TY - CHAP M1 - Book, Section TI - Pediatric Burns A1 - Fishe, Jennifer N. A1 - Hendry, Phyllis L. A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert Y1 - 2019 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - Burns are the fifth leading cause of unintentional injury–related death in children. Children younger than 4 years typically suffer scald-related burns, whereas older children typically sustain flame-related burns.For pediatric patients, the Lund and Browder chart estimates percent of body surface area (BSA) burned by adjusting for age. Another method to estimate percent of BSA uses the area of the child’s palm (including fingers) to approximate 1% BSA.The primary survey should focus on airway patency as well as burn severity. Facial burns, the presence of soot, carbonaceous sputum, or singed nasal hairs should alert the physician to impending airway edema.Circumferential burns may cause both vascular and respiratory compromise. If vascular compromise is present, 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 the fluid volume is given over the first 8 hours; the second half is given over the next 16 hours.Pain control is of the utmost importance in burn management. Opioid analgesia is often required.Initial emergency department (ED) wound care consists of covering 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 so the specialty burn service may visualize the wounds.Topical antibiotics (such as bacitracin or 1% silver sulfadiazine) are routine in outpatient burn care.All burn patients should be re-evaluated at 24 to 48 hours to ensure proper wound healing and to examine for signs of infection. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1155749747 ER -