Expanding Burn Expertise Through Telemedicine For The Frontliners During The Covid-19 Pandemic
Myra Alexandra P. Firaza, Fellow-in-Training in Plastic Surgery, Maria Redencion B. Abella, Attending, Plastic Surgery.
Jose R. Reyes Memorial Medical Center, Manila, Philippines.
PURPOSE: Inexperience of frontliners in burn wound assessment results to unnecessary COVID-19 exposures during this pandemic. This study determined the accuracy and timeliness in diagnosing and classifying burn patients assessed by a frontliner non-burn specialist in-person (NBSP), a Burn Specialist online (BSO), and a Burn Specialist in-person (BSP).
METHODS: All burn patients (January to March 2021) with signed consents for participation were photographed in a standardized manner by the NBSP and referred to a BSO via Telegram™. These patients were also assessed independently by the BSP. The % total body surface area (TBSA), burn depth classification, and the timestamps (seen by the NBSP, online referrals sent to the BSO, BSO sent the diagnoses, and assessment by the BSP) were recorded. One-Way Repeated Measures Analysis of Variance (ANOVA) with and without blocking were done.
RESULTS: Data gathered from 82 patients throughout the study demonstrated that burn size (% TBSA) among the three different physicians (NBSP, BSO, BSP) was not statistically significant (p=0.8794). Our analysis showed no statistical difference for the 19 different body parts per patient and burn depth classification (p=0.9718). One-way ANOVA tests on timeliness were statistically significant with p<0.0001. Post-hoc comparison using Tukey test revealed no statistical significance between the BSO and BSP (p=0.892).
CONCLUSION: Frontliners can refer to burn specialists using smartphone telemedicine platform for optimum burn care with an accurate diagnosis during and even after this pandemic. Timeliness can be improved with a dedicated 24/7 online available burn specialists and a reliable network access.
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