So when we see adults, we often
think of the rule of 9’s.
This is a way of assessing or guessing
how much body surface area has been
affected by burns because we’re
going to use body surface area
as a decision point as to whether these
patients need to go to a burn unit
or whether they should be okay.
And this rule of 9’s is,
as you can see here,
9% is the head, 9% is each arm,
the front and the back are each about 18%,
and the legs are each about 18%
of your total body surface area.
don’t work well for this
because their heads
are typically bigger.
So for children, we use
a different number
and you can sort of guesstimate
it based on a table.
So the idea here is that as kids grow,
their bodies are changing in terms of what
percent surface area is
accommodated by which age.
Always remember a palm is about 1% of you
body surface area and that will hold true.
But generally, you can see here
and this is not worth memorizing,
but it’s worth knowing and
you can look this up,
is that as infants grow, their head becomes
a lower and lower body surface area.
Likewise, this area or that area,
and so there are tables and
charts where you can guesstimate
body surface area based on age.
So how do we treat burns?
Well, for superficial, it’s just red.
There’s no blistering.
Generally, NSAIDs and
cold packs for pain,
and people should be just fine.
For the management of partial thickness
these are the ones that have
blistered and peeled a bit,
it’s important to clean them well to
prevent any superinfection and dress them.
We will often use topical antibiotics
and we may use something like Xeroform
gauze, which is a little bit less adhesive.
If you put something that can
dry out against that skin,
it’s going to be very
painful to remove it.
Generally, Vaseline-impregnated things.
The Xeroform adds a little
antibiotic component to it.
And also, we’re going to provide these
patients with pain medications.
So they really need pain
medication to stay comfortable.
Next, for more extensive burns,
generally outcomes are better if patients
are sent to certified burn centers,
especially nurses who have to provide very
significant care are more trained on burns.
They’re going to do a better
job for those patients,
especially around things like dressing
changes and other issues like that.
Generally, we’re going to stabilize them.
Then, we’ll do any surgical
correction if it’s needed.
And they may require down the
road cosmetic surgery as well
to minimize the impact of
scarring on their lives.
So that’s my review of burns in children.
Thanks for your attention.