Inhalation injury is the leading cause of death in pediatric burn patients.
Child abuse comprises up to 10–20% of pediatric thermal injuries and must be ruled out.
Due to the larger body surface area to mass ratio of children compared to adults, the modified Parkland formula, which adds maintenance fluids to resuscitation fluids, is used in the resuscitation of smaller children.
Fluid resuscitation should be guided by the patient’s response (urine output).
Extremity escharotomy may be needed to prevent compartment syndrome, and chest escharotomy may be needed to prevent respiratory compromise.
Recent developments of silver-impregnated sustained release dressings (e.g., Aquacel® Ag) have allowed for the treatment of partial-thickness burns in a nearly painless fashion.
Recent advances in the care of the critically burned patient with use of an aggressive multidisciplinary approach have led to significantly improved outcomes in children.
A multidisciplinary approach to burn care including participation of surgeons, nurses, occupational therapists, physical therapists, dieticians, play therapists, social workers, psychologists, and discharge planners, leads to the best outcome.