Alcohol Use Indicator

🤔 Question: Can the blood labs from an autopsy for alcohol level and drug test be used?

🌱 Answer: Yes, if done within the first 48 hours after death when they will be accurate.

Drug Use Test Results

🤔 Question: Can Fentanyl be added as a separate drug field value?

🌱 Answer: Not at the present time. Please select “Opioid” and select "Other drug(s)" and specify in the text field.

Report of Physical Abuse

🤔 Question: Physical abuse - In a case where there was suspected abuse, a full police and children and family report was done with documentation and followed through the patient's stay in hospital. It was documented that the case was low risk for abuse. Would you enter physical abuse as yes but then the circumstances of injury entered as accidental since it was later decided that patient was at low risk for abuse?

🌱 Answer: Select Report of Physical Abuse as it is important to note that a report was made to law enforcement and/protective services, regardless of the outcome of the investigation. In the circumstance described, list the Circumstances of Injury as described below but note that this determination needs to be ultimately decided by the treating physician.
BCQP Form: Injury Information; Circumstances/ICD-10
Circumstances of Injury
Suspected assault/abuse – yes
Report of physical abuse – yes
Investigation of physical abuse – yes
Caregiver at discharge – yes or no (depending on who the patient was discharged to)

Circumstances of Injury

🤔 Question: How should abuse should be captured. Some pediatric patients come in with suspicious burns and child protective services (CPS) is called. After CPS investigates, sometimes it's ruled as not abuse and patient goes home with the caregiver that brought them in. In order to get the Report of Abuse fields to open, you have to click on Suspected Assault/Abuse. Is that what should be entered even after the investigation rules out abuse? And if so, does the Primary ICD-10 External Cause Code have to be an abuse code? In other words, does the circumstance of injury have to match the ICD 10 external cause code? This feels like underreporting the number of investigations of abuse, but then if no abuse is found, there will be overreporting abuse cases.

🌱 Answer: That question has been identified by others as well. The Data Definitions Workgroup looked at this and agreed that these 2 fields should not be linked. BData has just unlinked the "Report of Physical Abuse" from the "Circumstances of Injury". You may now select the appropriate Circumstances of Injury (like Accidental Injury, Recreation) and the Report of Physical Abuse. Note when an investigation was done and was found negative.

🤔 Question: For circumstances of Injury for the non-burn, non-injury patients (e.g. the rash/skin infection conditions), what should be selected? The most likely selection seems to be either 'OTHER' or 'NOT KNOW/NOT RECORDED' or leaving the question blank.

🌱 Answer: The best selection is "Other" and then enter the non-burn injury details in the dropdown box. You will also enter “Rash/Skin infection” in the Etiology of Non-Burn Injury section.

Etiology of Burn Injury

🤔 Question: A patient with diabetic neuropathy sustained a burn from the radiant heat of a fire because they were too close. They could not feel that they were being burned due to their condition. Their clothes didn’t catch fire from the radiant heat of the fire. How would this etiology be entered into BCQP?

🌱 Answer: If this was from an open flame, record this as flash from an open flame and then document more specifics in the injury note. This will be forwarded to the Data Definitions Workgroup to determine if an additional etiology of burn injury should be added.

🤔 Question: There is a patient that states they received their injury from a scald from boiling water. When the patient went to surgery the surgeon stated this injury is not a burn. What should be entered for the patient as a burn or non-burn etiology in the registry?

🌱 Answer: The burn surgeon should determine the most likely cause of the injury (burn or non-burn) and then the specific cause if known. If the surgeon thinks it was, for example, a friction/shearing injury but does not sure specifically what type you can enter Friction/Shearing: Other or if it looks like a Traumatic Injury select a cause or Other.

🤔 Question: Contact with hot candy or caramel is a burn caused by contact with hot food, however, food is not an option when selecting the etiology category within “contact burn”. What should be selected?

🌱 Answer: Hot candy or caramel should be classified as a “scald” from “hot food”, not a “contact burn”.

🤔 Question: Is there any discussion about adding an etiology specific to smoking while on home oxygen? And/or adding use of home oxygen as a comorbidity?

🌱 Answer: This will be brought to the Data Definitions Workgroup for discussion.

🤔 Question: A person was using liquid nitrogen to make ice cream and it got on their hand, would this be considered a cold injury or a chemical burn?

🌱 Answer: This should be considered a cold injury. A liquid nitrogen burn, also known as a cryogenic burn, is a skin injury caused by exposure to extreme cold. The liquid inside skin cells freezes when exposed to liquid nitrogen, damaging the cells and making it difficult for them to return to normal.

Non-Burn Injury

🤔 Question: Are Road Rash Injuries being reinstated as burn injuries?

🌱 Answer: No, Road Rash Injuries are considered Friction/Shearing Injuries and are categorized as Non-Burn Injuries.

🤔 Question: Should patients be tracked who have partial amputations as a non-burn etiology injury? Is this for any and all partial amputations under traumatic circumstances (i.e. table saw, chainsaw, lawn mowers)? What about patients the burn/plastic surgery does not consult on.

🌱 Answer: Only enter patients in the Registry that are cared for by your burn service. This means the burn service is caring for the patient, not just consulting on these patients.

🤔 Question: A patient had a leg cellulitis and subsequently had a fasciotomy and skin graft placement by the burn surgeon.  Would this be entered as a non-burn injury, rash, skin infection; other?

🌱 Answer: Yes, enter a cellulitis as a non-burn injury/Rash or Skin infection/Other and when you select Other a pop-up window will open so you can specify cellulitis.

🤔 Question: What type of non-burn injury would a frostbite patient be recorded?   , rash, skin infection; other?

🌱 Answer: Frostbite is a Non-burn Injury listed under Cold Injury in the Data Dictionary. 

🤔 Question: What etiology should be used for patients with 3rd-degree injuries to the arm and abdomen from contact with a nitrogen oxide canister? How are cold burns captured?

🌱 Answer: The etiology would be a Non-Burn Injury/Cold Injury/subcategory: Cold Injury.