Areas of erythema and superficial burns are not included in calculations of TBSA.Īccurate documentation of wound assessment should be recorded.įurther information regarding wound assessment in a burn injury can be located on theīurns Clinical Practice Guideline as well as theįurther information regarding wound assessment and healing can be located on theĪ thorough patient history should be collected on admission to hospital. Assessment of Total Body Surface Area (TBSA) burnt, utilising the Lund Browder chart.Wound assessment of a burn injury includes (available on Electronic medical Records): As burn injuries heal accurate wound assessment will ensure wound management is altered as needed to ensure appropriate wound care continues to be delivered to the patient. Burn injuries can take up to 10 days to truly present the depth and extent of injury so reassessment is vital.
Information regarding procedural pain management can be located on the Procedural Pain Management Clinical Guideline.Īssessment of the burn injury should occur on the initial presentation to the Royal Children’s Hospital as well as prior to completing wound care throughout the inpatient stay and outpatient visits. Consider the need for an ECG and continuous cardiac monitoring if the burn is of electrical origin.ĭetailed information regarding paediatric pain assessment can be located on the Pain Assessment Nursing Clinical Guideline.Neurovascular observations nursing guideline) and the affected area elevated where ever possible. Circumferential burns should be identified, monitored for circulatory compromise (.
If inhalation burns are suspected high flow oxygen therapy via a Hudson mask should be administered to the patient and changes/abnormal findings reported to the treating team immediately for further assessment and management.Ĭhildren who sustain burns injuries are at increased risk of circulatory compromise due to significant fluid loss and fluid shifts, these patients must be closely monitored for:
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TBSA – percentage of total body surface area burnt (not including erythema or superficial burns) calculated using theīurn – In paediatric burns a minor burn is considered to be less than 10% TBSA.īurn – In paediatric burns a major burn is considered to be more than 10% TBSA.īurn injuries cause a significant insult on the body and a thorough ABCD assessment, followed by a full head to toe and focused assessment are vital to ensure clinical issues/deterioration are identified early and appropriate management initiated. See Burns- Acute management CPG for further details of burn injury assessment.Īssessment of the pediatric patient with a burn injury should occur on admission and regularly throughout care.ĭetailed information regarding completion and documentation of ABCD, head to toe and focused assessments can be located on theīurns specific information is outlined below.Īssessment and monitoring of airway patency and breathing should be carefully observed as patients at risk of inhalation burns can deteriorate up to 72 hours post burn injury, particularly if they have: Multidisciplinary Team – consists of Burns Consultant/Fellow, Burns Clinical Nurse Consultant, Burns registrar/resident, Nurse Coordinator, Occupational Therapist, Physiotherapist, Dietitian, Social Work, Mental Health, Child Life Therapy (CLT), Specialist Clinics Team. The aim of this clinical guideline is to assist and support nursing staff at The Royal Children’s Hospital to plan and deliver care to children with burn injuries, across all departments including: Emergency, Paediatric Intensive Care Unit, Inpatient Units, Theatres and Outpatients. Ongoing care requirements are based on the size, depth, anatomical site and mechanism of injury. As the injury itself and required treatment often causes distress, pain and anxiety, appropriate management by nurses is essential in providing family centered care. The impact of these injuries on children and families is often long lasting. Burn injuries have a significant impact on paediatric patients and may affect a range of body systems.
Children are vulnerable to sustaining a burn injury due to their physiological, psychological, and developmental differences.
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