Consider early intubation in patients with suspected pharyngeal or airway swelling Inquire about the circumstances of the burn and determine the potential for associated injuries Remember to remove sources contributing to ongoing thermal damage Current Evidence Globally, burns are the 11th leading cause of death in children aged to and the fifth most common cause of nonlethal injury A recent study examining data on pediatric burns from the Nationwide Emergency Department Sample (NEDS) found that the majority were burns to the wrists/hands, followed by the lower limbs, with the most common causes being electric appliances and hot liquids/vapors Data from the National Burn Repository suggest that burn injuries are more prevalent in minority children than would be expected based on demographics alone Scald and contact burns are more common in the younger ages, with fire/flame more common in adolescent and adult patients Recent data suggest significantly improved survival for children with careful attention to burn care In one study, half of children with burn injuries up to 90% TBSA survived their injuries, and research is ongoing into new methods for surgical management and pharmacologic treatment of burn wounds Burn size and inhalational injury are two key predictors of survival in children Major systemic pathophysiologic effects are seen in children with burns of more than 20% of body surface area (BSA) Burn injury causes increased capillary permeability and the release of osmotically active molecules to the interstitial space resulting in extravasation of fluid Protein is lost from the vascular space to the interstitium during the first 24 hours In patients with large burns, vasoactive mediators are released to the circulation and result in systemic capillary leakage Edema develops in both burned and noninjured tissues Circulating factors that depress myocardial function decrease cardiac output Acute hemolysis of up to 15% of red blood cells may occur both from direct heat damage and from a microangiopathic