Burn Epidemiology & Prevention
What type of burn injury is most common in infants and toddlers in developed countries?
Scald burns (bath/kitchen incidents)
At what approximate % total body surface area (TBSA) do systemic changes usually begin?
>10% TBSA
What is the most important priority in the primary survey of a burned child?
Airway integrity
Burns appropriate for outpatient care usually heal within how many weeks?
~3 weeks
What formula is classically used to guide crystalloid fluid resuscitation?
Parkland formula
Name two components of burn aftercare programs that improve long-term outcomes.
Scar management, PT/OT, counseling, reconstruction
Name two household strategies parents can use to reduce the risk of scald injuries.
Keep hot beverages out of reach; test bathwater before use
Which metabolic state follows the initial hypodynamic phase of severe burns?
Hypermetabolic/catabolic state
What does the “palmar surface of a child’s hand” represent in burn size estimation?
~1% of TBSA
Why are prophylactic antibiotics not routinely recommended for outpatient burn care?
They don’t reduce infection risk and encourage resistance
What is the author’s practice regarding albumin use in children with >30% TBSA burns?
Add 5% albumin at maintenance rate
What common nonburn pediatric dermatologic condition may require burn unit care due to diffuse epidermal sloughing?
Toxic epidermal necrolysis (TEN)
In low-income countries, why are burn injuries more frequent and severe?
Why are young children more prone to airway obstruction after burns?
Small airway diameter → edema risk
What type of burn pattern should raise suspicion for child abuse?
Immersion patterns or flexor-sparing burns
Name one key family requirement for safe outpatient burn management.
Adequate family support for wound care/transport
What is the nutritional protein goal (g/kg/day) for children with severe burns?
2–2.5 g/kg/day
Why do children with burns often need revision surgery as they grow?
Grafts don’t grow with skeleton → need revisions
What product regulations have been mandated to reduce pediatric burn injuries?
Flame-retardant sleepwear, fire-safe cigarettes, smoke detectors
Name one pharmacologic intervention studied to reduce hypermetabolism after large burns.
β-blockers, growth hormone, anabolic steroids
What procedure relieves pressure from circumferential eschar that impairs circulation?
Escharotomy
Which type of dressing both decreases pain and reduces bacterial colonization?
Silver-releasing dressings
Why is fever in burned children diagnostically challenging?
Fever may be due to burn hypermetabolism or infection
What role does family and peer support play in pediatric burn recovery?
Crucial for emotional healing & reintegration
What type of counseling during well-child visits may be most effective in prevention?
Family counseling during pediatric visits
Why do children with burns require earlier nutritional support than adults?
Higher energy needs & risk of rapid catabolism
Which sedation agent is particularly useful for painful wound debridement in children?
Ketamine
What percentage TBSA and depth typically require inpatient transfer per ABA criteria?
>10% TBSA in <10 or >50 y, >20% in others
What 4 phases organize the care of large burns?
Evaluation/resuscitation, excision/closure, definitive closure, rehab
Name two nonburn injuries (besides TEN and scalded skin syndrome) that burn centers commonly treat.
Electrical injuries, frostbite, chemical injuries, crush injuries, blast injuries