Emergency - SIDS/Burns/Trauma

Question 1

In which children are burns most common?

Answer 1

under 5s
•Low economic status
•Low education levels of mother
•High population density
•Household crowding
•Psychological stress in the family
•Single parents + younger mothers, esp if unemployed

Question 2

What is the immediate first aid for burns outside of hospital?

Answer 2

• Area run under cold water (not icy) for 5+ min
• Cold water compress
• Calmed + reassured
• Wrap in cling film or sterile bandage
• Protect from friction + pressure
• Ibuprofen + paracetamol

Question 3

How are burns assessed in ED?

Answer 3

ABCDE
any smoke inhalation?
depth of burn? skin grafting is needed in deep burns
surface area of the burn? calculate of SA chart
mouth and face involvement? can cause disfigurement and compromise the airway

Question 4

How are burns treated in ED?

Answer 4

relief of pain with strong analgesia
treat shock with IV fluids
wound care and cover the burns with plastic wrapping to protect against the air and infection

plastic surgery may be needed for reconstruction and psychological support may be needed in severe burns

Question 5

Explain the importance of safeguarding in burns?

Answer 5

not all are accidental
need investigating if severe or recurrent
site, depth and type of burn are important

Question 6

What measures can be taken to reduce the prevalence of burns in children?

Answer 6

• Smoke alarms in house
• Fire safety + hazards
• Keep children away from stoves or pans/irons/oven doors
• Turn pot handles towards back of stove
• Fire extinguishers in key locations
• Remove electrical cords from floor + keep from reach
• Use plug covers

Question 7

What are the consequences of facial burn or smoke inhalation?

Answer 7

• Airway burn has impact on survival of patient
• Upper airway swelling, acute respiratory failure + CO intoxication
• Oedema 12-24 hours after injury – early intubation recommended
• Oxygen at high flow
• If respiratory effort fails then mechanical ventilation

Question 8

What is the difference with an electrical burn?

Answer 8

• primarily occur in the household
• assess according to power source and type of current
• mostly low tension and on hands/mouth
• muscle damage and cardiac anomalies

Question 9

When are injuries and trauma common in children?

Answer 9

injury is leading cause of death in children 1 years +
road accidents make up a large proportion
male adolescents are most at risk

Question 10

Be aware of near drowning info

Answer 10

Most victims young children
Drowning 3x more common in boys than girls
Warmer, affluent countries tend to have higher incidence of drowning than UK
Up to 30% fatalities can be prevented by skilled on-site resus