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Published on: February 23, 2024
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Small Pediatric Burns Can Be Safely Managed on an Outpatient Basis
Andrea C Grote1, Alexandra M Lacey2, Warren L Garner1,2
1Keck School of Medicine, Los Angeles, California.
Summary
Most pediatric burns under 10% TBSA can be safely managed as outpatients. This approach, using non-daily dressings, proves effective for pediatric burn care.
Area of Science:
- Pediatric Burn Management
- Ambulatory Care
- Burn Center Care
Background:
- American Burn Association (ABA) guidelines suggest transferring pediatric burns if hospital resources are insufficient.
- Current practice at our institution includes outpatient management for small burns (<10% Total Body Surface Area [TBSA]) using non-daily dressings.
Purpose of the Study:
- To evaluate the safety and efficacy of outpatient management for small pediatric burns.
- To determine if ambulatory care is a viable alternative to inpatient admission for these cases.
Main Methods:
- Retrospective review of 742 pediatric patients at a single ABA-verified burn center over three years.
- Data collected included patient demographics, burn characteristics (TBSA, etiology, location), treatment setting (outpatient vs. inpatient), and outcomes.
- Analysis focused on successful outpatient completion rates and reasons for subsequent admission.
Main Results:
- 86% (641) of patients were treated as outpatients with a mean TBSA of 3%.
- 96% (613) of outpatient cases were successfully managed, while 4% (28) required subsequent admission.
- The primary reason for admission failure in the outpatient group was nutrition optimization (61%), with a slightly higher mean TBSA (4%) compared to successfully treated outpatients (3%).
Conclusions:
- The majority of small pediatric burns (<10% TBSA) can be safely and effectively managed in an outpatient setting.
- Non-daily dressing protocols are suitable for ambulatory pediatric burn care.
- Further focus on nutritional support may improve outcomes for pediatric patients managed as outpatients.
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