Burns Flashcards
What are the leading causes of pediatric burns?
→ Unintentional injuries are the 3rd leading cause of death for those under 19 years.
→ 28% of burn admissions are under age 16.
→ Fireworks injuries account for about 3,000 injuries around July 4th.
→ Non-accidental trauma (NAT) contributes to up to 8% of burn hospital admissions.
List risk factors for pediatric burns.
→ Male gender
→ Age under 4 years
→ Disabilities
What are common etiologies of pediatric burns?
→ Thermal (e.g., fires, MVA, fireworks, kitchen scalds)
→ Chemical (contact, ingestion, or inhalation)
→ Electrical (contact with faulty wiring, power lines)
→ Mechanical/Friction (road rash, treadmills)
→ Cold (frostbite)
→ Radiation
What are key prevention strategies for pediatric burns?
→ Educate parents on safe cooking practices.
→ Use engineering controls like child-proofing.
→ Enforce safety laws for smoke alarms, water heaters, and children’s sleepwear.
How are burns classified?
→ Superficial (1st degree): Involves only the epidermis.
→ Partial-thickness (2nd degree): Involves the epidermis and dermis.
Superficial partial thickness: Epidermis + papillary dermis, with pain and blistering.
Deep partial thickness: Down to reticular dermis, may be waxy and insensitive to light touch.
→ Full-thickness (3rd degree): Involves epidermis, dermis, and subcutaneous tissue.
How is TBSA used in burn classification?
→ TBSA (Total Burn Surface Area) measures burn severity.
→ Lund and Browder chart is commonly used.
→ TBSA > 20% is considered a major burn.
What professionals are part of a burn center team?
→ Surgeon
→ Surgery Practitioner
→ Nurse
→ Occupational Therapist (OT)
→ Physical Therapist (PT)
→ Dietitian
→ Child Life Therapist
→ Psychiatrist
→ Plastic Surgeon
Describe symptoms of superficial burns.
→ Involves only the epidermis.
→ Pink to red color, no blisters.
→ Commonly caused by sunburns.
→ Heals without scar tissue.
What are the characteristics of superficial partial-thickness burns?
→ Involves the epidermis and papillary dermis.
→ Painful, red with blisters.
→ Heals in 2 weeks or less without scarring.
Describe deep partial-thickness burns.
→ Involves epidermis, papillary, and reticular dermis.
→ Waxy white appearance, may be insensitive to light touch.
→ Takes 3-6 weeks to heal, scar tissue forms, but no grafting needed.
What are the symptoms of full-thickness burns?
→ Involves epidermis, dermis, and subcutaneous tissue.
→ May appear red, cherry, white, or brown.
→ Anesthetic to touch but painful due to nerve activation around the burn.
→ Requires grafting to heal.
What factors contribute to the depth of burn injury?
→ How the injury occurred
→ Thickness of burn
→ Clothing over burned area
→ Age (children have thinner skin)
What factors affect initial burn treatment?
→ Depth, size, location of burn
→ Presence of other injuries (e.g., smoke inhalation)
→ Age and premorbid health
What are the initial pulmonary considerations in burn care?
→ Ensure adequate airway and breathing.
→ Check for inhaled smoke or fumes.
→ Administer oxygen or intubate if needed.
→ Watch for carbon monoxide inhalation and pulmonary edema.
Describe burn shock and its treatment.
→ Caused by fluid loss and increased capillary permeability.
→ Leads to reduced circulatory volume and cardiac output.
→ Requires aggressive fluid resuscitation.
How is fluid resuscitation managed in pediatric burns?
→ Burns < 10-20% TBSA: Oral fluids, vasoconstriction, and urine retention.
→ Burns > 20% TBSA: IV fluids, urinary catheterization, and monitoring for hypovolemic shock.
What are the renal considerations for burn management?
→ Fluid loss can cause renal vasoconstriction and failure.
→ Electrical burns can release myoglobin, leading to kidney occlusion.
What are circulatory concerns in full-thickness burns?
→ Inelastic skin and edema can cause compromised circulation.
→ Compartment pressures > 30 mmHg may require escharotomy.
How are musculoskeletal injuries addressed in burn care?
→ Splinting and traction are common.
→ Internal fixation within 48 hours is recommended.
What nutrition considerations are there in pediatric burns?
→ Increased calories and proteins are needed.
→ Hypothermia risks require maintaining room temperature above 85°F.
Describe physical therapy goals for pediatric burn patients.
→ Wound management
→ Increase ROM and strength
→ Promote normal development
→ Prevent deformities and contractures.
What are pain management strategies for pediatric burns?
→ Pharmacologic: Premedication before therapy.
→ Non-Pharmacologic: Cognitive behavioral therapy, relaxation, distraction, etc.
What is the role of splinting and positioning in burn care?
→ Prevent contractures and maintain ROM.
→ Splints are worn 24 hours/day except during dressing changes.
Describe early mobilization strategies for pediatric burns.
→ Begin with dangling at the edge of the bed (EOB).
→ Progress to ambulation with compression for edema control.
What exercises are beneficial for burn rehabilitation?
→ Resistance training
→ Aerobic exercises
→ Stretching and breathing activities.
What are family considerations in pediatric burn care?
→ Involvement in wound care, massage, and exercises.
→ Addressing psychosocial needs for community reentry.
How do social factors affect pediatric burn recovery?
→ Disfigurement impacts quality of life.
→ Strong family support improves outcomes.
What are scar management strategies for pediatric burns?
→ Pressure garments
→ Scar massage
→ Silicone, taping, sun protection, and surgical options (e.g., laser, Z-plasty).
What role do burn camps play in recovery?
→ Provide physical, psychological, and social support.
→ Facilitate social integration for burn victims.
Summarize key takeaways for managing pediatric burns.
→ Use a systems approach tailored to each case.
→ Begin early mobilization and advocate for social reentry.
→ Monitor for contractures and pressure sores.
