![]() Airway oedema will progress rapidly therefore, early tracheal intubation is mandatory in severe cases. Burns sustained in an enclosed fire will be associated with smoke inhalation, and resultant airway injury will be compounded by soot, noxious substances and hypoxia. It is important to have an understanding of the mechanism of injury to guide initial management. Anaesthetists will be involved at the initial management stages of seriously burned children to provide airway assessment and management, i.v. The initial approach to the child should follow Advanced Paediatric Life Support principles, with an ‘airway, breathing, circulation, disability and exposure’ (ABCDE) approach, and vigilance for other injuries in addition to the burn. 3 This article aims to give an updated perspective on burns care in children.Ĭhildren with burns may present to any hospital, not just a tertiary centre, and therefore, it is essential that practitioners are able to make an initial assessment of the burn and initiate resuscitation. Further details of paediatric burns care are available in the BJA Education article ‘Burns in children’. As an integral part of a multidisciplinary team, the roles of an anaesthetist include initial resuscitation, perioperative care, procedural sedation and pain management. The anaesthetist has an important role in the management of a child with a burn injury. The acute and background pain, multiple procedures and physical changes that the children experience can lead to a significant psychological impact on them and their families. If transferred to a specialist burns unit, this may be far from home, friends and family. Both acute and long-term treatments can lead to lengthy stays in a hospital. The importance of the integrity of the skin means that all but minor burns must be managed by treating the injury promptly and managing the sequelae.īurns have a multifaceted impact on patients. By doing so, this effective barrier is lost and complications, such as hypothermia and infection, can occur. Hence, the same exposure can lead to more significant burns over a shorter period of time.īurns cause thermal injury to the skin, which in turn compromises its protective functions. Infants have thinner and less heat-resistant skin compared with older children and adults. The impact of heat on the skin varies with age. Toddlers often start reaching up for cups on tables that may contain hot drinks. Babies, in particular, can be more vulnerable because of their inability to move away from the causative agent. However, there is a wide spectrum of injury pattern and severity. Most paediatric burns are small and can be managed in non-specialist centres. The incidence of burns is higher in children than in adults. Less common injuries in children include electrical, chemical and radiation burns. 2 The majority of admissions result from scalds, followed by contact and flame burns. Approximately 6,600 (17.5% of all trauma cases) are admitted for burns management. 1 An estimated 37,700 children per year attend emergency departments in England and Wales. They are the fifth most common presentation of non-fatal childhood injuries worldwide (WHO). Optimising procedural sedation and analgesia in the child will help improve experience and reduce anxiety.īurns injuries in children are common.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |