Care and needs in a children's burns unit.

The burned child requires an overall care that recognises the child not as a small adult, but as a person in his own right with special physiological and psychological needs. Proper management requires a team approach with each member having a recognised role, but all working with one aim in view -- the earliest return of the child to his home and school environment with well healed burns and an acceptance of his injury with as little psychological disturbance as possible. Each child must be recognized individually and care adjusted according to the child's age and background and in relationship with any associated specific psychological disturbance. Special fears, including death and apprehension as to treatment, pain and disfigurement, require understanding and sympathetic support. A child should not be isolated from other children or his family unless absolutely necessary. An early decision has to be made as to whether the seriously burned child should be resuscitated, and children presenting with burns may be at risk from maltreatment and need protection and supervision of their growth and development. Parent need to be fully informed of their child's injury and treatment, have easy access to staff with open visiting, and be able to attend therapy discussion groups. Provision of manuals and booklets from parents and children on burns and their treatment can relieve anxiety and secure a confident attitude to the total management of the burned child. Rehabilitation involves both the child and the family and requires careful management and, in the severely burned, a gradual reintroduction to normal home and school life.