BURN INITAL MANGEMNT

• Patient Summary: 6-year-old child; Weight not specified; [Assume 20 kg for calculations unless otherwise stated]. Type of Burn: Not applicable (this is not a burn case, but following formatting protocol).

• Assessment:

  • Clinical: Progressive periorbital oedema, pitting lower limb oedema, heavy proteinuria, hypoalbuminaemia (albumin 20 g/L), hyperlipidaemia, with normal renal function and blood pressure.
  • Diagnosis: Clinical features are highly suggestive of Nephrotic Syndrome Example.
  • Estimated TBSA: Not applicable (no burn; TBSA for burns is not estimated here).
  • Vitals Required: Monitor for fluid overload, vital signs, daily weight, and urine output Example.

• Fluid Management Plan:

  • There is no indication for burn fluid resuscitation (Parkland) in nephrotic syndrome. Maintain euvolemia with judicious fluid restriction tailored to insensible losses and ongoing urine output to prevent fluid overload Example.

• Analgesia:

  • Pain is typically not a major complaint; if required, Paracetamol may be prescribed using standard paediatric dosing: 15 mg/kg/dose orally every 4–6 hours as needed, not exceeding 60 mg/kg/day Example. For a 20 kg child:
    • Paracetamol Dose: 300 mg per dose.
    • Volume (if using 125 mg/5 mL suspension): 12 mL per dose.

• Wound Care & Dressing:

  • Not applicable (no open wounds or burns). Good skin care is essential to prevent infection from oedematous skin Example.

• Special Instructions:

  • Strict monitoring of fluid input/output and daily weights is essential to guide ongoing fluid management.
  • Monitor for complications such as infection (especially peritonitis, cellulitis), thromboembolism, and relapse Example.
  • Early initiation of corticosteroid therapy as per nephrotic syndrome guidelines after excluding underlying infections Example.
  • Laboratory evaluation: urine protein quantification, renal function, lipid profile, serum albumin Example.
  • Close blood pressure monitoring (should remain normal; hypertension suggests secondary glomerulonephritis) Example.
  • Consider paediatric nephrology referral.

References:

1. laboratory-reference-ranges