The London Browder chart is probably the best chart to use because it takes into account the body shape variations in children, and it actually provides a much more accurate estimation of the, of the body surface area.
Giving colloid has been in a, actually, uh, a prospective study by Dietrich to show that there is statistically less fluid use overall, shorter lengths of stay, and a reduced incidence of fluid creep.
Transfer criteria to a burn center include burns of more than 5% total body surface area, particularly if they involve the face, hands, feet, genitalia, perineum, or major joints.
epidemiologicalBurns result in over 300 visits and 2 deaths per day in pediatric patients.↗
▶Ep 1 · 0:45
quoteBurns, one of the most common causes of pediatric injury, resulting in over 300 visits and 2 deaths per day.↗
▶Ep 1 · 1:00
quoteThe mechanism, hot liquids or steam in younger children, and fire in older children.↗
▶Ep 1 · 1:00
epidemiologicalThe mechanism of pediatric burns is hot liquids or steam in younger children, and fire in older children.↗
▶Ep 1 · 2:10
guidelineTransfer criteria to a burn center include burns of more than 5% total body surface area, particularly if they involve the face, hands, feet, genitalia, perineum, or major joints.↗
▶Ep 1 · 2:40
guidelineElectrical burns, chemical burns, and inhalational injury should be transferred to a burn center.↗
▶Ep 1 · 2:50
guidelinePatients with significant circumferential burns should be transferred to a burn center.↗
▶Ep 1 · 3:10
quoteI think most importantly, that if you suspect in any way, shape or form that this is part of, uh, non-accidental trauma, then that patient should definitely be transferred to a tertiary care center where they can provide the appropriate care to that patient.↗
▶Ep 1 · 3:40
guidelineAdmission criteria at a burn center include any infant under age 1 with a total body surface area burn greater than 8%.↗
▶Ep 1 · 4:00
guidelineAny 2nd degree burn greater than 10% or any 3rd degree burn greater than 5% are indications for admission.↗
▶Ep 1 · 4:50
clinicalBefore transfer, provide adequate pain control, apply silver sulfadiazine, and wrap wounds lightly with gauze, possibly adding Bactigras to prevent sticking.↗
▶Ep 1 · 6:00
clinicalPatients with smaller burns can be treated with oral rehydration therapy and do not necessarily require intravenous fluids.↗
▶Ep 1 · 6:20
clinicalAt the speaker's center, IV resuscitation is initiated for patients with greater than 10% total body surface area burns or teenagers with greater than 15%.↗
▶Ep 1 · 6:50
clinicalThe Lund-Browder chart is the best chart for estimating burned surface area because it takes into account body shape variations in children.↗
▶Ep 1 · 6:50
quoteThe London Browder chart is probably the best chart to use because it takes into account the body shape variations in children, and it actually provides a much more accurate estimation of the, of the body surface area.↗
▶Ep 1 · 7:10
clinicalThe palm of the patient can be used as an estimate of 1% body surface area burn.↗
▶Ep 1 · 7:20
clinicalThe Parkland formula uses Ringer's lactate solution at 3 cc per kg per percentage body surface area burn.↗
▶Ep 1 · 7:35
opinionThe Cincinnati and Galveston formulas are more pediatric-specific than the Parkland formula.↗
▶Ep 1 · 7:45
clinicalDextrose-containing solutions should be added as maintenance fluids for any patient under 30 kg.↗
▶Ep 1 · 8:10
clinicalA prospective study by Dietrich showed that colloid use results in statistically less fluid use overall, shorter lengths of stay, and reduced incidence of fluid creep.↗
▶Ep 1 · 8:10
quoteGiving colloid has been in a, actually, uh, a prospective study by Dietrich to show that there is statistically less fluid use overall, shorter lengths of stay, and a reduced incidence of fluid creep.↗
▶Ep 1 · 8:40
clinicalFluid creep is the phenomenon of giving too much fluid and not accounting for fluid already given, such as previous boluses or miscalculating total volume.↗
▶Ep 1 · 9:00
clinicalFluid overload can lead to respiratory compromise, making the patient difficult to ventilate.↗
▶Ep 1 · 9:10
clinicalIf a patient is adequately fluid resuscitated, controlled diuresis and addition of colloid can help eliminate excess fluid.↗
▶Ep 1 · 9:30
clinicalFoley catheter placement is indicated for patients with extensive burns, multiple trauma, or electrical burns where rhabdomyolysis may occur.↗
▶Ep 1 · 10:00
guidelineAll patients should receive at least a tetanus booster if their vaccination card is not available.↗
▶Ep 1 · 10:15
opinionThe speaker does not give antibiotics until there is a proven infection, as prophylactic use leads to development of resistant organisms.↗
▶Ep 1 · 10:40
clinicalCarbon monoxide levels should be checked in any patient with suspected closed space fire or inhalational injury.↗
▶Ep 1 · 11:00
clinicalPatients with carbon monoxide poisoning will have normal transcutaneous oxygen saturation but low PaO2 on blood gas because all hemoglobin is saturated with carbon monoxide rather than oxygen.↗
▶Ep 1 · 11:40
clinicalPatients with suspected inhalational injury need to be intubated very quickly because once edema sets in, intubation becomes extremely difficult.↗
▶Ep 1 · 12:00
clinicalBronchoscopy is useful in inhalational injury to assess the extent of airway injury and for pulmonary toilet, as patients often shed mucosa and develop casts in their airways.↗
▶Ep 1 · 12:25
clinicalIf a patient with chest burns is desaturating without good chest rise, an escharotomy may be needed with incisions in the anterior axillary lines bilaterally and an oblique chevron incision connecting them.↗
▶Ep 1 · 13:00
clinicalBurns evolve over time, and what initially appears as a superficial burn may progress to partial or full thickness requiring surgical debridement and grafting.↗
▶Ep 1 · 13:20
clinicalWounds should be reassessed every 24 hours for the first 48 hours.↗
▶Ep 1 · 13:40
clinicalResuscitation endpoints must be reached before considering surgical debridement, with urine output as the primary endpoint: 1 cc/kg/hr for children under 30 kg and 0.5 cc/kg/hr for those over 30 kg.↗
▶Ep 1 · 14:10
clinicalHalf of the calculated fluid should be given in the first 8 hours and the remainder over the next 16 hours according to resuscitation protocols.↗
epidemiologicalBurns result in over 300 visits and 2 deaths per day in pediatric patients.↗
▶Ep 2 · 0:45
quoteBurns, one of the most common causes of pediatric injury, resulting in over 300 visits and 2 deaths per day.↗
▶Ep 2 · 1:00
quoteThe mechanism, hot liquids or steam in younger children, and fire in older children.↗
▶Ep 2 · 1:00
epidemiologicalThe mechanism of pediatric burns is hot liquids or steam in younger children, and fire in older children.↗
▶Ep 2 · 2:10
guidelineTransfer criteria to a burn center include burns of more than 5% total body surface area, particularly if they involve the face, hands, feet, genitalia, perineum, or major joints.↗
▶Ep 2 · 2:40
guidelineElectrical burns, chemical burns, and inhalational injury should be transferred to a burn center.↗
▶Ep 2 · 2:50
guidelinePatients with significant circumferential burns should be transferred to a burn center.↗
▶Ep 2 · 3:10
quoteI think most importantly, that if you suspect in any way, shape or form that this is part of, uh, non-accidental trauma, then that patient should definitely be transferred to a tertiary care center where they can provide the appropriate care to that patient.↗
▶Ep 2 · 3:40
guidelineAdmission criteria at a burn center include any infant under age 1 with a total body surface area burn greater than 8%.↗
▶Ep 2 · 4:00
guidelineAny 2nd degree burn greater than 10% or any 3rd degree burn greater than 5% are indications for admission.↗
▶Ep 2 · 4:50
clinicalBefore transfer, provide adequate pain control, apply silver sulfadiazine, and wrap wounds lightly with gauze, possibly adding Bactigras to prevent sticking.↗
▶Ep 2 · 6:00
clinicalPatients with smaller burns can be treated with oral rehydration therapy and do not necessarily require intravenous fluids.↗
▶Ep 2 · 6:20
clinicalAt the speaker's center, IV resuscitation is initiated for patients with greater than 10% total body surface area burns or teenagers with greater than 15%.↗
▶Ep 2 · 6:50
quoteThe London Browder chart is probably the best chart to use because it takes into account the body shape variations in children, and it actually provides a much more accurate estimation of the, of the body surface area.↗
▶Ep 2 · 6:50
clinicalThe Lund-Browder chart is the best chart for estimating burned surface area because it takes into account body shape variations in children.↗
▶Ep 2 · 7:10
clinicalThe palm of the patient can be used as an estimate of 1% body surface area burn.↗
▶Ep 2 · 7:20
clinicalThe Parkland formula uses Ringer's lactate solution at 3 cc per kg per percentage body surface area burn.↗
▶Ep 2 · 7:35
opinionThe Cincinnati and Galveston formulas are more pediatric-specific than the Parkland formula.↗
▶Ep 2 · 7:45
clinicalDextrose-containing solutions should be added as maintenance fluids for any patient under 30 kg.↗
▶Ep 2 · 8:10
clinicalA prospective study by Dietrich showed that colloid use results in statistically less fluid use overall, shorter lengths of stay, and reduced incidence of fluid creep.↗
▶Ep 2 · 8:10
quoteGiving colloid has been in a, actually, uh, a prospective study by Dietrich to show that there is statistically less fluid use overall, shorter lengths of stay, and a reduced incidence of fluid creep.↗
▶Ep 2 · 8:40
clinicalFluid creep is the phenomenon of giving too much fluid and not accounting for fluid already given, such as previous boluses or miscalculating total volume.↗
▶Ep 2 · 9:00
clinicalFluid overload can lead to respiratory compromise, making the patient difficult to ventilate.↗
▶Ep 2 · 9:10
clinicalIf a patient is adequately fluid resuscitated, controlled diuresis and addition of colloid can help eliminate excess fluid.↗
▶Ep 2 · 9:30
clinicalFoley catheter placement is indicated for patients with extensive burns, multiple trauma, or electrical burns where rhabdomyolysis may occur.↗
▶Ep 2 · 10:00
guidelineAll patients should receive at least a tetanus booster if their vaccination card is not available.↗
▶Ep 2 · 10:15
opinionThe speaker does not give antibiotics until there is a proven infection, as prophylactic use leads to development of resistant organisms.↗
▶Ep 2 · 10:40
clinicalCarbon monoxide levels should be checked in any patient with suspected closed space fire or inhalational injury.↗
▶Ep 2 · 11:00
clinicalPatients with carbon monoxide poisoning will have normal transcutaneous oxygen saturation but low PaO2 on blood gas because all hemoglobin is saturated with carbon monoxide rather than oxygen.↗
▶Ep 2 · 11:40
clinicalPatients with suspected inhalational injury need to be intubated very quickly because once edema sets in, intubation becomes extremely difficult.↗
▶Ep 2 · 12:00
clinicalBronchoscopy is useful in inhalational injury to assess the extent of airway injury and for pulmonary toilet, as patients often shed mucosa and develop casts in their airways.↗
▶Ep 2 · 12:25
clinicalIf a patient with chest burns is desaturating without good chest rise, an escharotomy may be needed with incisions in the anterior axillary lines bilaterally and an oblique chevron incision connecting them.↗
▶Ep 2 · 13:00
clinicalBurns evolve over time, and what initially appears as a superficial burn may progress to partial or full thickness requiring surgical debridement and grafting.↗
▶Ep 2 · 13:20
clinicalWounds should be reassessed every 24 hours for the first 48 hours.↗
▶Ep 2 · 13:40
clinicalResuscitation endpoints must be reached before considering surgical debridement, with urine output as the primary endpoint: 1 cc/kg/hr for children under 30 kg and 0.5 cc/kg/hr for those over 30 kg.↗
▶Ep 2 · 14:10
clinicalHalf of the calculated fluid should be given in the first 8 hours and the remainder over the next 16 hours according to resuscitation protocols.↗
