KK Women's and Children's Hospital opens Singapore's first dedicated paediatric burn centre

Key Concepts

• Pediatric Burn Center: A specialized unit dedicated to the care of children under 16 with burn injuries.
• Streamlined Processes: Optimized workflows to reduce treatment and waiting times.
• Infection Control: Measures to prevent the spread of infections, crucial for burn patients.
• Child Institution for Pediatric Pain Management: Certification ensuring pain-free and fuss-free patient experiences.
• Psychosocial Trauma: The emotional and psychological impact of an injury, particularly significant in children.
• Rehabilitation: The process of restoring function and managing long-term effects, such as scarring.
• First Aid for Burns: Immediate actions to take after a burn injury to minimize damage.

Singapore's First Dedicated Pediatric Burn Center at KKH

Singapore has launched its first dedicated pediatric burn center at KK Women's and Children's Hospital (KKH). This new facility aims to provide faster and more comprehensive care for children under 16 who have sustained burn injuries. The center's introduction signifies a significant improvement in treatment and waiting times, enhanced infection control, and a focus on shaping the long-term recovery of young patients.

Case Study: Julius Limb

The transcript highlights the experience of Julius Limb, who was just 7 years old when he suffered a burn injury to his chest from hot water. His mother recounts the distressing moment of realizing his skin was "curling up" after he was scalded while getting warm water. This personal account underscores the severity and suddenness of burn injuries in children.

Statistics and Common Causes of Burns

KKH treats up to 400 new young burn patients annually. A significant finding is that over 70% of these injuries last year were caused by scalding from hot water, soups, and beverages. The remaining injuries were due to contact or friction burns.

Dr. Gail Lim, Head and Senior Consultant at the Department of Plastic, Reconstructive and Aesthetic Surgery at KKH, elaborates on the common causes of burns in the 0-2 year old age group. These toddlers are highly curious and often pull hot beverages onto themselves when caregivers are not anticipating their movements. The kitchen is identified as a high-risk area, accounting for 40% of home accidents involving burns due to the prevalence of hot water and cooking appliances.

Rationale for a Dedicated Pediatric Burn Unit

Previously, pediatric burn patients at KKH were treated at the general pediatric plastic surgery clinic, which also houses the cleft and cranial facial center. This meant that burn patients often faced longer waiting times due to the presence of children with other conditions.

The new pediatric burn center is strategically located next to the children's intensive care unit (where severe burn cases are managed) and on the same level as the main operating room complex. This proximity allows for better integration of services and ensures burn patients receive the best possible integrated care.

Differences in Treating Adult vs. Pediatric Burn Patients

Dr. Lim emphasizes the crucial difference in treating adult versus child burn patients. Adults can generally tolerate painful procedures and understand the process. However, children, especially toddlers, experience a significant emotional component attached to pain. The goal is to reduce the psychosocial trauma associated with the experience, particularly for young children with limited understanding. This necessitates the use of sedation, general anesthesia, and distraction methods like art, music therapy, and child life specialists.

Design and Patient Experience at the New Center

The interiors of the new KKH pediatric burn center are intentionally designed with playful, brightly lit decor to comfort and soothe children's anxiety. KKH is also certified as a "Child Institution for Pediatric Pain Management," ensuring that every interaction is pain-free and stress-free for patients and their caregivers.

From a child's perspective, entering the center is designed to feel like an "amusement park" with friendly cartoons on the walls. Shortened waiting times for procedures like dressing changes help alleviate anticipation of pain and reduce stress.

Specialized Features and Equipment

The new center boasts several specialized features:

• Dedicated Treatment Rooms: Two dedicated rooms with adjoining procedure rooms for burn patients, replacing the previously shared spaces.
• Shower Trolley: A movable shower trolley has been installed for patients with extensive bandages who may have limited mobility. This allows for ergonomic and effective cleaning under general anesthesia, ensuring patient comfort.

Role of Child Life, Art, and Music Therapy

These programs are integral to enhancing the patient experience and mitigating stress and anxiety. By attaching a "fun experience" to burn treatment, the aim is to reduce psychological trauma. This is crucial for long-term recovery, as it helps mitigate fear and avoidance behaviors that can arise after the healing process, especially during the rehabilitation period for scars.

Preventive Measures for Burn Injuries

Dr. Lim offers practical advice for preventing burn injuries, particularly for toddlers:

• Keep hot beverages out of reach: Avoid leaving hot drinks unattended.
• Cooling tip: Adding an ice cube to hot beverages can reduce their temperature, making them less dangerous if spilled.
• Kitchen safety: Keep children out of the kitchen when hot water is present.
• Secure appliances: Keep pots, pans, shiny utensils, and dangling electrical wires out of children's reach.
• Teamwork and Supervision: Better delegation of duties among caregivers and increased supervision of toddlers can significantly reduce accidents.

Immediate Aftermath: First Aid for Burns

Dr. Lim stresses the importance of immediate first aid for burns:

• Irrigation under tap water for 20 minutes: This is the most beneficial action if instituted within the first 30 minutes of the injury. This can be done immediately at the scene of the accident.

Conclusion

The establishment of Singapore's first dedicated pediatric burn center at KKH marks a significant advancement in pediatric healthcare. By providing specialized care, streamlined processes, a child-friendly environment, and advanced equipment, the center aims to improve treatment outcomes, reduce waiting times, and enhance the overall physical and mental well-being of young burn survivors. The emphasis on prevention and immediate first aid further empowers caregivers to protect children from these often devastating injuries.