EMSC Connects

December 2025; Volume 14, Issue 12

Utah Emergency Medical Services for Children

Pedi Points

Tia Dickson RN, BSN

PCH Trauma RN, Utah EMSC Nurse Clinical Consultant

Burns happen fast, especially to kids. A spilled cup of hot chocolate, a grab at a curling iron, or touching a hot stove for just one second can cause serious injury. And because kids’ skin is thinner and their bodies are smaller, burns affect them much more quickly and more seriously than adults. Responding quickly and confidently isn’t just a skill for EMS, it’s a chance to change the outcome of a child’s life.

Expert Input

Pediatric Burn Injury

Courtney Lawrence RN, BSN

Community Outreach and Disaster Coordinator, University of Utah Health

Excerpts from the November 10th, 2025 PETOS

Burn injuries are typically caused by exposure to dry heat sources, such as flames, hot objects, or hot surfaces. These types of burns can range from mild to severe, depending on the duration and intensity of the heat exposure. Scald injuries, on the other hand, are caused by exposure to wet heat sources, such as hot liquids or steam.

Pediatric Fire and Burn Injuries in the U.S.: Key Facts

• Up to 600 children die from fire and burn injuries in the U.S. each year.

• Although overall mortality has decreased, fires and burns remain a leading cause of unintentional death in the home for children.

• Children under 5 years old are at the highest risk for home fire deaths and injuries.

• Pediatric burn patients who reach a hospital or burn center generally have better outcomes than adults, with lower morbidity and mortality.

• Each year, about 100,000 children sustain burns severe enough to require medical treatment.

Scald Injury

Scald burns happen when hot liquids or steam come into contact with the skin. They’re among the most common burns, especially in children. Studies show;

• 58% of all pediatric burns are scald injuries.

• 75% of burns in children under 2 are caused by scalds.

• In 2024 3.9% of suspected abuse burns were scalds

As children get older, the number of scalds and flame burns evens out, and by adolescence, flame injuries become more common.

From National Data

University of Utah Burn Center Data 2023

Prevention

To reduce the risk of burn injuries, advise patients to exercise caution around common household heat sources such as stoves, ovens, fireplaces, and heating appliances. Emphasize the use of protective equipment—like oven mitts and pot holders—to prevent contact burns from hot surfaces or cookware.

To prevent scald injuries, remind patients to handle hot liquids and steam with care, particularly in kitchen environments. Encourage safe practices such as turning pot handles inward to avoid accidental spills and using deliberate, controlled movements when pouring or transferring hot liquids.

• Macaroni and cheese fresh off the stove is 200 F

• Cup of noodles 173 F

• Soup 152 F

• Typical frying oil is 350-365 F

Turn your water heater down to below 120 degrees F to prevent burns.

Pediatric Burn Management

In the initial approach to a pediatric burn patient, your first priority is actually not the burn. Start with the PAT and your primary assessment—because trauma and airway/breathing/circulation issues will kill the child long before the burn itself. Most pediatric burn patients present alert, tachycardic, and maintaining a good blood pressure. If any of those are not true, assume there’s a more serious underlying problem and assess accordingly.

Direct heat and chemical burns almost always create progressive airway edema, so intubate early if there’s any concern—and have your most experienced provider perform the airway. Avoid taping the tube to burned skin; instead, consider a twill tie secured around the ears and below the occiput. Once the tube is in place, keep the patient well sedated to protect the airway and prevent accidental extubation.

Fluid Resuscitation

If during the primary survey, you determine this is a significant burn (greater than 20% TBSA), then fluids should simply be set at 125 mL/hr. During the secondary survey you will start fluid resuscitation.

1. Begin by figuring the total body surface areas of the burn (TBSA).

2. Calculate the resuscitation rate.

3. Calculate the maintenance fluid rate. In the hospital the maintenance fluid will likely include dextrose (D5LR) for all children under 13 years. This is not expected in the prehospital setting but providers should monitor glucose closely.

A case example:

Pain Management – Burns Hurt!

When caring for burn patients, use gentle pressure when handling wounds and elevate burned extremities to reduce swelling and discomfort. Cover burns with dry dressings, and manage pain using small, frequent doses of narcotics rather than large single doses, avoiding IM injections due to unpredictable absorption in burned tissue. Follow local protocols closely, and take time to educate the patient and family about why the injury is painful and what to expect. Remember that despite appropriate medication, the patient is unlikely to be completely pain-free, but your interventions can significantly improve comfort and reduce anxiety.

Child Abuse and Burns

Watch for burn patterns that just don’t look right—like perfect circles from cigarettes, stovetop marks, or any injury that doesn’t match the story you’re being told. Be extra cautious if the burn doesn’t line up with what the child is capable of doing for their age. Clear lines of demarcation, like a “glove” or “sock” pattern from being dipped in hot water, are big warning signs. And if the story keeps changing, that’s another red flag. When something feels off, trust your gut, document well, and follow your reporting requirements.

Transport Decisions

If you are transporting from the scene and are within the vicinity of Primary Children’s Hospital, the University burn center requests that pediatric patients be transported directly to the PCH Emergency Department for trauma evaluation and stabilization. For those outside the valley, transport to the nearest local hospital is appropriate; that hospital will then consult with the burn center as needed. All hospitals have access to the Utah Pediatric Trauma Network burn guidelines and will stabilize the patient before transfer if required.

Additional Resources

Protocols in Practice

Deep Dive

CME credit for this issue

News from National EMSC

Non-Fatal Burn Injuries in U.S. Infants, Children, and Adolescents: Statistics and Prevention Tips – Sept 2025

Burn injuries cause physical bodily damage, in addition to immediate and long-lasting psychological harm and quality of life losses to children, adolescents, and their families.

According to the 2020-2023 National Electronic Injury Surveillance System (NEISS) data operated by the Consumer Product Safety Commission (CPSC), there were approximately 296,299 unintentional, non-fatal burns treated in emergency departments related to consumer products among infants, children, and adolescents ages <1–19. This reflects an average of over 74,000 non-fatal burn injuries per year.

CSN’s new infographic breaks down these data to show where and how burn injuries most often occur—by age, body part, type, and consumer product. It also highlights practical prevention recommendations to help protect children and adolescents from these common, yet preventable, injuries.

Upcoming Free Webinar

EMSC Pulse

National EMSC has a newsletter filled with fantastic pediatric information, resources, and links. Check it out!

News from Utah EMSC

Hospital NPRP is right around the corner

We are excited to announce that the next National Pediatric Readiness Project (NPRP) assessment of Emergency Departments (EDs) across the U.S. is set to launch in March 2026, reflecting updated national guidelines and growing momentum in pediatric emergency care.

www.pediatricreadiness.org to start preparing today.

PECC development

For Utah hospital and EMS Agency PECCs

ENA passes resolution in support of PECCs

The Emergency Nurses Association (ENA) delegation voted overwhelmingly, 95% in favor, to adopt GA25-02A: Designation of a Nurse Pediatric Emergency Care Coordinator (PECC) in Every ED. The vote, held at ENA’s General Assembly in New Orleans last weekend, underscores ENA’s strong commitment to Pediatric Readiness and the essential role of PECCs. Pictured at right are the authors of the resolution (several of whom are members of the EMSC community), just after the vote.

PECCs ensure EDs are prepared to care for children by supporting policies, equipment, training, and quality improvement. Studies show that EDs with designated PECCs consistently achieve higher Pediatric Readiness scores. Learn more about PECCs.

Understanding the PECC role

For hospital PECCs

• EMSC has launched its first pediatric emergency care coordinator (PECC) learning module for ED-based PECCs. You are invited to view the module and provide feedback.

For EMS PECCs

• EMS PECC resources can be found on the EIIC website here.

PECC quarterly meeting

You will receive an invitation with the link through email. If you are a PECC and don’t receive this invitation, contact our program manager, Jared Wright jaredwright@utah.gov.

When?

Tuesday, February 17th,  2026, 10:00 AM

Pediatric education from Utah EMSC

Pediatric Emergency and Trauma Outreach Series (PETOS)

PETOS (pediatric emergency and trauma outreach series)

We’re thrilled to announce that our PETOS lecture series is now eligible for both RN and EMS CME credit!

CME certificates are now digital and available instantly through CloudCME, where you can also access your transcript anytime.

The lectures are presented by physicians and pediatric experts from Primary Children’s Hospital. The format is informal; inviting questions and discussion.

Upcoming topics

Dec 8th, 2025 – Matthew Steimle, DO – Cardiac Emergencies

Jan 12th, 2026 – Seantae Jackson – A Patient Perspective

Feb 9th, 2026 – Laurie Merrick RN, BSN – Hypothermia

02:00 PM Mountain Time (US and Canada)

Join Zoom Meeting
https://zoom.us/j/98193757707?pwd=UzdNeXppQUdtZ01KZUp2UFlzRk9vdz09
Meeting ID: 981 9375 7707

Password: EmscPCH

Archived presentations can be viewed and also qualify for CME credits. You can access them at https://intermountainhealthcare.org/for-professionals/PETOS.

To obtain a completion certificate—follow the instructions on the website

Emergency Pediatric Course – NAEMT

Need a Pediatric Education Course for Recertification?

Contact Jared Wright at Jared.wright@utah.gov

Other pediatric education for all

St. George Autism Awareness Training

University of Utah Pediatrics ECHO 2026

University of Utah Injury Prevention Learning Series

These offerings are quarterly.

Register here.

To view previous sessions for all these series visit this link.

Note the University has a new EMS education website.

Pediatric Injury Prevention Resources

EMS-focused education

University of Utah’s EMS Trauma Grand Rounds

Offered every second Wednesday of even months at 2:00pm.

Click here to join

Virtual—zoom meeting

Meeting ID: 938 0162 7994 Passcode: 561313

To view archives link here https://admin.physicians.utah.edu/trauma-education/ems-grand-rounds.

The University has a new EMS education website.

Hospital-focused pediatric education

Primary Children’s Pediatric Grand Rounds

Offered every Thursday, September-May (currently on hiatus, archives available)

Offering both RN and MD CME

The pediatric grand rounds weekly lecture series covers cutting-edge research and practical clinical applications, for hospital and community-based pediatricians, registered nurses, and other physicians and practitioners who care for children of any age.

Every Thursday, 8 a.m. to 9 a.m. from September through May in the 3rd Floor Auditorium at Primary Children’s Hospital and at Lehi a broadcast will be held in the education center (1st floor in rooms 1 & 2).The lectures are also broadcast live to locations throughout Utah and nationwide. Click on this link to view the broadcast: https://www.youtube.com/channel/UCNQP-M_3-PdPDvnICr2Fjpg 

Connect live

Click here for the PGR PCH YouTube channel to find the live broadcast. Archives (without continuing education credit) will be posted here within 1 week of the broadcast.

Need follow up from PCH?