This study aims to compare the demographic, clinical characteristics, and outcomes of burn injuries in toddler and preschool children, and to validate the American Burn Association (ABA) Burn Triage Decision Matrix in the Turkish pediatric population.

A retrospective analysis was conducted on 684 pediatric burn patients (494 toddlers, 190 preschoolers) admitted to our burn center over a 5-year period. Variables including gender, burn etiology, burn area, depth, treatment modalities, complications, length of hospital stay, and mortality were analyzed. The performance of the ABA Burn Triage Decision Matrix was evaluated in both groups.

Scalding was the predominant cause of burns in both groups, with a significant difference in the involvement of anterior trunk (p = 0.027). The mean Total Body Surface Area (TBSA) was comparable between the groups (p = 0.286). There was no significant difference in mortality rates (p = 0.385), treatment modalities, and complications. The ABA Burn Triage Decision Matrix demonstrated consistency in triaging the severity of burn injuries, with a notable discrepancy observed in the moderate risk category of toddler group.

This study highlights the distinct characteristics and outcomes of burn injuries in different pediatric age groups. The ABA Burn Triage Decision Matrix’s validation suggests its utility in enhancing triage accuracy and resource allocation in pediatric populations, especially in disaster-prone regions.

This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).

This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.

A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).

Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.

Identifying early predictors of dialysis requirements in earthquake-related injuries is crucial for optimal resource allocation and timely intervention. This study aimed to develop a predictive scoring system, named SAFE-QUAKE (Seismic Assessment of Kidney Function to Rule Out Dialysis Requirement), to identify patients at high risk of developing acute kidney injury (AKI) and requiring dialysis.

A retrospective analysis was conducted on a cohort of 205 patients presenting with earthquake-related injuries. Patients were divided into two groups based on their need for dialysis: the no dialysis group (n = 170) and the dialysis group (n = 35). Demographic, clinical, and laboratory data were collected and compared between the two groups to identify significant predictors of dialysis requirements. The parameters that would form the score were determined by conducting an importance analysis using artificial neural networks (ANNs) to identify parameters that exhibited statistically significant differences in univariate analysis.

The dialysis group had a significantly longer median duration of being trapped under debris (48 hours) compared to the no dialysis group (eight hours). Blood gas and laboratory analyses revealed significant differences in pH levels, lactate values, creatinine levels, lactate dehydrogenase (LDH) levels, and aspartate transaminase (AST)-to-alanine transaminase (ALT) ratio between the two groups. Based on these findings, the SAFE-QUAKE rule-out scoring system was developed, incorporating entrapment duration (<45 hours), pH levels (>7.31), creatinine levels (<2mg/dL), LDH levels (<1600mg/dL), and the AST-to-ALT ratio (<2.4) as key predictors of dialysis requirements. This score included 139 patients, and among them, only one patient required dialysis, resulting in a negative predictive value of 99.29%.

The SAFE-QUAKE scoring system demonstrated a high negative predictive value of 99.29% in ruling out the need for dialysis among earthquake-related injury cases. This scoring system offers a practical approach for health care providers to identify patients at high risk of developing AKI and requiring dialysis in earthquake-affected regions.