TY  - CHAP
M1  - Book, Section
TI  - Pediatric Burns
A1  - Hendry, Phyllis L.
A2  - Schafermeyer, Robert
A2  - Tenenbein, Milton
A2  - Macias, Charles G.
A2  - Sharieff, Ghazala Q.
A2  - Yamamoto, Loren G.
PY  - 2014
T2  - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e
AB  - Burns  are  the  fifth  leading  cause  of  unintentional  injury-related  death.  Children  younger  than  4  years  tend  to  have  scalding-related  injuries,  whereas  older  children  tend  to  suffer  from  exposure  to  flames.Most  physicians  use  the  classic  Lund  and  Brower  chart  to  estimate  %BSA  burned  as  it  adjusts  for  the  age  of  the  patient.  Because  of  the  possibility  for  error  in  estimations,  some  physicians  use  the  child's  palm,  considered  approximately  1%,  to  measure  the  total  %BSA  burned.The  primary  survey  should  focus  on  the  patency  of  the  child's  airway  as  well  as  the  severity  of  the  burn.  Any  carbonaceous  sputum  or  singed  nasal  hairs  should  alert  the  physician  to  impending  airway  edema.Of  particular  importance  are  circumferential  burns,  which  may  cause  both  vascular  and  respiratory  compromise.  If  vascular  compromise  is  apparent,  the  patient  should  undergo  an  immediate  escharotomy.The  Parkland  formula  is  widely  used  to  estimate  fluid  requirements.  This  formula  calls  for  an  isotonic  crystalloid  solution  (such  as  Lactated  Ringers)  to  be  given  at  4  mL/kg/%BSA  over  a  24-hour  period.  Half  of  this  fluid  volume  is  given  over  the  first  8  hours,  and  the  second  half  is  given  over  the  next  16  hours.Pain  management  is  an  important  consideration  in  burn  management.  Opioid  analgesia  is  often  required.Initial  wound  care  in  the  emergency  department  should  consist  of  covering  the  burns  with  a  dry,  sterile  sheet.  Antiseptic  solutions  such  as  povidone–iodine  and  topical  antibiotics  should  be  avoided  in  patients  who  are  being  transferred  to  a  burn  center  until  the  primary  service  has  had  the  opportunity  to  evaluate  the  wounds.Topical  antibiotics  are  routine  in  outpatient  burn  care.  One  percent  silver  sulfadiazine  is  most  commonly  used.All  burn  patients  should  be  reevaluated  at  24–48  hours  to  ensure  proper  wound  healing  and  to  examine  for  signs  of  infection.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessemergencymedicine.mhmedical.com/content.aspx?aid=1105687563
ER  -