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Burns, fluid, pain in children (Pain (Assessment (Observational and…
Burns, fluid, pain in children
Pain
Assessment
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e.g. FLACC (Face, Legs, Activity, Cry, Consolability each scored on a 3 point scale, total score out of 10)
Management
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Need to titrate IV opiates in a potentially shocked child (Morph 0.1mg/kg every 5 mins - max 0.3mg/kg, then infusion 0-40 mcg/kg/hr, with simple analgesics)
Fluid Requirements
Assessment
TBSA burned: 'Rule of nines' not appropriate (larger head, smaller legs). Use Lund-Browderchart.
Burn depth
Epidermal/superficial: red, painful, no blisters
Superficial dermal: red, painful, blisters, CRT normal
Deep dermal: lobster/cherry red, no blisters, no CRT, not painful, usually requires grafting
Full thickness: white and charred, not painful, requires excision and grafting
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