PEM Playbook – Major Burns in Children

Originally published at Pediatric Emergency Playbook on February 1, 2020 – Reposted with permission – Listen to accompanying podcast on original site

Follow Dr. Tim Horeczko on twitter @EMTogether

Lund and Browder Chart to Estimate Burn Size in Children

Parkland Formula for Burns

Amount needed in addition to maintenance fluids:

4 mL/kg x BSA% = X

Add 1/2 of X to maintenance over the 1st 8 hours

Add the other 1/2 of X to maintenance over the next 16 hours


Escharotomy Guide and the “Roman Breastplate”

Yin et al. Bedside Escharotomies for Burns

Selected References

Mahar PD et al. Clinical differences between major burns patients deemed survivable and non-survivable on admisssion. Injury. 2015; 46:870-873.

Mathis E et al. Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects. Medicines. 2017; 4:91.

Osuka A et al. Glycocalyx shedding is anhanced by age and correlates with increased fluid requirement in patients with major burns. Shock. 2017; 50(1):60-65.

Sebastian R et al. Percutaneous pigtail catheter in the treatment of pneumothorax in major burns: The best alternative? Burns. 2015; e24-227

Sherren PB et al. Lethal triad in severe burns. Burns. 2014; 1492-1496.

Strobel AM et al. Emergency Care of Pediatric Burns. Emerg Med Clin N AM. 2018; 441-458.

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