Burns in children

Burns make a significant contribution to paediatric hospital admissions; in 1 year, around 50,000 such patients attended accident and emergency departments and of these approximately 6400 attend a burns unit. Most burns occur at home, usually in the kitchen and bathroom. The aetiology changes with age; younger children suffer more scalds, older children more flame burns. Outwardly, burns treatment for children is similar to that for adults, but there are significant physical, psychological, and social differences. Paediatric surgical services are no longer an appendage to those for adults, and the burns team must be able to manage these different needs. A given injury inflicts a greater burn on a child. Children have thinner skin, lose proportionately more fluid, are more prone to hypothermia, and mount a greater systemic inflammatory response. Their youthfulness does make possible early, aggressive surgery and they demonstrate extraordinary ability to adapt to injury and survive extensive burns that are fatal to most adults. The focus of this article is the immediate and day-to-day management of children requiring admission to hospital for burns. The prolonged management of massive burns and inhalation injury is beyond the scope of this paper.