Recorded Pre-Hospital First Aid and Citizenship in Children Hospitalized for Burns: Retrospective Analysis of a Single-Center Hospital Cohort

Background/Objectives: We compared recorded pre-hospital first-aid categories by citizenship among children hospitalized for burns, accounting for a classification rule that may obscure the use of multiple first-aid actions. Methods: This exploratory descriptive analysis included 369 children aged 0–17 years, each contributing one index hospitalization at Meyer Children’s Hospital, Florence, Italy (January 2020–April 2026). Free-text histories had been classified as running-water cooling, explicit no first aid, or a remedy labeled inappropriate. When cooling and a remedy were both documented, the record was assigned to the remedy category. We estimated absolute differences, fitted multinomial logistic models, and calculated bounds for receipt of any cooling. Results: Recorded citizenship was Italian for 253 children and non-Italian for 116. The cooling, no-first-aid, and remedy categories accounted for 79.1%, 12.3%, and 8.7% of Italian records and 61.2%, 19.0%, and 19.8% of non-Italian records, respectively (global p = 0.0009). The difference in the cooling category was −17.8 percentage points (95% CI −28.0 to −7.9). After adjustment for age, admission year, and residence, multinomial odds ratios for non-Italian versus Italian citizenship were 2.04 (95% CI 1.07–3.91) for no first aid and 3.15 (1.56–6.35) for remedies, each relative to cooling. Because cooling status within remedy records was unknown, the difference in receipt of any cooling could range from −26.5 to +2.0 percentage points. Conclusions: Recorded categories differed by citizenship in this hospital cohort, but did not establish the direction of a difference in receipt of any cooling or a difference in guideline adherence. Separate recording of first-aid actions is needed before interpreting this association as a gap in care.