UMEM Educational Pearls

Category: Pediatrics

Title: Pediatric Burns

Keywords: Pediatric Burns (PubMed Search)

Posted: 1/10/2009 by Don Van Wie, DO (Updated: 9/24/2021)
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  • Burn injuries are common in children and are the 3rd leading cause of unintentional injuries in children age 0 to 18 yrs, only behind MVCs and drowning.
  • Burns greater than 20% TBSA require agressive fluid resuscitation. Lactated Ringer's is the most commonly used fluid. 
  • Parkland Burn Formula:  LR over 24 hours = 4mlxkgx %BSA burned. 1st half over 1st 8 hours, 2nd half over subsequent 16 hours.  Add maintenance fluids to this amount for patients < 30 kg.
  • Urine output is the best way to assess adequate fluid resuscitation.  Place a foley and goal output is 1-2 ml/kg/hr in children.  (0.5 to 1 ml/kg/hr in adults)
  • Oligoanalgesia is very common in pediatric patients.  Use morphine 0.1 mg/kg IV/IM or Oxycodone 0.1 mg/kg po.
  • 6% of burned children < 12 years old are victims of abuse.  So keep a high index of suspicion in children with burns. 

References

Granger,Estrada,Abramo. An Evidence-Based Approach to Pediatric Burns. Pediatric Emergency Medicine Practice. Jan 2009. Vol6,No 1