Paediatric Burns

Question 1

What are the care objectives in paediatric burns?

Answer 1

1. Identify and manage potential airway burns as a priority
2. To minimise the impact of injury by maintaining tissue and organ perfusion, minimising pain, appropriate burn wound cooling and minimising heat loss during transfer to hospital

Question 2

In paediatric burns, when must PIPER be notified?

Answer 2

All airway burns or >10%TBSA if the pt is not being directly Tx to the RCH.

Question 3

If airway burns suspected in a paediatric pt, what should be done early?

Answer 3

Early involvement of senior airway expertise via AAV and/or PIPER is essential.

Question 4

If a paediatric pt has burns >10% TBSA, what is the management?

Answer 4

1. Request MICA for IV fluids
2. Tx as time critical
3. Standard burn care

Question 5

What standard burn care should be done for all paediatric burns pts?

Answer 5

1. Rx pain
2. Cool the burn, warm the pt
3. Apply appropriate dressing
4. Tx to an appropriate facility

Question 6

Where should all paediatrics who meet time critical trauma burns criteria be Tx to, if within 45 minutes?

Answer 6

RCH

Question 7

Any paediatric burns involving…are recommended for assessment by a major burns service, and if distance not prohibitive, transported to the RCH.

Answer 7

Face, hands, feet, genitalia, major joints or circumferential burns of chest or limbs.

Question 8

In all cases of significant paediatric burn injuries, due to TBSA or location, consider consultation with …?

Answer 8

PIPER for further management, appropriate destination and hospital notification.

Question 9

At what age are genitalia considered 1% of TBSA in paediatric burns pts?

Answer 9

10

Question 10

At what age do paediatric patients have the same TBSA as an adult?

Answer 10

10

Question 11

For all paediatric burns patients, what is the TBSA of the circumference of each arm?

Answer 11

9% circumferentially, per arm

Question 12

For all paediatric burns patients, what is the TBSA of chest + abdo (front) and the upper + lower back?

Answer 12

18% for chest + abdo (full front)

18% for upper + lower back (full back)

Question 13

What is the TBSA of the head and legs of a 1 y.o?

Answer 13

18% head

14% legs

Question 14

What is the TBSA of the head and legs of a 5 y.o?

Answer 14

14% head

16% legs

Question 15

What is the TBSA of the head and legs of a 9 y.o?

Answer 15

10% head

18% legs

Question 16

What is the algorithm for determining TBSA for a child under 10?

Answer 16

Starting from a 1 y.o who has an 18% head, count backwards, -1 for each year of age.
The total value of the head + legs = 46%
So the legs will = (46 - %head) divided by 2.