Pediatric Burns.ppt

Pediatric Burns Epidemiology 1,000,00 pediatric burn injuries each year Preschoolers are 50% of pediatric burns 3rd leading cause of death in youth Due to medical advances, children now routinely survive massive burns But, little research is devoted to the psychological aspects of pediatric burns Types of Burn Injuries Thermal Scald Flame Radiation Chemical Electrical Household Burn Risks Developmental Trends Key Concepts TBSA = % of Total Body Surface Area Using standard charts displaying dorsal (back) and ventral (front) views for the body Heat intensity and duration of skin contact determine the extent and depth of skin damage Degrees of Burn Injuries Based on depth of burn injuries 1st degree: damage to epidermis Heals in ~2-5 days with peeling; minimal scarring 2nd degree: damage to dermis Partial thickness Heals in ~ 1-3 weeks with no grafting 3rd degree: damage to multiple layers including subcutaneous tissue Full thickness Heals in ~3-5 weeks; requires grafting Layers of Skin Degrees of Burns Medical Management: Emergency Phase Remove source of heat Apply first aid Assess for and treat shock Evaluate breathing (inhalation injury) Use CPR at scene, if necessary Fluid resuscitation – to correct electrolyte imbalance and decreased blood volume Medical Management:Acute Phase Goal: close the wound Reduce infection risk Remove eschar (dead skin) by debridement Apply topical dressings Use physiological dressings to reduce fluid and heat loss Perform autografting surgery Use tissue-cultured skin as last resort Medical Management:Rehabilitation Phase Surgical procedures Physical therapy Nutritional concerns Pressure garments Psychological Issues:Injury Occurrence Child abuse Scalds from immersion in hot water Child neglect Neglect vs accident? Socioeconomic status Substandard housing Lack of basic resources (e.g., outlet covers) Higher rates of child/parent psyc disorder Psychological Issues:Acute Phase Pain Management Burns are among most painful injuries Pa