Flashcards in Paediatric burns and trauma Deck (23):
what type of burn is not painful?
full thickness burns as the nerve endings are burnt off
what is an escharatomy
escharatomy is a surgical procedure used to treat full-thickness (third-degree) circumferential burns. In full-thickness burns, both the epidermis and the dermis are destroyed along with sensory nerves in the dermis. The tough leathery tissue remaining after a full-thickness burn has been termed eschar.
what type of burn is sunburn
epidermal burn (superficial)
what burns are counted in calculating body surface area of burns?
superficial dermal burn
mid dermal burn
deep dermal burn
full thickness burn
(NOT epidermal burns)
First aid management of burns?
call for ambulance
for at least 20 minutes- cold running water over burns
cling wrap over burn area
warm the child
what are the components of a burn wound assessment?
Determining the depth of the burn
Is it circumferential?
What is the %TBSA
what might you do for a circumferential SUPERFICIAL burn?
always elevate the limb if possible
how might you calculate the %TBSA of burns?
discount simple erythema (epidermal burn)
Rules of 9s
Lund and Browder chart (most accurate)
describe the rule of 9s for TBSA?
Think of the person in anatomical position
whole head = 10%
whole arm = 9%
Front of chest= 18%
Bigger head= 18%
smaller legs= 14%
why is TBSA% important for burns patient?
guides fluid resuscitation requirements
what are the x-rays we order for trauma?
what consists of a secondary survey for a burns patient?
head to toe examination
1. AMPLE history
2. Tetanus status
3. Wound care
4. Reassess need for primary survey
why are children more susceptible for abdominal trauma?
Kids ribs are very compliant and so more vulnerable to abdominal injury
More force going through a smaller body- hence more prone to abdominal trauma
why is a child's airway more likely to obstruct than an adults?
-the child's airway is smaller
-relatively larger tongue and smaller oral cavity
-cartilaginous nature of a child's airway is more collapsable
what are some reasons why intubation may be difficult in a child?
-smaller airway and oral cavity
-may have enlarged tonsils
-larynx is higher and more anterior than in adults
-larger head, particularly occiput region
how might you check capillary refill in a child? what are the normal values?
CRT= press for 5 seconds, and make sure you lift the limb above the level of the heart! Normal is less than 2 secs. Delayed is greater than 3 or more seconds
what are some adjunct management things you need to consider in a burns patient?
-warming the patient as they are often hypothermic
-analgesia (usually opiate)
-gastric tube (NGT may not be possible)
what are the organs we need to consider in a paediatric abdominal injury?
spleen, kidney, liver as they make up 75% of intra-abdominal injuries
other= bowel/pancreas etc
what is a common mechanism for causing abdominal injuries in a child?
blunt force at high velocity e.g. seatbelt injury
what are some adjunct management procedures to consider in a child with an abdominal injury
Gastric decompression tube
why do we use a gastric decompression tube in a child with an abdominal injury?
prevents gastric dilation
improves image quality
what is the admission criteria for a child with a burn to hospital?
Criteria for Admission
• Partial thickness (superficial) burns with a surface area greater than 10%, except very superficial burns.
• All full thickness burns, except those that are extremely small.
• All burns to face, ears, eyes, hands, feet, genitalia, perineum or a major joint, even if less than 5‐10%.
• Circumferential burns.
• Chemical burns.
• Electrical burns (including lightening). Extensive tissue damage can occur to underlying structures.
• Burns associated with significant fractures or other major injury.
• All inhalation burns.
• Burns in children under the age of 12 months.
• Small burns in patients with social problems, including children at risk.