Pediatric emergency medicine trisk 3228 3228

Suspicious injuries should be reported to the appropriate
authorities and should prompt further clinical investigation.
Assess the safety of the household and provide anticipatory
guidance even in cases where there is not a suspicion of inflicted
injury.
Ensure adequate wound care and follow-up.

Goals of Treatment
A small minority of all burns in children requires therapy in the hospital.
Once a careful assessment has led to a decision to manage a burn as an
outpatient, preparations for treatment at home should begin. Parents or
guardians need to be instructed carefully regarding wound care and reasons
to return. The goal of the treatment of minor burns is to reduce pain,
decrease risk of infection, and improve functional outcome through careful
home management and close outpatient follow-up.

Clinical Considerations
It is important to consider the possibility of inflicted burns and to carefully
examine even minor burns for characteristic shapes and patterns.
Additionally, it is crucial to perform a detailed secondary survey to ensure
that no other traumatic injuries are missed.
Clinical Recognition
A child with superficial or partial-thickness burns <5% TBSA may be a
suitable candidate for outpatient burn care. There should be no concern for
inflicted burn, and appropriate parental and family resources need to be in
place to ensure careful home care and close follow-up.
Triage Considerations
See Table 104.1 for suggested triage guidelines. Most minor burns can be
triaged to the urgent or nonurgent level of care.
Clinical Assessment
Analgesia may be needed to perform a careful wound assessment. Sloughed

epidermis should be removed with sterile normal saline and gauze, allowing