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Oral fluid therapy in paediatric burns (5-10%): an appraisal
1Department of Plastic Surgery, Royal Preston Hospital, Fulwood, UK.
Insights
Oral fluid therapy for pediatric burns (5-10% body surface area) lacks standardized protocols in the UK. Practices vary widely, impacting fluid content, palatability, and potential complications.
Area of Science:
- Pediatric Burn Care
- Fluid Resuscitation
- Clinical Practice Surveys
Background:
- Oral fluid therapy is standard for smaller pediatric burns (<10% body surface area).
- Current practices for moderate pediatric burns (5-10% BSA) require investigation.
Purpose of the Study:
- To assess oral fluid therapy practices for pediatric burns (5-10% BSA) in UK hospitals.
- To evaluate the uniformity, palatability, acceptance, and side effects of oral fluids used.
Main Methods:
- A phone survey of UK hospitals managing pediatric burns.
- Inquiry into fluid composition, palatability, patient acceptance, and adverse events.
Main Results:
- Significant lack of uniformity in oral fluid therapy policies for pediatric burns (5-10% BSA).
- Wide variation in fluid types (electrolyte, non-electrolyte, juices) and administration approaches.
- Electrolyte solutions required flavoring for palatability; no major complications reported, though fluid overload was queried.
Conclusions:
- Urgent need for standardized guidelines for oral fluid therapy in pediatric burn patients.
- Varied fluid content and palatability may affect treatment efficacy and patient adherence.
- Further research into optimal fluid composition and potential complications is warranted.
Abstract:
Fluid therapy by the oral route is the accepted method of treatment for smaller burns in children (less than 10%). [Settle JAD. Burns - the first five days. Essex: Smith and Nephew Pharmaceuticals Ltd, 1986.] A phone survey was carried out of all the hospitals in the United Kingdom that manage burns, to record their oral fluid therapy practices for burns (5-10% BSA) in paediatric patients. Included in the survey was an assessment of the uniformity of the contents of the fluids, their palatability and acceptance by patients and any side-effects from this form of treatment. There appears to be no uniformity in policies regarding fluid therapy in children with this percentage of burns. Treatment ranged from a formula guided resuscitation therapy (as practised generally with large burns) to a 'drink as you like' policy. Fluids used varied from electrolyte to non-electrolyte containing solutions and fruit juices and were, therefore, markedly different in content. The electrolyte solutions were reported as being non-palatable unless flavoured with fruit juices. No complication was reported although one unit queried a possible case of fluid overload. Potential complications from this mode of therapy are discussed. The cost implications of using various fluid types are also presented.