Strobel Ashley M, Fey Ryan
Department of Emergency Medicine, University of Minnesota School of Medicine, Hennepin County Medical Center, University of Minnesota Masonic Children's Hospital, 701 South Park Avenue R2.123, Minneapolis, MN 55414, USA.
Department of Surgery, University of Minnesota School of Medicine, Hennepin County Medical Center, 701 South Park Avenue, Minneapolis, MN 55414, USA.
Emerg Med Clin North Am. 2018 May;36(2):441-458. doi: 10.1016/j.emc.2017.12.011.
Although the overall incidence of and mortality rate associated with burn injury have decreased in recent decades, burns remain a significant source of morbidity and mortality in children. Children with major burns require emergent resuscitation. Resuscitation is similar to that for adults, including pain control, airway management, and administration of intravenous fluid. However, in pediatrics, fluid resuscitation is needed for burns greater than or equal to 15% of total body surface area (TBSA) compared with burns greater than or equal to 20% TBSA for adults. Unique to pediatrics is the additional assessment for non-accidental injury and accurate calculation of the percentage of total burned surface area (TBSA) in children with changing body proportions are crucial to determine resuscitation parameters, prognosis, and disposition.
尽管近几十年来烧伤的总体发病率和死亡率有所下降,但烧伤仍是儿童发病和死亡的重要原因。重度烧伤的儿童需要紧急复苏。复苏过程与成人相似,包括疼痛控制、气道管理和静脉输液。然而,在儿科,烧伤面积大于或等于体表面积(TBSA)15%时需要进行液体复苏,而成人则是烧伤面积大于或等于20% TBSA时才需要。儿科特有的是对非意外伤害的额外评估,对于身体比例不断变化的儿童,准确计算烧伤总面积(TBSA)的百分比对于确定复苏参数、预后和处置至关重要。