Pediatric Considerations
Pediatric Considerations
- Relatively thinner skin results in deeper burns at any given temperature.
- Larger skin surface area to body mass ratio predisposes to greater fluid and heat loss.
- Larger head to body ratio results in different distribution of Total Body Surface Area (TBSA) calculation compared to adults.
- Smaller and shorter airway results in earlier onset of upper airway obstruction secondary to inhalational burn-related edema.
- Higher metabolic rate causes increased oxygen and glucose demand, respiratory rate, and insensible fluid losses.
- Burns without clear explanation or an explanation that does not match the pattern of injury are concerning for maltreatment.
- Patterns that may raise concern for an inflicted burn include:
- Immersion patterned scald burns
- Patterned contact burns
TREKK. Pediatric Thermal Burns [Internet]. 2020. Available from: https://cms.trekk.ca/wp-content/uploads/2023/11/2020-11-27-Burns_v_1.0-1.pdf.
Criteria for Referral to a Burn Centre (BCCH)
Burns that involve the following warrant a referral to a burn centre:
- Partial thickness burns greater than 10% total body surface area (TBSA)
- Burns that involve the face, hands, feet, genitalia, perineum, or major joints
- Third degree burns in any age group
- Electrical burns, including lightning injury
- Chemical burns
- Inhalation injury
- Burn injury in patients with pre-existing medical disorders that could complicate management, prolong recovery, or affect mortality
- Any patient with burns and concomitant trauma
The University of British Columbia Division of Plastic Surgery. PEDIATRIC BURN REFERRALS [Internet]. Available from: https://www.ubcplastics.ca/copy-of-adult-burns.