The infants and toddlers less than 2 years of age are frequently burnt. Etiology An important factor leading to burns even in neonates is overcrowding in a small house, where a small area in the room serves as kitchen (with floor level cooking). Scald burns are the commonest type of thermal injury in children. They usually suffer scalds by pulling down or knocking hot liquids on to themselves. Immersion scalds can occur when a child steps into a tub of hot water or stumbles onto a container of hot milk or cooked food Other causes are playing with match boxes Fireworks during diwali Playing around Campfire during winters Electrical burns due to biting of electrical cords , introducing fingers or metallic objects into electric sockets.
The burned area is cooled immediately with tap water to bring the burning skin to normal body temperature. Very cold water or ice should not be used as this can lead to hypothermia.
After cooling, remove the clothing from the burnt area. However, do not try to pull out clothing that is stuck to the skin. This may cause more harm.
Paracetamol or ibuprofen syrup may be given to decrease pain.
Rings, bracelet or watches, etc. should be removed from the affected area as they may cause tightness or constriction, when edema occurs.
Before going to hospital, cover the burned area with a clean sheet to prevent contamination and hypothermia.
No topical agent should be applied to the burnt area.
Burns size and depth are estimated first Criteria for admission
Children with more than 10% burns.
Involvement of face, neck, both hands,both feet or perineum.
Children with electrical or chemical burns, third degree burns of greater than 5%.
If burns are associated with soft tissue trauma or head injury, fractures etc.
Inhalation burns can be silent but deadly—smoke and toxic fumes can damage airways before symptoms appear.
If there is suspected child abuse or neglect, self-inflicted burns.
Fluid management
Nutrition-very important in child (energy and protein)
Antibiotics to prevent infection
Dressings like collagen and paraffin gauze etc
Topical antimicrobials like silver sulfadiazine
Early excision and grafting in deep burns
Fasciotomy in case of circumferential full thickness burns and electrical burns
Burns in children leave lifelong scars which are enormous stressors for both the child and his parents as they affect their development not only physically but mentally as well.
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