Burns

How To
Cool…
“All the
flower,
children
were as
alike”
What actually burning.....

Burns are leading cause of Death in

children

Approximately 1.2 million

people require medical care
each year,
most shocking is
30% to 40% are younger than
15 years of age
What burns your child…..?
But how….?
Child abuse-18%
Accidents
Neglect
House fires
Electrical shocks
 - Cover the child with
a blanket , coat, or

first aid
carpet
- Remove child from
smoke
- Ensure that child’s
airway is patent.
- Remove jewelry if any
- If it happen by
chemicals brush it off
reaming
- Cover burn area with
a clean dry sheeting
- do not apply cold for
large injury
HOW DEEP IT MAY BURNS...?
1st degree burn
 Skin
Dry, no blisters. Minimal or no edema.
Erythematous. Blanches, bleeds
 Pain
Very Painful
 Depth
Epidermal layers only
 Healing time
2-5 days with no scaring
2nd degree
 Skin
Moist blebs, blisters. Underlying tissue is mottled
pink and white, with fair capillary refill. Bleeds
 Pain
Very Painful
 Depth
Epidermis, papillary, and reticular layers of
dermis. May include domes of subcutaneous
layers.
 Healing time
Superficial: 5-21 days with no grafting. Deep
partial: 21-35 days with no infection. If infected,
converts to full-thickness burn.
3rd degree
 Skin
Dry, leathery eschar. Mixed white, waxy, khaki,
mahogany, soot-stained. No blanching or bleeding
 Pain
insensate
 Depth
Down to and may include fat, subcutaneous
tissue, fascia, muscle, and bone.
 Healing time
Large areas require grafting, but small areas may
heal from the edges after wks.
Children are
not little
adults
rule OF Palm or nine…?
The Rule of Palm’s
assumes that the palm size
of the patient represents
approximately 1% of the
TBSA. TBSA is then
estimated by
approximating the number
of “palms” it would take to
completely cover the burn.
Start
Parkland formula
Parkland formula is an
appropriate starting
guideline for fluid
resuscitation-4 mL lactated
Ringer/kg/% BSA burned-.
Half of the fluid is given
over the 1st 8 hr,
calculated from the time of
onset of injury. The
remaining ½ is given at an
What to apply for burnt skin…..?
If it burnt below
10% of BSA
0.5% silver nitrate
solution

Silver sulfadiazine
If above
30%...........?
Cover the wound
Grafting
Sodium supplement
Protein and electrolyte
supplement
Control infections
 Covering of wound should be
made by sterile material
 Isolate the child to prevent
cross infections
 Use penicillin as prophylactic.
 Periodic replacement of
central venous catheter.
 Strict aseptic dressings
 Topical anti microbial
Inhalation injury…..!
These may occur from
2. Direct heat
3. Acute asphyxia
4. Carbon monoxide
poisoning
5. Toxic fumes, including
cyanides from plastics.
HOW TO TREAT THIS……..?

Maintain patent
airway
Put naso-trachial tube
Oxygen therapy
Corticosteroids
Chest physiotherapy
What to do for pain….?
 Adequate analgesics
 Psychological support

 Allow the primary care giver to be with the

child
 Decrease the stress of child and primary care
giver
 Oral morphine suphate 0.3-0.6mg/kg every 4-
6th hourly
 Benzodiazepines SOS
Nutrition for child………..?

Mortality related burn injury is

related mainly due to
malnutrition not the skin that
burnt
Proteinsupplement
Albumin supplement
High caloric diet
Future must be BEAUTIFUL….…
Ensure maximum cosmetic
effect of treatment
Physical and occupational
rehabilitation
Assist in ADL
Special garments
If Not Treated Well……?
 Pain
 Dry skins

 Itching

 Amputations

 Osteoporosis

 Sleep disorders

 Depressions

 Phobia

 Renal failure

 C.V disorders
So stop it before it happens….
 Install and use smoke detectors
 Control hot water to be reached to children

 Keep cloths away form heat

 Avoid smoking in child’s presence

 Protest child abuse

 Do not leave child alone

 Do not neglect child

 Keep chemicals out of reach to child

 Use safe electrical devices

“There is no other
sadness in this world
than losing a child”