Burn injuries are common in children and are the 3rd leading cause of unintentional injuries in children age 0 to 18 yrs, only behind MVCs and drowning.
Burns greater than 20% TBSA require agressive fluid resuscitation. Lactated Ringer's is the most commonly used fluid.
Parkland Burn Formula: LR over 24 hours = 4mlxkgx %BSA burned. 1st half over 1st 8 hours, 2nd half over subsequent 16 hours. Add maintenance fluids to this amount for patients < 30 kg.
Urine output is the best way to assess adequate fluid resuscitation. Place a foley and goal output is 1-2 ml/kg/hr in children. (0.5 to 1 ml/kg/hr in adults)
Oligoanalgesia is very common in pediatric patients. Use morphine 0.1 mg/kg IV/IM or Oxycodone 0.1 mg/kg po.
6% of burned children < 12 years old are victims of abuse. So keep a high index of suspicion in children with burns.
References
Granger,Estrada,Abramo. An Evidence-Based Approach to Pediatric Burns. Pediatric Emergency Medicine Practice. Jan 2009. Vol6,No 1
