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

Guidelines for Wound Care

Step 1 Debridement

The majority of burns can be gently cleaned with sterile soaked gauze
Consult MD/CRNP to assess need for sharp debridement

Step 2 Topical Antibiotics

Apply topical ointment directly to wound surface or to
non-adherent dressing

*Do not use Silvadene if patient has sulfa allergy
Face, head Bacitracin
Periorbital Polysporin ophthalmic
Perineum Bacitracin
Fingers, toes Bacitracin if risk of ingestion, Silvadene
All other burns Silvadene

Step 3 Dressings

Non-adherent dressing

Adaptic or conformant
EXU DRY If significant wound exudate

Secondary dressing Kerlix