Pediatric Burns

Happy Friday! Today we’re shifting gears a bit, because I’m actually highlighting a lecture from HippoEd’s pediatric EM bootcamp. While I’m not in EM, I’ve started this bootcamp recently as a way to improve on my weakness. I love the challenge of seeing pediatric patients but also know that there is so much to learn
 
All my blogs are free, however be sure to check out Hippo education and all their lectures. You can use my link for $25 off HippoEd’s Pediatric EM bootcamp: here
 
I will go back and forth between topics in HippoEd's urgent care rap podcasts and pediatric EM Boot Camp, so stay tuned. All the pediatric posts will have an UC focus/approach to it, so no worries there!

Today’s topic: pediatric burns
 
What should I do first? 

• Remove any clothing/diapers/jewlery around wound
• Cool the burn with COOL (not cold) water to stop the burning process. This can be done for 20 mins, up to 3hrs after burn
  • Caution with cooling if it is a large area, as it may cause hypothermia
• Cover area with clean, loose, wet bandages—but nothing that is going to stick and nothing that is soaking wet
  • Tetanus status 
  • Pain relief
  • Educate patients on not placing anything such as butter/mustard/oil on the burns

 
Estimate: 

• Size-- rules of 9’s
• depth--superficial/superficial partial/deep partial thickness/full-thickness/fourth degree

 
 
What should I do with blisters?
• If small, not near a joint, and not obstructing the dressing, should be left intact
• De-roof if: large blister, blister overlying joint, using silver dressing, opaque blister fluid


Ideal burn dressings for partial thickness burns? 

• Dressing must be: Comfortable, non-toxic, non-adherent, which protect wound and allow gaseous exchange
• Can use: hydrocolloids, biologic, alginates, foams, antimicrobial products containing siver
  • If using silver-based dressing—DO NOT use on the face as it causes discoloration
• Most commonly used: 
  • Vaseline-impregnated gauze, adaptic gauze (adaptic is a bit more permeable)
  • Vigilon
  • Silvadene cream & telfa dressing

 
When to transfer to a burn center?
 
Be sure to review general burn center referral criteria as it also applies to children (e.g. burns that involve hands/genitalia/perineum), however below are pediatric SPECIFIC criteria to transfer to a burn center:

• Partial-thickness burns >10% TBSA (<10 years or >50 years)—remember that this means the partial-thickness burn must be >10% not just the erythema/superficial burn
• Burn injury in children at hospitals without qualified personnel or equipment for the care of children
• Burn injury in patients who will require special social, emotional or long-term rehabilitative intervention

Always appreciate any feedback you may have! Let me know if there is a topic you'd like me to discuss :) See you all next week!