Introduction

Burns in paediatric patients create many diagnostic and therapeutic problems not seen in adults. These include correct estimation of burn size and depth, fluid resuscitation and fluid maintenance, vascular access, airway management, nutritional support and prevention of sepsis. A child is not just a small adult, but a person who is even more devastated by the burn injury, and who is less able to respond to it.

Approximately one-third of burn unit admissions are children under the age of 15 years and one-third of all burn deaths involve children. Burns are second only to motor vehicle accidents as the leading causes of death in children older than one year. Most paediatric burns occur in the home and are very often the result of adult inattention or carelessness. However, about 10% are the result of deliberate abuse by adults.

Scald burns are the most common type of injury (50–60%), followed by flame burns (30%) and burns caused by contact with hot solids (10%). Chemical and electrical burns are very rare in children. Males predominate (about two-thirds), but this gender difference is not as large as in adults (75% male). Flame burns are frequently very severe; they often involve burning clothing, prolonged exposure and panic resulting in either flight or complete immobilization.

It is very difficult to make definitive statements based solely upon patient age, as any age groupings are also influenced by patient size and the other factors influencing burn severity.