Pediatric Burns By Bradley J. Phillips

Chapter 2:

Principles of Pediatric Burn Injury

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onto their charges.⁴¹ Depending on the patient’s age and stage of development, family counseling may be an appropriate option as well.

Follow-Up

Patients suffering from burns have a better prognosis when consistent, long-term follow-up and early integration occurs.⁶ A multidisciplinary team can help provide physical and occupational therapy, scar management, reconstructive surgery, and family support.³² A significant burn is often a life-changing event for the patient as well as for his or her family. Health care providers must involve family in their children’s management as early as possible since a functional family and early reintegration are key components of a good prognosis.⁴² Severe burns are no longer synonymous with a poor quality of life, and it is our responsibility to make it a priority to help return these children to normal, meaningful, and productive lives.

Key Points

Determination of the extent of burn injury is based on depth and total body surface area (TBSA) involvement.

Extent of the burn injury is based on the temperature and duration of contact with the offending agent.

Burn management should always begin with PALS and ATLS protocols, along with specific management of fluid resuscitation and temperature maintenance.

Early excision and grafting is imperative in optimizing patient outcomes from significant burns.

Physical therapy with early range of motion and exercise will improve long-term outcome.

Continued follow-up for years with the patient and his or her family with a multidisciplinary burn center improves long-term rehabilitation and reintegration.

TABLE 1 The Lund and Browder Chart, Calculating the Percent Total Body Surface Area Involved in Burn Injury