Paediatric burns guideline

• 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

Guideline for the management of paediatric burns (Poster)

Non accidental burns and scalds in children

Management of airway burns and inhalation injury

Paediatric burn referral guideline

Fluid resuscitation