Management of Electrical Burns in the Mouth of Children
Classification as Severe Burns
- The American Society of Anesthesiologists considers any electrical burn in children as severe and requiring management in a specialized center 1, 2, 3, 4, 5
- Burns in functionally sensitive areas (face, mouth, commissures) qualify as severe due to the risk of significant functional and aesthetic sequelae 1, 2, 3, 4, 5
Acute Phase Management (First 48 Hours)
Initial Evaluation and Stabilization
- The American College of Surgeons recommends evaluating the airway, considering intubation if there are extensive burns with cervical compromise or symptoms of airway obstruction 6
- Establishing intravenous access and starting reanimation with balanced crystalloids if associated burns are present 6
Pain Management
- The American Society of Anesthesiologists suggests multimodal analgesia based on validated pain scales 7, 8
- Ketamine intravenously titrated combined with other analgesics for severe pain 7, 8
- Short-acting opioids for procedures and dressing changes 7, 8
- Nitrous oxide inhalation when intravenous access is not available 7, 8
- Considering general anesthesia for very painful procedures 7, 8
Local Burn Care
- Limited cooling: cooling with clean running water for 5-20 minutes only if TBSA < 10% in children and without shock 7, 8, 9
- The American Burn Association recommends covering with a non-adherent clean dressing 9
Referral to Specialized Center
- The French Society of Anesthesia and Resuscitation recommends immediate referral criteria 1, 2, 3, 4, 5
- Any electrical burn in children 1, 2, 3, 4, 5
- Burns in functionally sensitive areas (face, mouth, commissures) 1, 2, 3, 4, 5
- Infants under 1 year with any burn 8
- TBSA > 10% in children 4
- Deep burns > 5% 2