A new study published in the Journal of Pediatric Psychology highlights the need for psychological screening for families/primary caregivers after a child sustains a burn injury.

Paediatric burn injuries are amongst the most traumatic injuries for both children and their parents. Parents are often more emotionally affected by the event than the children themselves and are at risk of developing psychological difficulties.

In the immediate aftermath of a burn event, between 24% and 50% of parents meet clinical criteria for post-traumatic stress syndrome (PTSS) while some parents show symptoms of post-traumatic stress disorder (PTSD) many years after the injury. Symptoms of depression and anxiety are also common both directly after and in the months following a burn event.

Some parents often develop feelings of guilt and shame. Guilt is often defined as a negative evaluation of one’s actions. By contrast, shame is a feeling of being inferior or deficient to other people. In the burns literature, no research to date has examined parents’ experience of shame.

Researchers from the University of Liverpool, University of Manchester and Alder Hey Children's NHS Foundation Trust, led by Dr Laura Hawkins and Dr Luna Centifanti, aimed to examine the association of guilt and shame on parents’ psychological adjustment to their child’s burn injury.

The researchers identified 71 children who had been admitted to the regional children’s burns unit, located at Alder Hey Children’s Hospital, for treatment. These included treatment for burns caused by scalding, contact, flame, friction, chemical and frost. Some children were treated as outpatients while others required hospital admission and skin grafts.

A total of 91 parents/primary caregivers were recruited during the first six weeks following their child’s burn injury and completed questionnaires measuring traumatic stress, depression and anxiety, guilt, shame and self-compassion.

The analysis found high levels of psychological distress and feelings of guilt in parents whose child had sustained a burn injury. Parents or caregivers who experienced feelings of guilt and shame showed more symptoms of psychological distress, while parents who adopted a compassionate self-attitude (known as “self-compassion”) appeared to cope better following the injury.

Finally, the study found that the way a parent thinks or feels about the injury was a better indicator of how well they cope following the burn than the size or severity of the burn itself.

Dr Hawkins, said: “Our study suggests that health care professionals should pay closer attention to families’ subjective injury experiences. Screening for psychological distress should be offered to all families regardless of the size and severity of the burn injury.”

The full study, entitled ‘Parental Adjustment Following Paediatric Burn Injury: The Role of Guilt, Shame and Self-Compassion’, can be found here 

The NHS in England has saved an additional 1,600 patients with severe injuries since major trauma centres were established in 2012.

New findings show the creation of major traumas centres has led to the survival of more than 1,600 patients who have suffered some of the most severe and complicated injuries thanks to top teams of surgeons, doctors and clinical staff. Patients also spent fewer days in hospital and had improved quality of life after receiving critical care.

The independent report, which features in the latest issue of EClinicalMedicine published by The Lancet, has been compiled by the (TARN) based at The University of Manchester supported by experts at the Universities of Leicester and Sheffield.

Major trauma centres have played a vital role in saving the lives of many victims of knife, gun and acid attack crimes that have seen a sharp increase in London and other inner city areas in recent months.

Research into the outcomes of more than 110,000 patients admitted to 35 hospitals between 2008 and 2017 represents an increase of nearly a fifth in the odds of survival from severe injury in the five years from 2012.

The findings endorse the shake-up of NHS trauma care in 2012 with seriously injured patients sent direct to newly designated major trauma centres, bypassing smaller, local hospitals that offered less specialist care.

Professor Keith Willett, NHS England’s Medical Director for Acute Care, who led the changes in 2012 and now leads the wider NHS urgent and emergency care review, said: “We have made major advances in urgent care over the last five years as this study demonstrates. As the NHS develops its ten year plan, the success of major trauma centres will help inform how we deliver better care for patients through the use of specialist clinical networks.”

Professor Chris Moran, NHE England’s National Clinical Director for Trauma Care, said: “This study shows that changes to trauma care, designed by clinicians, are saving hundreds of lives every year. Patients suffering severe injury need to get to the right specialist centre staffed by experts, not simply the nearest hospital. Thanks to the skills of NHS staff, we are confident that we will continue to see further increases in survival rates for this group of patients.

“Major Trauma Centres deal with the victims of stabbings and acid attacks as well as car and motorbike accidents. We have all seen the terrible increase in knife crime in our cities, especially in London, and there is no doubt that the new trauma system has saved many lives as these patients receive blood transfusion and specialist surgery much quicker than before. The whole system, from prehospital care through to recovery and rehabilitation, has improved.”

Professor Timothy Coats, Professor of Emergency Medicine at the University of Leicester, said: “We used patient outcomes data in the first four years prior to 2012 as the baseline, then looked at the five years since 2012. The baseline was flat, whereas the five years since the reorganisation of trauma care showed improved outcomes.

“These findings demonstrate and support the importance of major trauma networks to urgent care with figures showing there were 90 more survivors in 2013 rising to an additional 595 in 2017. Over the course of the five years 1,656 people have survived major trauma injuries where before they would probably have died. It’s a fantastic achievement.”

“It takes between five and 10 years for a trauma system to 'mature' and reach its full potential. So 595 additional survivors in 2017, five years after the systems started, is ahead of the target for the eventual 450 to 600 additional survivors that NHS England were predicting when the reorganisation was announced.

“It also shows that with changes to the way patients are treated from the moment doctors and paramedics get to them, with pre-hospital intubation, improved treatment for major bleeding and advances in emergency surgery techniques, there has also been a significant reduction from 31% to 24% in the number of patients needing critical care, and their length of stay on critical care wards reduced from four to three days on average.”

The study states that its analysis shows the whole system change to major trauma centres can be ‘associated with significant improvements in care and outcomes for patients with severe injury’.

It concludes: “A change in the organisation of care for patients with severe injuries, including the development of Major Trauma Networks that cover the entire national population, was associated with a significant 19% increase in the odds of survival for trauma victims who reach hospital alive.”

For those under the age of 40 in England, trauma remains the commonest cause of death, with survivors often suffering long-term disability. The National Audit Office estimates there are 20,000 major trauma cases a year, with 5,400 deaths.

A 2007 report ‘Trauma, who cares?’ identified serious failings across England and since its inception 70 years ago the NHS had based emergency care on ambulances taking patients to the nearest A&E, irrespective of the hospital’s capability to provide resuscitation and the care needed.

The Trauma Audit and Research Network had also identified great variation in the standard of care across the country and other studies showed England’s trauma care did not meet the standards of other countries, with almost 60% of major trauma patients receiving care that was less than good practice and avoidable deaths still occurring. This led the NAO to recommend the setting up of regional trauma networks.

The NHS reorganisation created 27 designated Major Trauma Centres, with the London network launched in April 2010 and networks across the rest of the country operating since April 2012.

A conflict surgeon who has risked his life in some of the world’s most dangerous conflicts is to deliver this year’s Cockcroft Rutherford Lecture at The University of Manchester on 31 May.

David Nott OBE, will speak to alumni of the University at the sell-out event which will also be streamed live on the University’s Facebook page.

The surgeon, who won the 2015 University of Manchester outstanding alumnus award, has operated under torchlight as battles raged around him.

For the past 23 years David has taken unpaid leave each year to work for the aid agencies Médecins Sans Frontières, the International Committee of the Red Cross and Syria Relief.

He has worked in Bosnia, Afghanistan, Sierra Leone, Liberia, Ivory Coast, Chad, Darfur, Yemen, the Democratic Republic of Congo, Haiti, Iraq, Pakistan, Libya, Syria, Central African Republic, Gaza and Nepal.

When Islamic State fanatics burst into his theatre in Syria he bravely refused to stop operating and leave the hospital, vowing to carry on operating on a little girl even if it ended in his own death.

Previous Cockcroft Rutherford lecturers include Professor Brian Cox OBE, Professor Dame Sally Davies, Chief Medical Officer for England and Chief Medical Advisor to the UK government, and Professor Danielle George MBE

As well as treating victims of conflict and catastrophe and raising hundreds of thousands of pounds for charitable causes, David teaches advanced surgical skills to local medics and surgeons when he is abroad.

In 2015 he established the David Nott Foundation with his wife Elly. The Foundation supports surgeons to develop operating skills in warzones and austere environments.

The Cockcroft Rutherford Lecture with David Nott OBE is on Thursday, 31 May 2018. It is in Theatre B, University Place and starts at 6pm prompt. The event is sold out, but will be streamed live on Facebook

The annual Cockcroft Rutherford Lecture is the flagship event for alumni and friends of The University of Manchester. At 91Ö±²¥, we have the largest global alumni community of any-campus based university in the UK, and we are in contact with over 380,000 graduates.

Over 7,000 of these graduates across the globe give up their time to benefit students and their local communities as part of our alumni volunteering programme – one of the largest in the UK. Alumni can find out more about volunteering at