Chapter 40 - Burns in Children

Summary

Burns are a common injury throughout the world and are mostly preventable. A moment of inattention by a guardian or an older child playing with fire can lead to a lifetime of burn care. Children have a higher incidence of burns than adults, although most burns are small. Burns over 10% require formal fluid resuscitation to mitigate the effects of systemic oedema and burn shock. Definitive treatment involves non-operative techniques, such as application of dressings, or for larger or deeper injuries, operations to debride the wound and apply skin grafts. Each burn generates background, breakthrough and procedural pain that must be managed effectively. Small burns may be complicated by infection, larger burns by multiple organ failure. The outcomes are generally good, and children can survive and thrive even after very large injuries. Anaesthetists are involved in all aspects of burn care once a child reaches hospital, and they are an essential part of the multidisciplinary burn care team. The aim of this team is to deliver faster healing and better pain control, and to prevent complications. This chapter describes current burns care for children in the United Kingdom.