hemolytic process The profound circulatory effects of severe burns can result in life-threatening shock early after injury Goals of Treatment High-quality care is key for functional outcome and survival from burn injuries Emergency management begins with prehospital care, assessment, resuscitation, treatment of potential inhalational injury, wound care, infection control, and appropriate admission The continuum of care extends through hospitalization, potential surgical management, and rehabilitation The unifying goals of these treatment modalities are to compensate for the physiologic effects of the burn and promote healing Clinical Considerations Clinical Recognition Immediately after arrival, the physician must determine if a patient with burn injury requires aggressive therapy for major burns In children with severe injuries, the evaluation and initial management take place simultaneously Smoldering clothing or other sources of continued burning must be removed Information about the circumstances of the burn and the potential for associated injuries should be sought from prehospital care providers, police, or family members, but this should not delay the initial treatment It is crucial to recognize inhalational injury as a cause of impending airway obstruction and respiratory failure A history of smoke exposure is a risk factor Clinical signs of potential inhalational injury include burns on the face, singed nasal hairs, soot in the sputum or soot visible in the upper airway Triage Considerations All children with nontrivial burns should be rapidly transported to a hospital setting Once in the hospital, the triage process should take into account the child’s age and medical history, the injury mechanism, and the surface area and depth of the burn Children