Pediatric Burns

Question 1

Burn Definition

Answer 1

damage to the skin or other tissues caused by thermal, chemical, electrical, or radiation energy

Question 2

Thermal Burns

Answer 2

• Caused by heat sources (flames, scalding liquids, hot surfaces)
• Most common in children (e.g., hot water spills)

Question 3

Chemical Burns

Answer 3

• Caused by acids or alkalis (e.g., bleach, cleaning agents)
• Tissue destruction continues until the chemical is neutralized

Question 4

Electrical Burns

Answer 4

• Caused by contact with electrical current (e.g., power cords)
• Can damage internal tissues and organs

Question 5

Radiation Burns

Answer 5

• Result from exposure to UV rays or radiation therapy
• Less common in children

Question 6

Friction Burns

Answer 6

Caused by skin rubbing against a rough surface (e.g., road rash)

Question 7

Why Burns are Critical in Children

Answer 7

1. Burns are the second leading cause of unintentional injury in children aged 1–4.
2. Children’s skin is thinner → higher risk for deep tissue damage.
3. smaller body surface area means the same size burn is proportionally more severe.

Question 8

Superficial Burn

Answer 8

• first-degree burns
• affect only the epidermis
• healing within a few days without scarring.
• Red, dry, painful (e.g., mild sunburn)
• No blisters

Question 9

Partial Thickness Burn

Answer 9

• second-degree burns,
• involve the epidermis and dermis (superficial and deep)
• Blistering, moist, very painful, with healing typically taking two to three weeks.

Question 10

Full Thickness Burn

Answer 10

• third-degree burns
• penetrate all skin layers and may damage underlying fat
• Waxy, leathery, painless due to nerve damage

Question 11

Deep Full Thickness Burn

Answer 11

• fourth degree burns
• extend to muscle and bone, necessitating urgent surgical intervention
• Charred appearance
• no sensation

Question 13

Emergency Care Procedures

Answer 13

1. Minor Burns
   - cool the affected area with running water for 10 to 20 minutes to minimize tissue damage.
   - Antibiotic ointment
   - sterile dressing
2. moderate to severe burns
   - do not break blisters; instead, cover them with a sterile dressing to prevent infection.
   - Topical antibiotics (e.g., silver sulfadiazine)
   - Debridement if needed
3. Severe Burns
   - IV fluid resuscitation (Plain LR)
   - Systemic antibiotics
   - Pain control
   - Physical therapy
   - Escharotomy if needed

Question 14

Assessment of Burns

Answer 14

1. Where?
   - burns in the neck and face are critical due to the risk of airway compromise and cosmetic/functional consequences.
2. How Wide?
   - estimate total body surface area (TBSA) burned.

Question 15

Management of Severe Burns: Neck and Face Area

Answer 15

1. Critical Concern: Airway Obstruction
   - Facial burns may lead to rapid edema of airway tissues.
2. Monitor for hoarseness, stridor, drooling, or respiratory distress.
3. Anticipate need for early intubation if airway compromise is suspected.
4. High-flow oxygen (humidified if available).
5. Secure airway early — consider intubation before swelling worsens.
6. Elevate head of bed to reduce facial edema.
7. Continuous pulse oximetry and ABG analysis if intubated.
8. Gentle cleansing; avoid agents that impair healing near eyes/mouth.
9. Ophthalmology
   - consult if eyes involved.
10. Non-adherent dressings over affected areas
11. Surgical consultation for potential grafting or reconstructive surgery.

Question 16

Fluid Resuscitation with Parkland Formula

Answer 16

• integral in calculating fluid resuscitation (PLR) for children with burns greater than 10% total body surface area (TBSA).
• Formula: 4 mL x Body weight (kg) x %TBSA burned
• 50% in first 8 hours (from time of burn)
• 50% over next 16 hours

Question 17

Burn Wound Care Techniques

Answer 17

1. Topical Agents
   - Silvadene
   - Betadine
2. Surgical Options
   - Escharotomy: Relieves pressure from swelling
   - Debridement: Removes necrotic tissue
3. Skin Grafting
   - Homograft: Human donor
   - Xenograft: Pig skin (common in children)
   - Autograft: Child’s own skin

Question 18

Prevention of Contractures

Answer 18

1. Early mobilization as soon as patient is stable
2. Use splints to maintain functional joint positions.
3. Range of motion (ROM) exercises at least 2–3 times daily.
4. Elevate limbs to minimize edema and maintain alignment.
5. Pressure garments after wound healing to reduce hypertrophic scarring.

Question 19

Infection Prevention

Answer 19

1. Maintain strict aseptic technique during dressing changes.
2. Daily wound assessment for signs of infection (odor, increased pain, drainage).
3. Topical antimicrobials
   - Silver sulfadiazine (Silvadene)
   - Mafenide acetate
4. Systemic antibiotics only when infection is confirmed.
5. Monitor for sepsis: fever, tachycardia, hypotension, altered mental status

Question 20

Physical and Occupational Therapy

Answer 20

1. Begin PT/OT (Physical Therapy and Occupational Therapy) early in recovery phase.
2. Tailored rehabilitation plans to restore function and independence.
3. Assist with activities of daily living (ADLs) and use of adaptive equipment.

Question 21

Focus areas of Physical and Occupational Therapy

Answer 21

1. Joint mobility
2. Muscle strength maintenance
3. Fine motor skills (hands, fingers)
4. Facial exercises for mouth/eyelid burns

Question 22

Psychosocial Support

Answer 22

1. Counseling for body image issues and trauma recovery.
2. Engage child life specialists and family support networks.