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clinical skills
literature review
evidence
patient care
injury

Cooling of thermal burn injuries: a literature review

02 May 2018
Features
02 May 2018
Volume 10 · Issue 5

Abstract

Correct initial management of thermal burns is key in promoting patient outcomes. Cooling burns with cool running water (CRW) for 20 minutes has been shown to accelerate the wound healing process, improve cosmetic outcomes and prevent burn progression. This literature review aims to increase understanding of this simple first aid (FA) intervention, help inform paramedic practice, and determine areas for further research. Three themes came to light following systematic searching of the available literature. As a result of a paucity in evidence, a wide range of topics relating to cooling burns have been explored. The topics look at how patients and carers may approach FA in burns, how pre-hospital practitioners currently manage burns patients, and the best methods to use for cooling burns. Findings suggest that there is need for improved education for the lay public and pre-hospital providers in order to improve burn outcomes through FA interventions. While CRW is supported as a beneficial intervention, further research is required into alternative cooling methods to enhance care and evidence-based practice.

This literature review aims to summarise and critically appraise the relevant available evidence relating to cooling burn injuries, with a particular focus on the pre-hospital setting. The literature around knowledge and awareness of cooling, pre-hospital management of burns and the effectiveness of cooling interventions will be explored. A gap in the evidence base will direct further research needs in the field. For the purpose of this article, the term ‘burn’ will refer to thermal injuries only, owing to variations in management of burns with different pathologies.

The use of the PICO technique (O'Connor et al, 2008) determined initial keywords around the topic and further synonyms were then generated. The chosen search strategy was ‘burns AND cool* AND outcome AND pre-hospital’. These keywords were searched for in the abstracts to help refine results.

Three databases were searched in order to obtain relevant articles for the literature review. CINAHL, MedLine and PubMed were chosen for their relevance and accessibility (National Institute for Health and Care Excellence (NICE), 2017). A flow diagram detailing the search strategy can be found in Figure 1.

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Burns
Cooling
First aid
Hydrogel
Pre-hospital
Education