7 (17.5%) from North America, 6 (15%) from Africa and 12 (30%) from other regions (including Western Pacific, Southeast Asia, Central and South Americas and Eastern Mediterranean). 20 (50%) respondents were intensivists/anaesthesists, 18 (45%) surgeons and 2 (5%) other professionals.Analgesia.The vast majority (92.5%) reported they routinely screen severe burns for pain, but 27.5% declared no specific score is used. The most popular analgesics were opioids, specifically morphine (75%) and fentanyl (72.5%). Among non-pharmacological approaches, the most used were psychological support (62.5%). Only a minority of respondents apply hypnosis (12.5%).Sedation.A significant percentage (70%) affirmed they routinely screen their patients for sedation, but 30% do not use a specific scale. The sedatives used more often were midazolam (72.5%) and propofol (55%). 20% of specialists affirmed to use dexmedetomidine frequently in their routine practice.Delirium.The majority (70%) affirmed to routinely assess burn patients for delirium, but 57.5% do not use a specific score. Burn specialists affirmed to prevent delirium in their patients combining pharmacological and non-pharmacological approaches (62.5%).ConclusionsAwareness concerning pain, sedation and delirium is increasing among burn specialists. Efforts are still needed to implement guidelines and best practices.