as demonstrated by the physician or nurse in the ED Burns should be examined by a physician every or days until healing is well underway Large burns or burns of the hands, feet, perineum, or overlying joints that are managed as an outpatient should be referred to a burn specialist and evaluated in follow-up more frequently Prophylactic antibiotics are not recommended Minor partial-thickness burns can be expected to have epithelial healing in to 14 days SPECIAL CIRCUMSTANCES Goals of Treatment Certain types of burns require special attention Clinicians should remain alert to historical and/or physical examination findings which suggest inflicted burn injuries, electrical injuries, and/or chemical burns Each of these burns warrants additional workup and specific treatment Inflicted Burns Child abuse must be considered in patients with specific patterns of burn injury Between 10% and 20% of burns in children are inflicted, accounting for 10% of child abuse cases Most inflicted burns are scalds Forced submersion of the hands or feet often causes burns that are deep, have a clear line of immersion, and are symmetric Scald burns of the buttocks and thighs in toddlers are frequently the result of forcible submersion in a tub of hot water Scald burns usually have scattered splash lesions In burns from spilled hot beverages, there is often a pattern of injury spreading downward from the falling liquid Inflicted contact burns also have characteristic patterns Small, round, deep burns result from cigarettes intentionally applied to the skin A deep wound with a geometric pattern and sharply demarcated borders suggests a contact burn Deep injuries with distinctive patterns may also be noted in children held against portable heaters or burned with irons In many children with inflicted burns, the pattern of injury is nonspecific and a history of abuse is not offered Physicians should make a judgment whether the characteristics of a burn correspond with the reported