Disposition of Pediatric Burn Patients

 

Transfer to Burn Center if meets any of the following criteria: 

Partial thickness or greater burn >10% TBSA 

Any significant burns to face, hands, feet, genitalia, perineum, or major joints 

Any full-thickness burn 

Any electrical or chemical burn 

Inhalational exposure 

Burns in children with medical conditions or social factors that could complicate management, prolong recovery, or affect mortality 

 

Admission for observation, IV fluids, and pain management if: 

Children with 5–10% TBSA partial-thickness burn (for adults, 10-20%)

Children with 2–5% TBSA full-thickness burn 

Any circumferential burn 

High voltage injury

Inhalational injury

Medical conditions with increased infection risk (e.g. diabetes or sickle cell) 

Concern for non-accidental presentation 

 

Outpatient follow-up in a burn center clinic is often an option.

Consider telemedicine burn consult when available!

 

For patients that do not meet these criteria and can be discharged home:

            Pain control – Tylenol, ibuprofen – especially prior to any dressing changes

            Benadryl/hydroxyzine for itching of healing wounds

            Moisturize once starting to heal

            SPF sun protection

            Burn prevention strategies 

 

Strobel, Ashley M, and Ryan Fey. “Emergency Care of Pediatric Burns.” Emergency medicine clinics of North America vol. 36,2 (2018): 441-458. doi:10.1016/j.emc.2017.12.011

 

Grote, Andrea C et al. “Small Pediatric Burns Can Be Safely Managed on an Outpatient Basis.” Journal of burn care & research : official publication of the American Burn Association vol. 41,5 (2020): 1029-1032. doi:10.1093/jbcr/iraa115

 

Tintinalli, Judith E. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9th Edition. Ch 150, 217