Special Considerations of Pediatric Burned Patient

One of the most common casualties among children is the burn injury. Because children are unique in respect to anatomical and physiological characteristic, one must pay special attention in managing their hospital care. A) Normally, children have small body weight to surface ratio, and thus, they have a greater loss of fluid. Those pediatric burn patients, who have greater than 10% TBSA, should receive I.V. fluid resuscitation immediately to prevent a hypovolumic shock. One of the major predictor of mortality in children with burn injury is the length of time to administer the intravenous-line. B) Children have remarkable cardiopulmonary reserve and low blood pressure and decreased urine output are late manifestation of shock; and a child with cool extremities, mental obtundation with delayed capillary refill is in danger. C) Infants and toddlers with their increased surface area, less insulating fat and lower muscle mass for shivering are susceptible to hypothermia; which cause CNS and respiratory depression. D) Pediatric burn patients have limited glycogen, endogenous calorie stores, and hype-metabolism, which can lead to slow wound healing, loss of lean body mass, increase in mortality; hence, nutritional support is essential for increased metabolic demands. E) The small aperture of pediatric trachea predisposes it to obstruction, as edema develops promptly following inhalation burn injury; thus, airway evaluation must be given priority in pediatric patients. In conclusion, specific considerations in pediatric burn management can lead to increase survival rate.