Risk management in children with burn injuries

The currently accepted "high risk/no risk" concept of assessing pediatric injuries inadequately describes the range of situations in which children are burned and the spectrum of appropriate interventions. All children are at risk for injury; the question is not when but how best to intervene. A retrospective chart analysis of 101 pediatric admissions in 1985 demonstrated that childhood burns and follow-up requirements varied, depending on circumstances of injury, presence and behavior of caregivers, and the ability of parents or caregivers to assume responsibility for the child's supervision, safety, and health needs. We must view childrens' risk for injury as dependent upon the supervisory capacity of their parents, and continue to identify and develop specific interventions appropriate to each level of understanding and responsibility. Adequate documentation of the circumstances of injury and parent behavior are the key factors in determining level of risk and appropriate management.