**5. Causes of burns**

The burns according to the cause of the injury can be divided into accidental and nonaccidental.

Most of burns in children are caused by the accident [12].

There are several features that can make a health-care provider to suspect nonaccidental injury.

Among them is delay in seeking medical help by parents. It is very important to write down all the details of mechanism of the injury provided by caregivers, because sometimes caregivers change the history of trauma with time. The non-accidental injury is suspected when the mechanism of injury given by parents is not coherent with the burn wound found in child and also when the history of trauma is not consistent with the developmental stage of the child. In older children the abnormal behavior, such as avoiding eye contact, can be observed.

Characteristic for nonaccidental burns are burn wound caused by cigarettes. Also the socalled glove or sock burns are typical for nonaccidental injury. In many children with nonaccidental burns, additional sings of trauma can be found, for example, bruises, fractures, etc.

According to Adronicus et al., there were no differences between the groups in age or mortality between children with accidental and nonaccidental burn injuries. The authors found that in the group of children with nonaccidental injuries, burns involving both hands or both legs were more common; these patients were more likely to require skin grafting and treatment in the intensive care unit [12]. Moreover the abused/neglected children were more likely to come from single parent families [12].

burn trauma in cases of burned patients. The obtained results were alarming, which revealed that the knowledge of burn first aid among young doctors is not satisfactory—none of the respondents answered correctly to all the questions. Only in 75% respondents knew that burn wound require cooling with running water, whereas only 25% respondents knew how to

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It seems that more attention should be paid on education of caregivers of small children and

Care for burned pediatric patient is a challenge for medical and paramedical staff. Treatment of burns is multidisciplinary. According to Juan P. Barret and David N. Herndon, in the burn team, apart from surgeons who specialize in the treatment of burns (general, pediatric, and plastic surgeons), should work also nurses (experienced with care for burned patients), intensive care professionals, scrub and anesthesia nurses, case managers (acute and reconstructive), anesthesiologists, respiratory therapists, rehabilitation therapists, dietitians, psychosocial experts, social workers, volunteers, microbiologists, research personnel, quality

The triage decision is based on the extent of burn, body surface area involved, type of burn, associated injuries, any complicating medical or social problems, and availability of ambula-

In addition to what has been mentioned above, the criteria that are taken into account to decide if the patient requires hospitalization or referral to the center of burns are anatomic

The most important aspect in pediatric population is age—all the children younger than 1 year old should be hospitalized. Moreover all patients with third-degree burns should be treated in the hospital. Apart from depth of the injury, also extension of burn is taken into account. Hospitalization should be considered in children from families with lower socioeconomic status. Pediatric patients with burns on the face, hands, feet, genitalia, perineum, and joints; all patients with inhalation injuries and electrical or chemical burns; and also patients with associated injury should be hospitalized. Moreover, each patient with suspected nonaccidental injury should be admitted to the hospital. In Poland children with burns are hospitalized in departments of pediatric surgery (with personnel educated about care of burnt patients) or

It is possible to classify burn injury according to the severity into minor, moderate, and major [1]. Patients with moderate and major burns require hospital treatment. Minor burns are burns covering less than 15% total body surface area in adults and less than 10% total body surface area in children; less than 3% total body surface area is full-thickness burn; they do not involve the head, feet, hands, or perineum [1]. Moderate burns are burns covering 15–25% total body surface area in adults and 10–15% total body surface area in children,

react after chemical injury [14].

**7. Treatment of burns**

tory management [4].

medical stuff about first aid in burns.

control personnel, and workers of support services [1].

location of the injury and age of the patient.

burn centers (children with major burns).
