Pediatric emergency medicine trisk 3210 3210

hemolytic process. The profound circulatory effects of severe burns can
result in life-threatening shock early after injury.

Goals of Treatment
High-quality care is key for functional outcome and survival from burn
injuries. Emergency management begins with prehospital care, assessment,
resuscitation, treatment of potential inhalational injury, wound care,
infection control, and appropriate admission. The continuum of care
extends through hospitalization, potential surgical management, and
rehabilitation. The unifying goals of these treatment modalities are to
compensate for the physiologic effects of the burn and promote healing.

Clinical Considerations
Clinical Recognition
Immediately after arrival, the physician must determine if a patient with
burn injury requires aggressive therapy for major burns. In children with
severe injuries, the evaluation and initial management take place
simultaneously. Smoldering clothing or other sources of continued burning
must be removed. Information about the circumstances of the burn and the
potential for associated injuries should be sought from prehospital care
providers, police, or family members, but this should not delay the initial
treatment.
It is crucial to recognize inhalational injury as a cause of impending
airway obstruction and respiratory failure. A history of smoke exposure is a
risk factor. Clinical signs of potential inhalational injury include burns on
the face, singed nasal hairs, soot in the sputum or soot visible in the upper
airway.
Triage Considerations
All children with nontrivial burns should be rapidly transported to a hospital
setting. Once in the hospital, the triage process should take into account the
child’s age and medical history, the injury mechanism, and the surface area

and depth of the burn. Children <2 years of age and those with significant
comorbidities have a higher risk of burn-related complications. The
physical response to burn injury and mortality prognosis appears to worsen