Trauma Burn Protocols

Please do not use Silverdene on partial thickness pediatric burns (pseudoeschar makes it difficult to determine deep partial vs full thickness burns)

• If there is concern for full thickness burn wound infection, excise and place Xenograft for temporarily coverage.

-Consult PT/OT on ALL BURN admission

Goals:

• UOP: 0.5-1ml/kg/hr
• Age appropriate vital signs

Admission location:

• 10% TBSA burn: floor
• 10-14% TBSA burn: intermediate
• >/=15% TBSA burn, inhalational injury, or
• intubated child: ICU

IV access:

• >15% TBSA burn deep partial or full thickness burn, inhalation injury, child needing multiple debridement, or intubated child ? consider central venous access for resuscitation, lab draws, prolonged stay
• Initial OR/sedation procedure for burns >15%
• nasal gastric feeding tube, foley catheter,
• central venous access

Uploaded in Sunrise on:

• Day of initial evaluation
• Immediately after initial debridement
• Post-burn day 3, 7, 14, and so on until wound is closed
• 1 month, 3 months, 6 months, and so on for up to 1 year post-burn
• If requiring grafting:
  • Prior to STSG
  • 1st wound vac take down

All patients should receive a social work consult

-Consult Pediatric Service for patients < 8 years old

-Injury prevention team education

-Determine need for license professional counseling for trauma/abuse

• Evaluation for prior family history of non-accidental trauma
• Determine need for CPS consultation