Burned Baby

 

History of Present Illness:

An infant is brought to the ER by mom after boiling water from a bottle strerilising thermos spilled onto his right side while he was wearing a onesie.

Vital Signs & Physical Exam:

Vital signs are normal.  He is intermittently crying but consolable with bottle feeds and wet gauze.  See image below

What is the most likely TBSA & dispo?

  • A) 5%, admit
  • B) 15%, admit
  • C) 5%, home
  • D) 15%, home

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

 

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ANSWER:

  • A) 5%, admit.  This is much more than 5%
  • B) 15%, admit.  CORRECT.  >10% TBSA in a patient younger than 10 should be considered for admission.
  • C) 5%, home. 5% could usually go home but this is much higher TBSA than that
  • D) 15%, home.  15% TBSA in an otherwise healthy adult could go home if pain control adequate, no complications/comorbidities and good follow-up.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: Transfer to burn center.  Did well.