B Landsleitner1, J Keil. 1. Abteilung für Anästhesie und Intensivmedizin, Cnopf´sche Kinderklinik/Klinik Hallerwiese, Diakonie Neuendettelsau, St.-Johannis-Mühlgasse 19, 90419, Nürnberg, Deutschland, bernd.landsleitner@diakonieneuendettelsau.de.
Abstract
BACKGROUND: Since pediatric emergencies and burn injuries are rare in prehospital emergency medicine, emergency teams can hardly develop routine in emergency care. OBJECTIVES: How to effectively treat burn injuries and avoid common errors? MATERIALS AND METHODS: A simple and severity-based therapy concept based on the current literature using the example of a case report is presented. RESULTS: About 80% of burns and scalds in children are not severe cases-in these patients an effective analgesia by intranasal administration is important and further invasive treatments are generally not necessary. The emergency care of children with severe burn injuries should start with intranasally administered analgesia and/or sedation. After an intravenous or intraosseous access is gained, moderate fluid therapy is started, which should be complemented by a fluid bolus only if signs of a shock are present. Additional administration of analgesia and/or sedation may be necessary. Estimation of the burned body surface area is best determined with the palm rule; the severity of the burn appears after a latency period. Induction of anesthesia and intubation are not required in the majority of cases. CONCLUSIONS: By applying a modified ABCDE scheme, all emergency teams can provide effective emergency care in children with burn injuries.
BACKGROUND: Since pediatric emergencies and burn injuries are rare in prehospital emergency medicine, emergency teams can hardly develop routine in emergency care. OBJECTIVES: How to effectively treat burn injuries and avoid common errors? MATERIALS AND METHODS: A simple and severity-based therapy concept based on the current literature using the example of a case report is presented. RESULTS: About 80% of burns and scalds in children are not severe cases-in these patients an effective analgesia by intranasal administration is important and further invasive treatments are generally not necessary. The emergency care of children with severe burn injuries should start with intranasally administered analgesia and/or sedation. After an intravenous or intraosseous access is gained, moderate fluid therapy is started, which should be complemented by a fluid bolus only if signs of a shock are present. Additional administration of analgesia and/or sedation may be necessary. Estimation of the burned body surface area is best determined with the palm rule; the severity of the burn appears after a latency period. Induction of anesthesia and intubation are not required in the majority of cases. CONCLUSIONS: By applying a modified ABCDE scheme, all emergency teams can provide effective emergency care in children with burn injuries.
Authors: Jerry P Nolan; Jasmeet Soar; David A Zideman; Dominique Biarent; Leo L Bossaert; Charles Deakin; Rudolph W Koster; Jonathan Wyllie; Bernd Böttiger Journal: Resuscitation Date: 2010-10 Impact factor: 5.262
Authors: Benjamin T Kerrey; Andrea S Rinderknecht; Gary L Geis; Lise E Nigrovic; Matthew R Mittiga Journal: Ann Emerg Med Date: 2012-03-15 Impact factor: 5.721