The C.R.A.S.H. AND B.U.R.N. Tool: Are You Missing The Leading Cause of Pediatric Heart Disease?
- The Review Course in Family Medicine
- Jun 4
- 2 min read
Have you ever splinted a mallet finger and wondered if you got it right? Check out our new video on mallet finger mistakes right here!
-Simon
Kids with Fever: Always look for these
Covered Recently in CPS and CFP Journal (See our YouTube summary on Kawasaki's disease)
Fever for five days? Don't just hand over the acetaminophen and send the patient home.
This history or triage note should trigger an automatic thought: KAWASAKI. Do you know the CRASH and BURN mnemonic that should be your next step to prevent possible permanent heart damage?
A recent practice point from the Canadian Paediatric Society confirms that Kawasaki disease remains the leading cause of acquired heart disease in Canadian children. Because the diagnosis is entirely clinical, you have to be ready to recognize the patterns before the coronary arteries suffer.
The best way to keep this top of mind is to use the CRASH AND BURN mnemonic.
C: Conjunctivitis - bilateral and non-exudative.
R: Rash - polymorphous.
A: Adenopathy - cervical, usually unilateral.
S: Strawberry tongue - or other oral mucosal changes.
H: Hands and feet - swelling or erythema.
BURN: High fever lasting five or more days.
Memory Tip When you have a child with these findings, don't just rely on the checklist. The Canadian Paediatric Society emphasizes that we must also screen for incomplete Kawasaki disease in younger infants or children who do not meet all criteria but have persistent fevers. If you suspect it, early referral for echocardiography is your best move.
For the MCQ-SAMP Remember that this is a classic "can't-miss" diagnosis. On an exam, they might give you a child with a rash and fever who has been treated with antibiotics for a viral illness or scarlet fever without improvement. If you see that clinical pivot point, consider Kawasaki disease immediately and look for the CRASH and BURN! Failure to recognize this could lead to coronary artery aneurysms. PLUS - this was covered in the CFP journal in 2020 (check out our YouTube summary of this article!) - another good reason to study it for the CCFP exam.
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