Paediatric burns emergency guidelines

NHS Tayside ED Guidance
NHS Tayside

Based on COBIS guidelines 2019.

Initial management

  • Assess pain score
  • Weigh child
  • Assess burn area/depth and cover
  • Paracetamol 20mg/kg orally or 40mg/kg rectally
  • Intravenous or intranasal opiates
  • Consider ketamine IM or IV

Burns dressings

Superficial dermal less than 3%

  • de-roof blisters and debride loose skin
  • cleanse with warmed normal saline
  • obtain wound swabs
  • apply Mepitel dressings and sterile gauze and crepe bandage
  • review in 24-48 hrs

Superficial dermal greater than 3%

As above but refer to plastics for consideration of Biobrane dressings

Deep dermal, full thickness less than 1%

  • as per superficial dermal but dress with Mepitel.
  • will require follow up by Plastics within 48 hrs for scar management.

Full thickness greater than 1%

Mepitel dressings and admission under care of Plastics.

Criteria for referral to Plastics

All burns requiring specialist input are to be referred to the on call plastic surgeon in Ninewells.

Burns requiring immediate referral:

• Any burn greater than 3% TBSA

• Full thickness burns greater than 1%

• Burns to hands, face, feet, perineum or joint involvement

• High voltage electrical injury

• Chemical injury

• Airway involvement

• Burns with associated significant injury

• Any burn suspected of being non accidental (refer to local child protection policy)

• Circumferential burns

Burns that do not require admission which need prompt review in an appropriate Burns clinic

• Burns less than 3% with doubt regarding depth of injury

• Deep dermal / Full thickness injuries less than 1%

• Burns less than 3% that have not healed within 7-10 days

COBIS guidelines

COBIS guidelines

Editorial Information

Last reviewed: 01/08/2018