Nursing Component Task
Nursing procedures & clinical learning

Paediatric Nursing (PAED)

RESPONDING TO CHILDHOOD EMERGENCIES: BURNS AND SCALDS

This is the act of giving immediate intervention by the Paediatric nurse/nurse to a child with burns and scalds as a result of dry and moist heat, severe cold, electricity, radiation, chemical or irritants etc.

Purpose

  • Maintain a patent airway and breathing
  • Control pain
  • Restore fluid and electrolyte balance
  • Prevent shock
  • Prevent infections/complications
  • Restore the integrity of the skin
  • Allay fear and anxiety

Indications

  • Child presents with burns or scalds from any cause

Equipment

  • Resuscitation tray containing spatula, nasal prongs/oxygen mask, Ambu bag/self inflating mask, IV cannula and giving set, IV fluid (Normal saline, Ringer's lactate, 5% & 10% dextrose), syringe and needle, prescribed pain and antibiotic medications
  • Oxygen cylinder/source
  • Drip stand
  • Appropriate PPEs
  • Sterile dressing packs
  • Antimicrobial dressing solution/ointment
  • Infusion pumps/infusion flow meter
  • Bed cradle
  • Glucometer and strips

Preparation

  • Prepare emergency/resuscitation area
  • Ensure all equipment is available and functional
  • Call for assistance

Procedure steps

  • Receive child into the emergency couch
  • Introduce self quickly to child and caregiver
  • Assess the degree of burns
  • Call for resuscitation tray and assistance
  • Perform five moments of hand hygiene as and when required
  • Position the child appropriately
  • Assess airway, breathing and circulation
  • Clear airway if necessary
  • Loosen tight clothing
  • Administer oxygen, intubate and provide ventilatory support if necessary
  • Assess level of consciousness
  • Assess blood sugar level and manage appropriately
  • Obtain weight on admission
  • Insert intravenous cannula for fluid resuscitation according to percentage of burns (>10% of total body surface)
  • Administer Ringers lactate or normal saline with 5% glucose at 4ml/kg for every 1% of surface burn
  • Administer half of total fluid in the first 8hours and the remaining fluid in the next 16hours
  • Dress wound using aseptically using prescribed topical antimicrobial dressing
  • Splint affected limb if necessary
  • Use bed cradle to lift bed clothings off the child to promote comfort
  • Insert an indwelling Foley's catheter to obtain specimen and monitor urine output hourly if necessary
  • Assess the level of pain and manage
  • Administer prescribed medications
  • Assess for the cause of burns from caregiver/passerby

Precautions

  • Maintain strict aseptic technique
  • Monitor for signs of shock
  • Ensure proper pain management
  • Prevent hypothermia

Aftercare

  • Monitor vital signs continuously
  • Assess wound healing progress
  • Provide psychological support to child and family
  • Schedule follow-up care

Nursing considerations

  • Consider age-appropriate communication
  • Involve parents in care where appropriate
  • Monitor for signs of abuse if cause is suspicious
  • Address psychological trauma

Patient education

  • Educate parents on burn prevention
  • Teach wound care techniques
  • Explain signs of infection to watch for
  • Provide guidance on nutrition for healing

Documentation

  • Document time and cause of injury
  • Record assessment findings including degree and extent of burns
  • Document interventions provided and child's response
  • Record fluid balance and urine output
  • Note medications administered

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

Open Component Task app