Paediatric burns emergency guidelines

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.

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