A study of burns and scalds in children.

The problem of burns and scalds in children has been materially altered during the past five or six years by the fact that human plasma and serum have become available for treatment. This means not only that many lives can now be saved which previously were lost, but also that new problem, arise from the survival of children with serious and extensive lesions. In short, resuscitation has so advanced beyond other aspects of therapy that it is possible to keep alive for several weeks or months children who stand little chance of ultimate recovery. The assessment of this chance of recovery and the decision that must be taken at the very beginning as to whether or not resuscitation should be attempted, is often very difficult. It appears that, with only ordinary hospital facilities availabld, cases with lesions affecting more than 40 per cent. of the body surface do not survive beyond a few weeks; with specially equipped units this could almost certainly be improved upon (Bourdillon and Colebrook, 1946). On the other hand, small children can die from fluid loss when the local lesion is neither deep nor extensive, and in this type of case plasma therapy has altered the outlook completely. There is no need now for any child over the age of one year to die from a lesion involving less than 30 per cent. of the body surface. The following study was undertaken in the hope of obtaining a better understanding of the problems that arise during the routine hospital treatment of burned and scalded children, and to determine the most reliable criteria for its guidance.