Modern management of paediatric burns

Abstract

Burns in children differ in multiple aspects from those in adults;
the extent and depth of the burn injury are often more severe, the
child’s body proportions differ, resulting in greater evaporative
water and heat loss, and fluid requirements are therefore generally
greater. Importantly, many childhood burns are preventable.
The National Injury Mortality surveillance system indicates that
burns are the leading cause of non-natural death in infants and
children under 5 years and the fourth major cause of accidental
death in the 5 - 9-year age group,1 with more than 1 300 children
dying annually from burns in South Africa (SA).
The majority of childhood burns in SA are treated by nonspecialists,
with referrals to burns units being reserved for the more
severe cases. It is well documented in the literature that in some
settings the majority of burn victims do not receive adequate first
aid;2 the majority of doctors treating burn wounds are unable to
correctly measure the extent of the burn and almost half of treating
doctors fail to prescribe adequate analgesia.3 This article will focus
on appropriate referral guidelines as well as deal with correct
management of burns within a general hospital setting.