Thermal or electrical burn in Child
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)
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.
T30.0 – Burn of unspecified body region, unspecified degree
314534006 – Thermal burn
- Chemical burn (eg, hydrogen fluoride, ammonia and sulfur dioxide) – Important to differentiate the agent involved.
- Cellulitis – May need IV antibiotics and, if left untreated, can result in sepsis.
- Toxic epidermal necrolysis
For a differential of dermatologic mimics of circular or patterned burns, see the Differential Diagnosis & Pitfalls section of Burn marks of child abuse.