There are more than 500,000 burns each year in the United States; 50,000 of these require hospitalization and 15,000 of these are pediatric.  Understanding and managing these patients is key to care.  Moreover, those burns involving the airway are even more acute. Using actual case airway and topical footage, the issue in the pediatric patient will be presented and discussed. A rational approach by EMS providers up and into the Emergency Department will be highlighted as well as when and how to secure the airway, how much fluids, and topical care including escharotomy.