Factors Influencing Emergency Department Length of Stay in Pediatric Burn Patients

Authors

Nishant S. Kumar BS, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow
Katherine Oag MSN, RN, ACCNS-P, CCRN, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow
Lisa Vitale BSN, RN, CPN, TCRN, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow
Mariah Malaniak MSN, RN, CPN, CBRN, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow
Justin Klein MD, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow
Elika Ridelman PhD, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow
Christina Shanti MD, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of MedicineFollow

Research Mentor Name

Dr. Elika Ridelman

Research Mentor Email Address

eridelma@dmc.org

Institution / Department

Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Michigan/Wayne State University School of Medicine

Document Type

Research Abstract

Research Type

clinicalresearch

Level of Research

no

Abstract

Introduction: Globally, the demand for pediatric emergency department (ED) visits has increased, leading to extended lengths of stay (LOS) in the ED. Prolonged ED length of stay (LOS) can delay definitive care and impact outcomes. This study investigates factors contributing to extended ED LOS in an urban, ABA-verified pediatric burn center.

Methods: We conducted a retrospective chart review of pediatric burn patients who presented between March 1, 2023, and March 1, 2024, with ED stays of ≥4 hours. Data on demographics, clinical presentation, and treatment were analyzed.

Results: Among 300 patients, the average ED LOS was 6 hours and 12 minutes. Patients arriving from outpatient burn clinics experienced longer stays (mean: 471 min) compared to injury sites (mean: 364 min, p=0.024) or ED transfers (mean: 362 min, p=0.019). Outpatient-in-bed (OPIB) dispositions were associated with longer LOS (mean: 438 min) than direct discharges home (mean: 362 min, p=0.013). Delays in triage (53 min, p<0.001), IV initiation (105 min, p<0.001), and burn nurse arrival (63 min, p<0.001) significantly correlated with prolonged LOS.

Conclusions: Extended ED LOS appears to be linked to small burns that require overnight stays to ensure appropriate consulting services and wound care teaching is performed. Other factors that contribute to an increase in ED LOS are delays in triage, IV start time, and burn resource team response. Identifying factors that affect length of stay in the ED for burn patients can help providers anticipate the patient’s expected length of stay, provide more cost-effective care, and improve patient outcomes.

Disciplines

Medicine and Health Sciences

Recommended Citation

Kumar, Nishant S. BS; Oag, Katherine MSN, RN, ACCNS-P, CCRN; Vitale, Lisa BSN, RN, CPN, TCRN; Malaniak, Mariah MSN, RN, CPN, CBRN; Klein, Justin MD; Ridelman, Elika PhD; and Shanti, Christina MD, "Factors Influencing Emergency Department Length of Stay in Pediatric Burn Patients" (2025). Medical Student Research Symposium. 427.
https://digitalcommons.wayne.edu/som_srs/427

Comments

This project was supported by the Medical Student Summer Research Fellowship.