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The aim is to provide clear guidance on the followup of children that present to hospital following a burn. This may mean admission to hospital, a discussion with a member of the burns team, discharge with follow-up or outpatient management by the paediatric Emergency Department.
This guideline should be used by healthcare professional in the paediatric Emergency Department for burns patients.
These patients should be admitted to ward 2C at RHCG following discussion with the burns team. Contact plastic surgery registrar Monday – Friday 8am-5pm on page 13931. If any difficulty contacting the plastic surgery registrar during these hours call the burns CNS on 84866 or 07984004853. Out of hours contact the plastic surgery registrar on call via switchboard and if you are unable to contact the plastic surgery registrar then contact the paediatric surgical registrar on call.
The patients should be discussed with the Burns Team (as above) as they may be a candidate for theatre management +/- Biobrane.
All patients with burns should be reviewed within 48hrs of presentation or as near to 48hrs as practically possible. There are 2 options for follow up:
The nurse led burns clinic runs on a Monday afternoon, Tuesday morning and Friday all day.
Patients can be referred to their local CCNT
See below sections to ensure most appropriate service utilised for follow up
a) Nurse-led Burns Clinic
Referral to the burns clinic can be made for any patient that does not require admission to ward 2C
To arrange an appointment at clinic:
If a burns clinic appointment is not available within the appropriate time frame (within 48 hours), children can be referred to the Community Children’s Nursing Team for a dressing change prior to being reviewed in the burns clinic.
b) Community Children’s Nursing Team (CCNT)
The Community Children’s Nursing Team will visit children in their homes, (or an appointed alternative eg. grandparents), to manage their burns.
They provide a Monday to Friday service, excluding public holidays.
They will liase directly with the Burns Nurse Specialist if there is any concern about the patient.
If they receive a referral within working hours it is possible for them to visit the next working day and they will try to do so if there is a particular concern about the burn or the family’s ability to manage the dressing. However, most visits should be requested for the second working day after their ED attendance eg. patient attending Saturday am – request a visit for Tuesday.
The CCN team in Glasgow will visit the patients between 9am-1pm but will usually call the family prior to the appointment. The other CCN teams will call the family prior to visiting
All patients being referred to the CCNT should be discharged from ED with supplies away with them for 2 dressing changes ie:
Referrals to the Glasgow CCN team are made via TrakCare:
Select "New Request" in top tabs, then , "other" in next set of tabs. Then in "item" (bottom box on right hand side) type "child" and select magnifying glass. Select the CCNT option to complete the form and then call to leave a message on their answer machine.
Referrals to the Paisley and Ayrshire teams can be made via a telephone call. Referrals to Lanarkshire, Vale of Leven, Inverclyde and Forth Valley are made via email
Nursing staff should:
Medical staff should:
Ensure the family have adequate analgesia for the child at home and advise a dose should be given before their next dressing change.
Arrange appropriate follow up as above.
Advise the parents to return to the ED if their child develops any symptoms of infection or Toxic Shock Syndrome. These are fever and/or vomiting and/or diarrhoea and /or rash.
Young children are at risk of developing Toxic Shock Syndrome even from a very small burn.
ALL PATIENTS BEING DISCHARGED FROM ED WITH A BURN SHOULD BE GIVEN THE “EMERGENCY DEPARTMENT ADVICE ON LOOKING AFTER YOUR CHILDS BURN” PARENT INFORMATION LEAFLET.
Last reviewed: 12 December 2019
Next review: 01 December 2022
Author(s): Sharon Ramsay, Burns Nurse Specialist
Reviewer Name(s): Dr Vincent Choudhery (Consultant in Paediatric Emergency Medicine, RHCG)