Paediatric burns guideline

Warning Warning: This guideline is 216 day(s) past its review date.

  • 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 below 3%

  • De-roof blisters and debride loose skin
  • Cleanse with warmed normal saline
  • Obtain wound swabs
  • Apply Silflex dressings and sterile gauze and crepe bandage
  • Review in 24-48 hrs

Superficial Dermal over 3%

  • As above but refer to plastics for consideration of Biobrane dressings

Deep dermal, full thickness below 1%

  • As per superficial dermal but dress with Silflex.
  • Will require follow up by plastics within 48 hrs for scar management.

Full thickness over 1%

  • Silflex dressings and admission under care of plastics.

All burns requiring specialist input are to be referred to the on call Plastic Surgeon in Ninewells.

Burn requiring immediate referral:

  • Any burn over 3% TBSA
  • Full thickness burns over 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 that need prompt review in an appropriate burns clinic:

  • Burns below 3% with doubt regarding depth of injury
  • Deep dermal / Full thickness injuries below 1%
  • Burns below 3% that have not healed within 7-10 days

Editorial Information

Last reviewed: 01/08/2020

Next review date: 31/08/2024

Author(s): C. Donald.