Paediatric burns guideline

Warning

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 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.

Criteria for referral to 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.