Figure 86.1 The SAFE approach Figure 86.2 Lund and Bowden assessment tool Figure 86.3 Classification, assessment, management and complications Figure 86.4 Zones of injury
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Thermal injuries
Thermal injuries have been described as some of the worst injuries for infants and children. Children experience physical and psychological trauma, which may leave disfigurement and disability. Approximately 50 000 children under the age of 5 years incur thermal injuries annually, the impact of which upon the child and the family cannot be quantified. Moreover, the evidence would suggest that accident prevention does not reduce the incidence of thermal injuries, particularly in the younger age group.
Incidence
The highest incidence occurs in children under 5 years. The most common thermal injury is scalds from hot water (66%), with a gender ratio higher in males than females. As young children become more mobile and curious their exposure to household thermal hazards increases. There may be seasonal and regional differences that affect the pattern of burn injuries. Cultural and socioeconomic factors may increase the risk patterns of thermal injuries in any community.
Priorities (Figure 86.1)
- Stop the burning and arrest any further damage.
- Assess if fluid resuscitation is required.
- Assess and mange pain.
- Communication with the child and family.
Total body surface area
The total body surface area (TBSA) affected can be estimated using a range of methods to assess whether a minor or major thermal injury is involved.
TBSA >10% is classified as major burns
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