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Reaching Out to Teach
The Burn Center is educating other hospital emergency departments about specialized treatment.

blank Carrie Cox reviews burn care at a recent burn treatment inservice for Air Force personnel.

From her years of bedside nursing, Carrie Cox knows how devastating a burn injury can be. Burns are not only painful and disfiguring, they place stress on the entire body, and treatment requires multiple specialists. That’s why Cox finds her teaching duties so personally rewarding. “If I can prevent these types of injuries or play a part in better patient outcomes, that’s very gratifying,” says the Burn Center’s outreach and education coordinator at Johns Hopkins Bayview Medical Center.

Since the spring of 2007, Cox has visited 23 hospitals—from Talbot County on the Eastern Shore to southern St. Mary’s County—to teach emergency medicine staff proper burn care. During her visits, she provides 30-minute lectures on initial emergency burn management, stabilization and Burn Center referral criteria.

When those criteria are overlooked, unnecessary harm to patients can result. Take the case of an elderly woman, burned in a cooking accident, who met three of the American Burn Association’s guidelines for referral to the Burn Center, the state’s top-level burn treatment facility. She was sent home from her local hospital with some medicinal creams even though she was 90 years old, had burns over 10 percent of her body and had injuries that crossed over two major joints. She was only referred to the center, where she received a skin graft, because during a follow-up visit a wound care nurse recognized the need for a  proper referral to the Burn Center.      

Johns Hopkins Bayview has Maryland’s only regional burn center, serving patients referred from 60 hospitals, 50 in Maryland as well as hospitals in Pennsylvania and West Virginia. The center admits 300 to 400 burn patients annually and cares for another 80 to 150 per month in its outpatient clinic. The impetus for the program that Cox oversees came from both the Maryland Institute for Emergency Medical Services Systems and the American Burn Association, which recommended increased community education when it last certified the Burn Center.           

Because so many burn patients regularly take themselves to hospital emergency rooms, “we feel it’s our responsibility to keep those hospitals as up to date as possible on emergency burn care,” says Cox, who has worked in the Burn Center for 10 of her 12 years at the hospital.

Cox also works toward preventing burns from happening in the first place. She regularly visits senior centers to lecture on fire safety and burn protection and even host a game of “Burn Bingo.” Most burn injuries to seniors are caused by cooking-related fires and smoking, so the game features questions and answers on how to prevent such incidents.

In another outreach initiative, Cox collaborated with Thomas McLhinney, a retired Baltimore City fire fighter and 27-year Burn Center associate, on developing the Juvenile Fire Setter Program. It is aimed at youths who have set fires, either intentionally or accidentally, and have gone through the court system as a result. The youngsters are given a tour of the center and are shown a video of patients who have been burned and what their treatment entails.

The Burn Center also participates in a training program for Air Force medical personnel deployed to Iraq and Afghanistan who see numerous burn injuries because of the explosive devices, says Cox.

More than 500 Air Force members have rotated through the center since 2005, Cox says. Twenty to 30 medics, nurses, technicians and physicians a month visit and perform burn wound care as part of their skills-enhancement course.

Meanwhile, Cox is prepared to spend the next two to three years continuing her visits to the region’s hospitals. It’s clear that the program is being well received. “When I first started my job, I was calling places to ask if I could come speak,” Cox says. “Now people are contacting me. There definitely is a need.”

—Neil A. Grauer



Johns Hopkins Medicine

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