CLARK BURN CENTER: A VITAL RESOURCE IN NEW YORK STATE
Every year, about 486,000 individuals seek care for burn injuries. And an average of 3,275 of these cases result in a death (ABA.2024).
Burn care is a unique specialty not available in all hospitals. The United States has 133 burn centers and about 300 burn surgeons to support them. It is essential to point out that certain states do not have a burn center; therefore, patients must be transferred out of state to receive the appropriate care.
Upstate University Hospital’s Clark Burn Center is the only burn center for the central and most of the northern and eastern portions of New York state. The Center covers a large geographic area in the state — 36 counties — along with two counties in Pennsylvania, with a combined population of over 3.5 MILLION People who at any time may require the specialty services of a burn center.
The Center’s scope encompasses not only patient-centered care with a multidisciplinary approach, but also education: prevention education in our communities, education for pre-burn center initial management and aftercare education to rehabilitation centers, skilled nursing facilities and homecare nursing agencies.
BURN INJURY PREVENTION IN 2023
For the Clark Burn Center, 2023 was a busy year for prevention and outreach. The year started out with tabletop educational events and “Learn Not to Burn” presentations in local pre-K classes.
In March, Kara Judd, burn injury prevention coordinator, was a guest on Upstate’s “The Informed Patient” podcast (upstate.edu/informed/2023/032823judd-podcast.php). She discussed the risk of burn injuries and increased fire-setting occurrences in children 5-8 years old. This group of children represents a unique risk, as they missed vital fire safety education due to school interruptions during the pandemic.
Some of the most vulnerable citizens in our 38county area, older adults, were another focus of prevention efforts in 2023. Through a grant from Upstate Advocates, over 1,660 burn prevention kits for seniors were distributed by county Meals on Wheels programs in 2023.
Focusing on an alarming increase in thermal and inhalation burn injuries in our coverage area, the Center held several Install the Device & Save a Life events. This unique program teaches community members how to install their own 10-year sealed smoke alarm to prevent burn injuries due to late escape from house fires. We have continued to make wonderful community partnerships with our local fire departments to meet the goal of reducing these injuries. We value our partnerships with Safe Kids, the Upstate New York Poison Center and the Camillus Home Depot to make this program a success.
Rounding out the year, the Rural Teen Outreach Program was presented seven times in Madison and Oneida counties. This program teaches teens in grades 8-12 about cooking safety, exit drills in the home, fire extinguisher use, and the dangers of fire-setting behavior. We partnered with local fire departments in school districts to bring this important educational information to teens, since they may only get fire prevention education in elementary grades. Developmentally appropriate education can help prevent burn injuries in teens and adults!
2023: AN AWARD-WINNING YEAR
ABA Prevention Award
The Clark Burn Center received the 2023 American Burn Association (ABA) Burn Prevention Award for the Install the Device & Save a Life smoke alarm giveaway initiative led by Tamara Roberts, MSN, CBRN, burn program manager, and Kara Judd, EMT-B, burn injury prevention coordinator, along with representatives from the Upstate New York Poison Center and Safe Kids.
The ABA recognized the Center as a prevention leader in the burn community by achieving wide-scale reduction of burn injuries and progress toward the elimination of burn injuries by utilizing community partnerships.
Gold Standard Award
Joan Dolinak, MD, was one of five recipients of Upstate’s Gold Standard Award. She is an associate professor of surgery and director of burn surgery at Upstate.
The awards recognize faculty for “work exemplifying the missions of Upstate, with particular emphasis on professionalism, work ethic and character.”
Community Service Team of the Year
Tamara Roberts, MSN, CBRN, and Kara Judd, RN, received a 2023 President’s Employee Recognition Award as Community Service Team of the Year. They have been called the Dynamic Duo because they are always on the go to promote fire safety and burn prevention.
Roberts, a former 6E burn nurse who is now Burn Program manager, runs the Phoenix Society burn survivor group.
Judd is a QI Fire & Burn outreach educator. As a juvenile fire setter intervention specialist, she developed a program for the autism community aimed at reducing fire-setting habits, especially for individuals who may not fully comprehend the consequences. She also serves as a firefighter and EMT in Cazenovia.
Roberts and Judd also provide burn safety information for older adults via Meals on Wheels, among other initiatives.
Certified Burn Registered Nurse (CBRN)
For over a decade, nurses have been advocating for a nursing certification that validates the burn nursing specialty. Burn nursing is a unique specialty that encompasses several skills that are unique to nursing care. Burn nursing requires skills that provide an elevated level of care to patients with burn injuries that include more than an understanding of the physical components, but also the essential psychosocial and emotional support that a patient and their families require.
This is perhaps best stated by Gretchen Carrougher, MN, RN, research nurse supervisor for the University of Washington Regional Burn Center: “We perform individualized patient and/or community assessments, identify problems, analyze and integrate subjective and objective data, determine a plan of nursing action, apply appropriate nursing interventions, and evaluate outcomes.”
In 2021, the ABA partnered with the Board of Certification for
Emergency Nursing (BCEN) to begin the process of creating the Certified Burn Registered Nurse (CBRN). A broadcast went out to recruit for burn nursing experts to apply to be part of the development of the certification. Over 100 individuals applied, with a group of less than 20 selected for the initial framework and development of the certification. One of the Clark Burn Center’s nurses, Tamara Roberts, MSN, CBRN, Burn Program manager, was selected to be on the working committee. The second round of applications involved a group of burn nurses responsible for writing the exam questions. Another Clark Burn Center nurse was selected: Nancy Mouer, BSN, CBRN.
In October 2023, the BCEN announced the availability of the CBRN certification. This was a monumental achievement for nurses in the burn world — to finally be recognized for the unique specialty that burn nursing is. Nurses within Upstate have already begun their efforts to study and prepare to sit for the examination.
In October 2023, the
2023: THE CLARK BURN CENTER CARE
Emergency Department
Patients with burn injuries are triaged and treated in Upstate’s Emergency Department. The decision as to whether a patient requires admission is determined by the burn team. Over the last three years, the number of patients who have transitioned through the Emergency Department has fluctuated, with the highest number of patients occurring in 2021 during the peak of the pandemic. This varied from all other burn centers across the United States, which witnessed peak elevations in 2022. In 2022, our burn
Etiology of Burn Injuries in 2023
In 2023, the continuing trend of pediatric scald injuries remained the largest percentage of preventable pediatric burn injuries. On the rise are injuries of 18-yearold and older adults caused by a flame, with the largest causative being the utilization of flammable liquids to ignite a fire. According to the ABA 2023 annual burn summary, across burn centers, flame/flash injuries rate the highest for preventable injuries at a staggering 56.1%. It is evident that there is an increase in need for preventive education across the United States to decrease these numbers.
center observed a decline in the number of burn injuries seeking medical treatment. Our speculation is individuals returned to work and were not home involving themselves in activities that they may not otherwise have been involved in. In 2023, interestingly, we saw an elevation in the number of patients seeking burn care; however, our admissions were slightly down. With advances in burn care, more patients were able to be treated and released with follow up in the burn clinic.
AFTERCARE AND THE BURN PATIENT
Aftercare and the Burn Patient
Survival rates of patients with a burn injury have improved considerably over the years with advances in medical care. The caveat to increased survivability is often patients and families are not prepared for what comes next. Burn injuries are unlike any other traumatic injuries that someone can sustain. Depending on the level of severity, patients do not simply come to the hospital, get “fixed” and go home. Those who have suffered a burn injury can have lifelong physical and psychological scarring that can influence their overall mental health, quality of life and ability to return to work.
During the first year of recovery, patients can endure a variety of physical and psychological complications, as well as changes in their health. As more patients survive their injuries and return home, a vital part of support for survivors is not only preparing them to be reintegrated back into society, but also educating society to provide the best support to the individuals.
References:
To ensure patients are prepared for discharge, they are provided with a variety of tools and resources, including peer-to-peer support, support groups, psychosocial supports and skills for coping. Upstate University Hospital is a Phoenix Society SOAR (Survivors Offering Assistance in Recovery) hospital, which is a peerto-peer program. This program provides the opportunity for patients and families to speak with someone who has been in a comparable situation. These individuals are trained postinjury through the Phoenix Society.
In addition to patient and family preparation for discharge, another vital component of aftercare for patients with a burn injury is knowledge and skill building for those that work with individuals who have experienced a burn injury. Education and hands-on training have been established and now provided to homecare nursing, skilled nursing facilities and rehabilitation centers.
Carrougher, Gretchen J. MN, RN, CBRN. Burn Nursing. AJN, American Journal of Nursing 124(2): p 16, February 2024. | DOI: 10.1097/01.NAJ.0001006676.50176.06
Kearns, R. D., Bettencourt, A. P., Hickerson, W. L., Palmieri, T. L., Biddinger, P. D., Ryan, C. M., & Jeng, J. C. (2020). Actionable, revised (v.3), and Amplified American Burn Association Triage Tables for Mass Casualties: A Civilian Defense Guideline. Journal of Burn Care & Research: official publication of the American Burn Association, 41(4), 770–779. https://doi.org/10.1093/jbcr/iraa050
Our mission is to provide consistent and comprehensive care for the burn patient at the highest possible level of excellence.
