2017-18 HSC Section 3 Green Book

Otolaryngology–Head and Neck Surgery 155(1)

25

Table 2. Number of Oral Electrical Burn Injuries per NEISS Product Category among Children ( 18 Years Old) in the United States, 1997-2012. a

20

Consumer Product

n (%)

Electrical wire Extension cord

14 (21.5) 12 (18.5) 7 (10.8)

15

Electrical outlet or receptacle

10

Electrical cord

5 (7.7) 3 (4.6) 3 (4.6) 3 (4.6) 2 (3.1) 2 (3.1) 2 (3.1) 1 (1.5)

Clock Radio Lamp

No. of NEISS cases

5

Fan

Television

0

< 2 2 3 4 5 6 7 8 9 10 11 >11 Age (Years) Figure 2. Number of oral electrical burn cases in National Electronic Injury Surveillance System (NEISS) database, according to age group, among children ( 18 years old) in the United States, 1997-2012.

Air conditioner

Telephone and/or accessory

Other b

11 (16.9)

Abbreviation: NEISS, National Electronic Injury Surveillance System. a Note that some cases recorded . 1 associated consumer products. b Includes hair dryer, light bulb, tape recorder or player, night light, battery and/or charger, electrical welding equipment, electric scissors, computer and/or accessory, massage vibrator.

0 1 2 3 4 5 6 7 8 9 10

remaining 6.9% of cases with a narrative, patients were visua- lized mouthing batteries prior to injury occurrence.

Discussion Pediatric electrical injuries are, primarily, unintentional and preventable. Due to their exploratory nature, young children are particularly at risk for electrical burns associated with low-voltage household electrical cords, outlets, and appli- ances. The low-voltage character of such injury patterns typically spares the patient of deep tissue involvement, loca- lized entrance and exit wounds, and the subsequent require- ment for hospital admission for extensive and repeated debridement and intensive cardiopulmonary monitoring. 9,10 Pediatric burn patients are also at risk for physiologic and psychological sequelae that require specialized comprehensive management with attempts to balance dynamic and aesthetic concerns. 11 Recognizing the need for specialized care, the American College of Surgeons has developed criteria for tria- ging burn patients with a specific recommendation that all patients with facial burns be transferred to American Burn Association–certified burns centers. 12 Recommended considera- tions for admission put forth by the American College of Surgeons include high-voltage exposure, presence of entrance and exit wound, neurologic instability, cardiovascular instability, extreme extent of burn, and/or oral burns preventing adequate oral fluid intake. 13 Increased burn injury survival has subse- quently led to an increased prevalence of secondary deformities. Our data demonstrate that oral electrical burns are an uncommon etiology, with chemicals, overheated foods/ liquids, and ingestion of commercial products contributing to the majority of overall oropharyngeal burns. 14 In compar- ison with historic estimates put forth by the CPSC, 6 our

No. of oral electrical burn-related ED visits

July

May

June

April

March

August

January

October

February

December

September

November

Month Figure 3. Number of oral electrical burns cases in National Electronic Injury Surveillance System database, according to month, among children ( 18 years old) in the United States, 1997-2012. ED, emergency department.

Table 1. Sex and Race Representation of Pediatric Oral Electrical Burns among Children ( 18 Years Old) in the United States, 1997- 2012.

Actual Cases

National Estimates a

Proportion, Estimate (95% CI), %

Characteristic

Sex

Male

34 23

594 448

60 (34-80) 40 (20-66)

Female

Race b

White/Caucasian

12

313 448 104

36 (7-54) 33 (12-74) 24 (0.6-20)

Black/African American 11

Hispanic American American Indian

8 1 1

63 94

3 (0-19) 3 (0-29)

Asian

a National estimates were calculated by utilizing statistical weights provided by the Consumer Product Safety Commission. b Race data not available for all cases.

243