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.
Aims
· 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
Types
· First degree burns
· Second degree burns
· Third degree burns
· Fourth degree burns
Requirements
a. Resuscitation tray containing the following:
· Spatula
· Nasal prongs/oxgyen 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
b. Oxygen cylinder/source
c. Drip stand
d. Appropriate PPEs
e. Sterile dressing packs
f. Antimicrobial dressing solution/ointment
g. Infusion pumps/infusion flow meter
h. Bed cradle
i. Glucometer and strips
Steps
1. Receive child into the emergency couch
2. Introduce self quickly to child and caregiver
3. Assess the degree of burns
4. Call for resuscitation tray and assistance
5. Perform five moments of hand hygiene as and when required
6. Position the child appropriately
7. Assess airway, breathing and circulation
8. Clear airway if necessary
9. Loosen tight clothing
10. Administer oxygen, intubate and provide ventilatory support if necessary
11. Assess level of consciousness
12. Assess blood sugar level and manage appropriately
13. Obtain weight on admission
14. Insert intravenous cannula for fluid resuscitation according to percentage of burns (>10% of total body surface)
15. Administer Ringers lactate or normal saline with 5% glucose at 4ml/kg for every 1% of surface burn
16. Administer half of total fluid in the first 8hours and the remaining fluid in the next 16hours
17. Dress wound using aseptically using prescribed topical antimicrobial dressing
18. Splint affected limb if necessary
19. Use bed cradle to lift bed clothings off the child to promote comfort
20. Insert an indwelling Foley’s catheter to obtain specimen and monitor urine output hourly if necessary
21. Assess the level of pain and manage
22. Administer prescribed medications
23. Assess for the cause of burns from caregiver/passerby
24. Monitor vital signs (TPR, BP, O2 Saturation and pain) fifteen (15) to thirty (30) minutes for the next two (2) hours
25. Reassure caregiver and provide psychosocial support
26. Explains procedure to child and caregiver
27. Document all procedure, findings and observations in the appropriate charts (manual or electronic)
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