Introduction Wound care compliance is a critical component in the success of treating burns in the outpatient setting. Patients and caregivers are educated with demonstration and written materials which have demonstrated a 24-hour retention rate of 30% and 10% respectively. This can leave the patient at higher risk for infection, increased pain from suboptimal dressings, and feelings of frustration. Research has shown that visual learners make up 65% of the population, with auditory learners at 30%, and tactile learners at 5%. We assessed that a combination of demonstration and visual aids could better assist different learning styles and improve wound care compliance. Our study goal was to assess the efficacy of the visual aids component through new patient encounters in the emergency department and outpatient setting using a six-question survey at subsequent encounters. Methods The study design is a prospective analysis with comparison to historical controls. Visual aids were designed by the burn physician assistants with assistance at an ABA-verified burn center. We created four double-sided cards made out of a water-resistant synthetic paper, with one for each of our most used dressings. The content of the cards included one of the following: bacitracin/fine mesh gauze with bismuth tribromophenate, bacitracin with low-adherent acetate gauze, silver nylon dressings, and silver foam dressings. Each card contains moulage wounds, step-by-step, and corresponding written instructions at a 4th grade education reading level. These visual aids were given to patients being discharged from the emergency department, or to new patients in the burn clinic. A six-question survey was administered at one week follow-up encounters with a scale of 1-10 (one being least helpful, and ten being the most helpful) assessing patients understanding of burn wound care and compliance. Compliance rates were abstracted from historical controls with similar burn wound severity. Results Limited data is available at the time of submission as the study is currently in-progress and anticipated to be completed by March 2021. We will be using descriptive statistics and comparative analysis to evaluate the results. Conclusions Patients initial feedback has been overall positive with a corresponding compliance rate that is successful. Our patients verbalized their approval, with multiple patients stating that they plan to keep the wound care card for any burn injuries that might occur in the future. Additional research is needed to examine the impact of combined demonstration, tactile, and auditory learning aids. In addition, we plan to further expand our engagement effort to include similar wound care cards for pediatric patients as well as language alternative cards to meet our surrounding community's needs.

Introduction Burn mass casualty incident (BMCI) planning efforts have been in practice and publication for 40+ years. Through these ongoing efforts, we know there are measurable limits to burn center capacity and capability through modeling and real-world events relying on conventional and contingency standards of care, even when the only focus is those patients with burn injuries. The southern region of the American Burn Association (ABA) includes 37 burn centers and continues to play a critical role in the BMCI preparedness process. COVID-19 has emerged as the greatest pandemic in terms of morbidity and mortality since the 1918 influenza pandemic. While COVID-19 has no direct connection to burn injuries, the impact of COVID-19 on the American Healthcare System to include burn care was and remains significant. Methods We conducted a retrospective analysis of (southern) regional data voluntarily submitted to the ABA from March 2020 to June 2021 and generally coincides with the first three waves of the pandemic. We focused on the self-reported data specific to the three critical components in managing a surge of patients: staffing, space, and supplies (to include pharmaceuticals and equipment). Results Staff: These data were collected over a period that coincided with the first three waves seen in the region. Staffing shortages were noted during each of the surges but were most excessive when a regional surge paralleled surges in other parts of the country (November-December 2020). Space Late November and early December 2020, space was in short supply with the surge of patients for more of the region than at any other time during the 28 weeks of reporting. While single facilities reported other episodes of limited space or supplemented with temporary structures, the peak was early December. Supplies As the first surge began to subside, the supply shortages were abated. However, as additional surges occurred, the supply chain had not recovered. Supply shortages were reported in greater numbers than either space or staffing needs through the multiple waves of the pandemic. Conclusions The surge of patients that had to be managed by the greater healthcare community placed a substantial strain on the burn centers to keep beds dedicated for patients with burn injuries. The pandemic directly led to a diminished available capacity for burn care in such a way that it could have compromised our ability to confront a surge of burn-injured patients. Future BMCI planning efforts must consider this aspect of the process. Crisis Standards of Care may come into play during such an event.