BURNS IN THE DISABLED

A retrospective analysis of 812 patients admitted to the Ross Tilley B urn Centre between 1984 and 1992 resulted in 37 cases of burn injuries which were directly related to premorbid disabilities. The majority o f these burns (83.8 per cent) occurred in the patient's home, most com monly as scald injuries in the bath tub, the shower, or following hot water spills. Nineteen patients were male, 17 were female. The median age was 58 years. Six patients had spinal card disorders: four had tra umatic cord damage, two had spina bifida. Six patients had seizure dis orders. Five of these patients had been taking antiseizure medications , but all had subtherapeutic blood levels on admission to hospital. Tw o patients had diabetes mellitus with peripheral neuropathies. Thirtee n patients had four miscellaneous neurological disorders, including. t ardive dyskinesia (two), CVA (four), Parkinson' s disease (two), Alzei mer's disease (two), cerebral palsy (one), multiple sclerosis (one) an d blindness (one). Three patients had a diagnosis of syncope. Two pati ents had emphysema, and four were morbidly obese. The average length o f stay (LOS) for the disabled patients was 2 7 6 days for a median bur n size of 10 per cent body surface area (BSA), compared to an average LOS for the general population of 25.7 days for a larger median burn s ize of 21 per cent BSA. The mortality rate was also much higher in the disabled population (22.2 per cent vs 6.0 per cent). Most of these bu rn injuries were preventable. A series of burn prevention guidelines i s presented, in an attempt to reduce the incidence of these burn injur ies in disabled patients.