Pediatric emergency medicine trisk 3214 3214

FIGURE 104.1 Estimation of surface area burned on the basis of age. This
modification by O’Neill of the Brooke Army Burn Center diagram shows the change in
surface of the head from 19% in an infant to 7% in an adult. Proper use of this chart
provides an accurate basis for subsequent management of the child with burn injury.

Deep partial-thickness burns involve destruction of the epidermis and
most of the dermis. Edema can lessen the exposure of sensory nerve
receptors, making some partial-thickness burns less painful and tender,
although there should be some intact pain sensation. Deep partial-thickness
burns have a paler, drier appearance than superficial injuries, at times
making them difficult to distinguish from full-thickness injury ( Fig.
104.3C ). Thrombosed vessels often give deep partial-thickness burns a
speckled appearance. Burns evaluated immediately may appear to be
partial-thickness injuries and subsequently become full-thickness injuries,
especially if secondary damage from infection, trauma, or hypoperfusion