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Paeds Vivasacute-care-resuscitation-and-toxicology

Paeds Vivas · acute-care-resuscitation-and-toxicology

Burns assessment, resuscitation and safeguarding — branching viva

A branching viva following one burned child from pre-alert through cooling, age-adjusted TBSA estimation, modified-Parkland fluid resuscitation titrated to urine output, recognition of the threatened airway and inhalation injury, circumferential burn referral, safeguarding in parallel, and a structured handover.

branching clinical structured oral7 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
Prompt
A four-year-old is brought to a regional emergency department after pulling a kettle of hot water onto herself at home. The examiner releases information in stages. The candidate must cool the burn correctly, estimate percent TBSA with an age-adjusted chart, calculate and titrate modified-Parkland fluid, recognise the evolving airway, run safeguarding in parallel, apply the burns-centre referral criteria, and hand over safely.

Branching cross-examination

This is a MedVellum formative viva. It is not an official RACP, MRCPCH, ABP, ACGME or RCPSC station, mark scheme, duration or pass standard. Release each update only after the candidate states the action, the expected change and the reassessment endpoint. [2] [3]

Candidate brief

You are the senior paediatric clinician leading the resuscitation of a burned child in a regional emergency department. Speak as you would at the bedside. Cool the burn correctly, estimate percent TBSA with an age-adjusted chart, start modified-Parkland fluid titrated to urine output, recognise the evolving airway, run safeguarding in parallel, apply the burns-centre referral criteria, and hand over safely. This is one continuous case. Each escalation branch leads to the next update. [2]

Paediatrics Fellowship Pro

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You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References8ShowHide
  1. [1]Hettiaratchy S, Papini R Initial management of a major burn: I--overview BMJ, 2004.PMID 15217876
  2. [2]Hettiaratchy S, Papini R Initial management of a major burn: II--assessment and resuscitation BMJ, 2004.PMID 15242917
  3. [3]Cuttle L, Fear M, Wood FM, et al. Management of non-severe burn wounds in children and adolescents: optimising outcomes through all stages of the patient journey The Lancet Child and Adolescent Health, 2022.PMID 35051408
  4. [4]Cuttle L, Kempf M, Kravchuk O, et al. The efficacy of Aloe vera, tea tree oil and saliva as first aid treatment for partial thickness burn injuries Burns, 2008.PMID 18603378
  5. [7]Stevens JV, Prieto NS, Ridelman E, et al. Weight-based vs body surface area-based fluid resuscitation predictions in pediatric burn patients Burns, 2023.PMID 35351355
  6. [8]Toon MH, Maybauer MO, Greenwood JE, et al. Management of acute smoke inhalation injury Critical Care and Resuscitation, 2010.PMID 20196715
  7. [9]Mullen S, Begley R, Roberts Z, et al. Fifteen-minute consultation: Childhood burns: inflicted, neglect or accidental Archives of Disease in Childhood - Education and Practice, 2019.PMID 29934360
  8. [10]Kazis LE, Sheridan RL, Shapiro GD, et al. Development of clinical process measures for pediatric burn care: Understanding variation in practice patterns Journal of Trauma and Acute Care Surgery, 2018.PMID 29140950
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