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