The impact of socioeconomic deprivation on the adequacy of burn first aid: a retrospective cohort study

AIM: This study aimed to examine the relationship between socioeconomic status, measured by the Index of Multiple Deprivation (IMD), and the adequacy of first aid provided for burn injuries. METHODS: A retrospective cohort study was conducted including all patients (paediatric and adult) treated for thermal burns at a regional burn unit between 1 May and 31 July 2024. Socioeconomic status was assessed using IMD deciles. First aid was categorised as "adequate" (cooling with water for ≥20 min) or "inadequate," with inadequate first aid further classified as "damaging" (e.g., ice, toothpaste, raw egg) or "not damaging." Logistic regression analyses adjusted for age, sex, burn aetiology and size of burn. RESULTS: 269 patients were included (median age 28.3 years; 66.9 % adults; 50.9 % male). Scalds were the most common aetiology (59.5 %), and most burns were superficial partial thickness (82.5 %). The median IMD decile was 7 (IQR 5-9). Increasing socioeconomic deprivation (lower IMD decile) was significantly associated with inadequate first aid (OR 0.898 [per unit decrease in IMD decile] 95 % CI 0.807-0.998, p = 0.046). Greater deprivation was also associated with increased odds of harmful first aid practices, compared with adequate first aid (RRR 0.836, 95 % CI 0.737-0.948, p = 0.005). CONCLUSION: Socioeconomic deprivation is inversely associated with adequate burn first aid and positively associated with harmful practices. Targeted public health interventions are needed to address this disparity.