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Burn size estimation in children: still a problem

Queenie E Chan1, Federica Barzi, Lukas Cheney

  • 1Douglas Cohen Department of Paediatric Surgery, The Children's Hospital Burns Research Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

Emergency Medicine Australasia : EMA
|April 11, 2012
PubMed

Insights

Accurate estimation of pediatric burn size is a persistent challenge, with 79% of referred children having inaccurate total body surface area burned (TBSA-B) calculations. Improved training is crucial for first responders to correctly assess burn severity in children.

Area of Science:

  • Pediatric burn management
  • Trauma assessment
  • Emergency medicine

Background:

  • Accurate burn size and depth determination is critical for initial burn injury assessment.
  • Errors in estimation can lead to improper fluid resuscitation and patient transfers to specialized burns units (BUs).
  • While adult burn estimation has improved, pediatric data remain lacking.

Purpose of the Study:

  • To evaluate the accuracy of burn size estimation in children referred to a specialized burns unit.
  • To identify discrepancies between initial estimations and actual measurements of total body surface area burned (TBSA-B).

Main Methods:

  • Retrospective review of pediatric burn patients admitted to a BU in 2009.
  • Comparison of TBSA-B estimated by referring centers with actual TBSA measured upon arrival.
  • Analysis of 71 pediatric burn cases.

Main Results:

  • 10 out of 71 patients had no documented TBSA-B estimation.
  • Inaccurate burn area estimation occurred in 48 of 61 patients (79%).
  • Overestimation of burn size was more common (2.2:1 ratio), particularly for burns exceeding 10% TBSA-B (P=0.002).

Conclusions:

  • Inaccurate estimation of pediatric burn size remains a significant issue.
  • Potential contributing factors include varied assessment methods, inclusion of erythema, and inadequate first responder training.
  • Accurate TBSA-B and burn depth assessment in children requires enhanced training and education.
Abstract

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