Background
An escharotomy is a time-critical, emergency limb or even life-saving procedure. As such it may need to be performed by health professionals with little or no previous experience, or by health professionals who have not performed this procedure in many months or years. Both situations occurred during the recent White Island volcanic eruption.
Whilst on-line resources are included as part of the National Burn Service website, on review, the quality of the illustrations identifying the optimal placement of incisions were found to lack the clarity required.
The goal of this research was to establish baseline knowledge of escharotomy incision placement in a cohort of registrars who may need to be able to perform an emergent escharotomy, and to test the effectiveness of new resource materials.
Methods
Literature review along-side expert opinion was utilized to produce new up-to-date escharotomy illustrations. Evaluation was undertaken in the form of a survey involving the plastic surgery registrars at Middlemore Hospital.
Results
Eighteen plastic surgical registrars were surveyed. With a median of 7 years post-graduate training; 45% were SET trainees. Overall, without consulting any escharotomy guidelines, 72% of participants correctly demonstrated placement of upper-limb incisions, 54% accurately placed anterior torso incisions, and 81.8% accurately placed lower limb incisions.
Discussion/Conclusions
Having established a baseline of knowledge in registrars who should be familiar with the correct placement of an escharotomy, the next stage is to update the Escharotomy Guidelines to address the areas identified as most problematic and to re-test the accuracy of placement. Feedback will also be obtained to ensure that the new resources will be useable by any health professional who may need to perform the procedure.