{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:28:10Z","timestamp":1787239690088,"version":"build-2736575974"},"reference-count":36,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"U.S. Department of Defense Clinical Translational Research Award","award":["W81XWH-2110965"],"award-info":[{"award-number":["W81XWH-2110965"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dissemination of evidence-based burn first-aid is critical for improving clinical outcomes for patients with acute burn injuries. The overarching goal of this research is the successful and sustainable translation of 20\u2009min of cool running water (20CRW), administered within 3\u2009hours of a burn, as a first-aid treatment for acute thermal injuries within emergency departments (EDs) and emergency medical services (EMSs). Despite the well-established benefits of 20CRW, this treatment is not included in relevant USA burn first-aid guidelines and has not been adopted in clinical settings as a standard first-aid treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This protocol outlines an investigation using an effectiveness-implementation hybrid type III design to evaluate the effectiveness of 20CRW implementation into ED and EMS settings in Sacramento, California. The principal aim of this research is to implement 20CRW as a first-aid treatment for acute thermal burn injuries within participating ED and EMS settings. We will assess adherence to 20CRW guidelines and provision following implementation into routine clinical practice. In addition, we will evaluate the clinical effectiveness of 20CRW in improving patient outcomes, and the acceptability of 20CRW as a burn first-aid treatment, considering both clinician and burn survivor perspectives. This research will generate critical evidence on the implementation and clinical impact of 20CRW in US emergency care settings. It will also evaluate whether the co-designed implementation strategies effectively support adoption of 20CRW within the US ED and EMS settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Institutional Review Board (IRB) approval has been awarded for this research (IRB ID: 18834-5) from the University of California Davis Office of Research Ethics Committee. Results of this investigation will be disseminated across participating hospital and EMS organisations, presented at national and international conferences and published in open access peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-120249","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:45:31Z","timestamp":1787237131000},"page":"e120249","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Implementing best-practice burn first-aid in emergency care: a type III hybrid effectiveness\u2013implementation study protocol in emergency department and prehospital settings"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9902-5122","authenticated-orcid":false,"given":"Maleea","family":"Holbert","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia"},{"name":"Children\u2019s Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Burn Division, Department of Surgery, UC Davis School of Medicine, UC Davis Health, Sacramento, California, USA"},{"name":"Shriners Children\u2019s Northern California, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, UC Davis School of Medicine, UC Davis Health, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Mackey","sequence":"additional","affiliation":[{"name":"Sacramento Fire Department, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Kuppermann","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Wood","sequence":"additional","affiliation":[{"name":"Perth Children\u2019s Hospital, Nedlands, Western Australia, Australia"},{"name":"Burn Injury Research Unit, The University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Joe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma, Burns, Critical Care & Acute Care Surgery, UC Irvine Healthcare, Orange, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cody","family":"Frear","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M","family":"McPhail","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Service Innovation and School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy M","family":"Kimble","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2282-4815","authenticated-orcid":false,"given":"Leila","family":"Cuttle","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Katzer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, UC Irvine Healthcare, Orange, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn","family":"Griffin","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia"},{"name":"Children\u2019s Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"2026082007452644000_16.8.e120249.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2008.10.011"},{"key":"2026082007452644000_16.8.e120249.2","unstructured":"British Burn Association . 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