Review of burn management app created by Johns Hopkins Physician, inspired by mass casualty event

Purpose of app review:

Evaluate how well the BurnMed app guides physicians in initial treatment of severe burns.

Introduction:

Johns Hopkins physicians were inspired to create BurnMed after a mass casualty incident in Kenya where a gas tanker exploded, killing one hundred people instantly and severely burning many others.

The influx of burn patients overwhelmed local health resources, so many did not receive correct treatment initially.

The developers’ goal was to provide a comprehensive fifteen minute training on initial burn management using a mobile, multimedia resource for lay practitioners. This app was a finalist for the 2012 iMedicalApps-Medicine 2.0 mHealth Award.

User Interface:

One of the initial steps in burn management is to document the areas burned, then calculate the total body surface area (TBSA) affected using either the Rule of Nines or a Lund-Browder Chart. This percentage is then entered into the Parkland Formula to calculate fluid requirements.

In BurnMed, the user draws the burned areas onto a 3-D anatomic figure. The app then uses this diagram to calculate the TBSA burned. The settings can be changed to use a different diagram for male, female, or pediatric patients.



The app then uses the diagramed TBSA percentage to calculate fluid resuscitation. The Treatment Guidelines summarize the essential steps in early management with links to further teaching about inhalation injuries, escharotomy, and dressings.




A video demonstrates techniques on how to perform an emergent escharotomy, with anatomic diagrams illustrating common pitfalls.


The authors focused on essential information, but excluded some key elements. Though the app focuses on identifying full thickness and circumferential  burns that require emergent escharotomy, it does not provide any guidance on differentiating superficial, partial-thickness, and full-thickness burns for the purposes of fluid resuscitation.

A common pitfall in calculating TBSA is including superficial (first-degree) burns. Only partial thickness and full thickness burns should be used in the Parkland Formula.

The app does not discuss or demonstrate how the calculations are made. Though this oversimplification may be appropriate for mass casualty incidents in low resource settings, more documentation of the calculations would be essential for use in everyday clinical environments like US Emergency Departments.

Price:

  • The free BurnMed Lite provides only the diagram for calculating TBSA burned.
  • $4.99 BurnMed Pro includes the treatment guidelines reviewed above.

Likes:

  • Excellent use of focused multimedia to teach essential concepts in burn management.
  • Accurate, relevant clinical calculations.

Dislikes:

  • Calculations not explained.
  • No teaching on superficial vs. partial and full thickness burns.
  • No universal app – must buy iPad and iPhone apps separately.

HealthCare Providers that would benefit from this App:

  • Emergency Physicians, General Surgeons, and other providers treating severe burn patients.
  • Medical Students learning about burn treatment.

Conclusions:

  • This app provides an excellent, comprehensive summary on the basics of initial burn management by using focused, mobile multimedia, but does exclude some important components.

iMedical Apps recommends?

  • Yes.

Rating: 4.25 / 5 Stars
1. User Interface - 5/5 – Intuitive and seamless.
2. Multimedia usage - 5/5 – Excellent use of multimedia, focused to optimize learning.
3. Price - 3/5 – $4.99 for iPhone or iPad App, must purchase separately
4. Real world applicability - 4/5 – Focused on practical knowledge and tools for emergent burn management.

 

Disclaimer:

This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.

Author:

Shannon McNamara, MD

View Comments

2 Responses to Review of burn management app created by Johns Hopkins Physician, inspired by mass casualty event

  1. Tom Lewis December 7, 2012 at 2:41 pm #

    This looks like a fantastic app! Will go and download now. It seems like someone took the idea of MerseyBurns (http://www.imedicalapps.com/2012/02/mersey-burns-app-uk-app-recognised-medical-device/) and added a whole load of useful educational information. Be interesting to see if the FDA approve it

  2. Iltifat Husain, MD December 9, 2012 at 1:58 am #

    completely agree. pretty psyched about this app and it was a great find by Dr. McNamara.

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