ED Pathway for Evaluation/Treatment of the Child with a Burn Injury

Burn Depth

Depth Cause Appearance

Sensation

Healing time
Superficial
  • Ultraviolet exposure
  • Very short flash
  • Dry, red
  • Blanches with pressure
Painful 3 to 6 days
Superficial partial-thickness
  • Scald (spill or splash)
  • Short flash
  • Blisters
  • Moist, red, weeping
  • Blanches with pressure

Painful to temperature and air

7 to 20 days
Deep partial-thickness
  • Scald (spill)
  • Flame
  • Oil
  • Grease
  • Blisters (easily unroofed)
  • Wet or waxy dry
  • Variable color
  • (patchy to cheesy white to red)
  • Does not blanch with pressure
Perceptive of pressure only >21 days
Full-thickness
  • Scald (immersion)
  • Flame
  • Steam
  • Oil
  • Grease
  • Chemical
  • Electrical
  • Waxy white to leathery gray to charred and black
  • Dry and inelastic
  • No blanching with pressure
Deep pressure only Never (if >2 percent total body surface area)

Adapted from:  Mertens, DM, Jenkins, MD, Warden, GD, Med Clin North Am 1997;32:343; and Peate, WF, Am Fam Physician 1992;45:1321; and Clayton, MC, Solern, LD, Postgrad Med 1995;97:151.

From Joffe, MD.  Emergency Care of Moderate and Severe Burns in Children.  UpToDate September, 2010