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ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesInformation for PatientsView all Images (11)
Potentially life-threatening emergency
Thermal or electrical burn in Child
Print
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Thermal or electrical burn in Child

Print Patient Handout Images (11)
Contributors: Anahita Azharian DO, Jeffrey D. Bernhard MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Thermal and electrical burns of the skin can result in painful and debilitating injuries and in some instances may be fatal. With any burn injury to the skin, it is important to obtain an accurate history of the manner, duration, and intensity of the exposure. In children who present with a burn, the history and physical examination are extremely important to recognize any possibility of child abuse or neglect.*

Scald burns are the most common type of thermal burn to the skin. Severity depends on duration and on the viscosity of the liquid involved. Other types of thermal burns are flame burns, contact burns, and flash burns. E-cigarettes and exploding lithium batteries from cell phones have been associated with thermal burns.

Electrical burns of skin are of two main types, depending on the voltage involved:
  • High voltage (>1000 volts)
  • Low voltage (<1000 volts)
Note: Chemical burns from specific agents (eg, hydrogen fluoride and ammonia and sulfur dioxide) present differently. Oral mucosal burns and ocular burns (thermal, chemical) are specific local presentations.

Numerous vital functions of the skin, including fluid homeostasis, thermoregulation, immunologic functions, neurosensory functions, metabolic functions, and primary protection against infection (by acting as a physical barrier), can be impaired by burn injury. In particular, the skin barrier is damaged to various degrees, allowing pathogens a direct route to infiltrate / infect the body. Careful physical examination is necessary to determine the depth of skin burn, total body surface area (TBSA) involved, and injury to any other vital organs.

To determine the TBSA involved, one can use the "rule of nines" or the Lund-Browder chart. It is important to note that because of differences in body proportion, the percentage assigned for each body area is different in adults and children.

Depth of skin injury in burn is classified as follows:
  • Superficial (1st degree) – Involves the epidermis only.
  • Partial thickness (2nd degree) – Involves all of the epidermis and part of the dermis. Characterized further according to the depth of dermal injury: superficial partial thickness or deep partial thickness.
  • Full thickness (3rd degree) – Involves all of the epidermis and the dermis.
*Childhood physical abuse is a problem of epidemic proportion affecting children of all ages and economic and cultural backgrounds. Abuse by burning comprises approximately 6%-20% of all child abuse cases. Scalding abuse is the most frequent form of burn abuse, with more than 80% resulting from tap water. Most abusive burn injuries occur in children between the ages of 1 and 3 years, although a child of any age can be a victim. Burns resulting from neglect are another form of child abuse, even if they result from an act of omission.

Codes

ICD10CM:
T30.0 – Burn of unspecified body region, unspecified degree

SNOMEDCT:
314534006 – Thermal burn

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

It is important to note that cultural practices such as cupping, coining, and moxibustion lead to burn-like lesions in distinctive patterns. See Cultural practices.

For a differential of dermatologic mimics of circular or patterned burns, see the Differential Diagnosis & Pitfalls section of Burn marks of child abuse.

Best Tests

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Therapy

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References

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Last Updated: 10/23/2017
Copyright © 2018 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Thermal or electrical burn in Child
Print 11 Images
View all Images (11)
(with subscription)
Thermal or electrical burn : Burn, Linear configuration
Clinical image of Thermal or electrical burn
Copyright © 2018 VisualDx®. All rights reserved.