Symposium: accidents and poisoningEarly management of paediatric burn injuries

Burns are a common form of trauma in children, resulting most frequently from scalds but also contact, flame, electrical and chemical sources. Burn patients have a wide spectrum of injury severity and diverse outcome, ranging from superficial burns with no lasting physical signs to deep, large body surface area burns which are profoundly life-changing, affecting all physiological systems. Size, site and depth are important factors affecting treatment and outcome. There are important anatomical, physiological and psychosocial differences between adults and children. Their body proportions are different, they have thinner skin, smaller airways, reduced blood volume and high levels of distress. They are vulnerable to non-accidental injury. Children require formal fluid resuscitation and maintenance fluids for burns more than 10% total body surface area. Complications include infection, toxic shock syndrome, adverse scarring and psychological sequelae. This paper discusses how correct assessment and management in the acute stage can reduce later morbidity and mortality.