The National Academy of Burns India (NABI) was established in 1992 as an all India organization.

NABI organizes NABICONasa leading annual conference exclusively dedicated to the field of burns, and its implications on health. The conference discusses the type of injury caused by fire, heat, electricity, chemicals, light, radiation or friction. Burns most often affect the skin epidermal tissue and dermis. In rare cases, deeper tissues, such as muscle, bone, and blood vessels can also be injured.

• NABICON provides a platform to its members as well as non-members to present their work, exchange knowledge, review the basics and discuss the recent advances in all prospects of burn awareness, burn prevention, burn wound management, burn reconstruction, as well as rehabilitation and research.

The objectives of NABICON are:

1)      To promote and direct the development of Burn care, Rehabilitation & Prevention along sound and progressive lines

2)      To nurture and coordinate training in burns management and to advice on organization of both undergraduate and post-graduate teaching programs for treatment for burns in India

3)       To provide for and promote dissemination and diffusion of knowledge of burns amongst General Surgeons, Plastic Surgeons, Paramedical personnel and members of the medical profession in general.

SAARAA  attended, NABICON 2016 and 2017 to empower our knowledge on burns– from electrical burns and thermal injuries to emergency first aid care; and equip ourselves with the current development in the field of burns by means of creating burn awareness, learn about advancement in surgical techniques, various treatment options, aftercare & rehabilitation.

NABICON 2016 exposed us to many aspects about the prevalence, risks, and challenges in treatment and evidence in the treatment of burn wounds. We all came to better understand, about the role NABI and the services discussed. With the acquired learning, we started doing research analysis to learn about the reason for the higher incidences, for burns in India, the societal causes and understand when burn accidents become classified as a disaster. Disaster happens when – the number of people “Injured + dead” exceeds the number of “burn beds available in the district” where the incidence occurs).We started to work on the major fire incidences which have occurred over the past 15 years(2002-2016). Our hope was that understanding previous events will provide insights and help develop methods to respond to future accidents.Our analysis focused on understanding some of the causes and management of burn casualty. We presented the analysis – ‘Managing mass casualty’ in NABICON 2017.

• Mass burn causalities are great challenges to medical teams because large numbers of seriously injured patients have to be attended at the same time. Our analysis outlined the 4 W’s and H of a burn wound. WHEN & HOW- the fire Incident occurred? WHERE -the fire Incident occurred? WHO- are affected in the Incidents? WHICH- state has the highest number of affected people?
• When & How: Among the 20 incidents, 12 are due to electrical short circuits, 4 due to firework explosion, 2 due to a gas leak and 1 each by explosives and kitchen fires.
• Where: An equal number of accidents happened in private and public places. In private places, the major incident occurred in fire cracker factory and in public places it is mostly in the market place caused by an electrical short circuit. Fire accident had a greater impact on people, taking 744 lives and injuring 1035.
• Which state: For every 100 dead people, 139 were injured; and happened across 10 states. The Kollam incident was the major disaster among all incidences where it took the lives of 100 and injured 383.
• 12 of 20 incidents would be a medical “disaster” – because the number of people affected by the fire exceeds the beds available in the district needed to treat the victims of the accident.

The presentation got a welcoming feedback, as we were analysing the reasons for the mishap and how to address the situation. We concluded with the probing question “Are there better ways to treat and rehabilitate patients sooner with better treatment options? “

LESSONS LEARNT- NABI 2017:-

The theme of the conference was “Survival & Beyond”

• Happened to see a live demonstration from OT for Scar excision and Tangential excision and split skin grafting for paediatric patient
• Many case studies were shown for grafting especially small portions like fingers, neck, chin, limbs, etc.and correction of facial deformity and scar management
• Among the cases demonstrated electrical burns in workplace was more common in males with high tension electrical wires
• Pain management is highlighted as a challenging task in burns apart from drugs through counselling sessions associated with rehabilitation
• Excisions demonstrated were done only aseptic procedures (Tangential, sequential excision, etc.)
• The presentations addressed sepsis and infection control in burns. Infection remains the number one cause of mortality among burn patients

INFECTION CONTROL PROTOCOL DISCUSSED:

• Care of the unit
• Care of the bed space
• Care at point of contact with the burn patient
• Care of indwelling devices
• Care of external devices
• Detection of epidemics
• Prevention of endogenous infection

• Implementation of good infection control practices play a major role in reducing these infections and thus reduce patient mortality and morbidity as well as treatment costs

The conference gave us a wide expose and knowledge about the management of burns. Burns are largely preventable; however, deaths and deformities due to the injury can also be preventable to a great extent provided timely and appropriate treatment is delivered

As a concluding note based on our research work, major emergencies, crisis, and disasters have become more frequent during the recent decades, affecting more people, and disrupting essential services. It is estimated that 20-30% of injuries from mass casualty events result in serious burns, requiring specialized care.  It is thus critical to determining how rescue and burn care should be organized in the event of such a disaster where the greatest challenges and triage decisions are made. In such crisis, coordination and communication between the various health system components (e.g., public, private, military, and NGOs) are needed. Accidents are a way of life. Being prepared and responding to these accidents is the order of the day. This can happen through mobilizing public-private partnership and trained volunteers who can be called upon during the crisis in the most effective manner.

We intend to work together to create awareness on burns nd burn management and build a relationship with the public, survivors, NGOs and Doctors to address the situation during an emergency. We invite professional organizations and institutions- such as doctors, patients, NGOS and emergency services personnel- involved in the prevention, care and post-treatment care of burn patients, to share their experience and provide perspective on their level of involvement and in the activities they are involved in this blog to enable us to involve you in our endeavors.