Burns
Definition
A burn results from destruction of tissues by dry heat, (in form of fire), wet heat (in form of scalds), electricity or chemicals.
Who is at risk?
Young children are most at risk of injury from burns and scalds. Burns and scalds are a major cause of serious injury in children aged 0 to 14 years. Children aged 0 to four years are at greatest risk.
How do they occur?
Children are curious and like to explore their surroundings. They don't know that hot water and hot drinks burn like fire About half of accidents resulting in burns to children happen in the kitchen, with scalds from hot liquids being the most common. Many accidents involve the child reaching up and pulling on a mug or cup of hot drink. Other common causes include children falling or climbing into a bath of very hot water, and accidents with kettles, teapots, coffee-pots, pans, irons, cookers, fires and heaters.
Burns may also occur from:
- contact with electricity,
- contact chemical substances,
- excessive sun
- friction with any hard surface such as roads ("road rash") or carpets.
How severe is a burn?
Treatment of burns depends on how severe they are.
Burns may be:
- First degree is limited to the outer layer of the skin, causing it to be dry, red and painful, but without blistering. Mild or moderate sunburn is an example of a first degree burn.
- Second degree or partial thickness burn is more serious, and involves blistering of the skin. This type of burn is also painful, but unlike a first degree burn, the affected skin will likely appear to be moist.
- Full thickness or third degree burn where all the skin layers have been penetrated and the burned area may be white, charred, firm and leathery.
- Third degree burn which also destroys nerve endings, so your child may not feel pain in the burned area.
- Fourth degree burns, which extend down to muscle and/or bone, but fortunately, these are rare.
Burns are best prevented!!!!!!!!!!!
Tips
Preventing scalds and burns
- Keep young children out of the kitchen unless they are fully supervised.
- The front of the oven, and even the washing machine, can become hot enough to burn a young child. Keep them away.
- Turn pan handles towards the back and away from where a child may reach and grab.
- Never drink hot drinks with a baby or child in your lap.
- Never let a child drink a hot drink through a straw.
- Teach older children how to boil kettles and how to use the cooker safely. There is no right age for this. Every child is different. However, it is important to teach them correctly when the time is right rather than let them experiment and find out for themselves.
- Never heat up a baby's milk in a microwave. It may heat the milk unevenly, and some parts may become very hot. Stir baby food well if it is heated in a microwave.
- Put cold water in the bath or sink first, and then bring up the temperature with hot water.
- Do not set the thermostat for hot water too high in case children turn on the hot tap.
- Preventing fires
- Shut all doors at night. This prevents any fire from spreading.
- Store matches away from children. Teach older children how to use matches correctly and safely. Do not just let them experiment and find out for themselves.
- Have a fire blanket in the kitchen.
Preventing sunburn
- Keep children out of hot sun, particularly between 11am and 3pm.
- When out in the sun remember: Slip, Slap, Slop - slip on a shirt, slap on a hat, and slop on some high protection sunscreen.
What to do if someone is burned - first aid
- Cool the burnt area immediately with cool water (preferably running water) for at least 20 minutes. For example, put the burnt area under a running tap. A shower or bath is useful for larger areas. Note: do not use very cold water or ice.
- Remove rings, bracelets, watches, etc, from the affected area. These may cause tightness or constriction if any swelling occurs.
- After cooling, remove clothing from the burnt area. However, do not try to pull off clothing that has stuck to the skin. This may cause damage.
- A cold compress such as a tea towel soaked in cold water may be soothing over the burnt area. You can apply this after the initial cooling under cool water.
- Before going to hospital cover the burn with cling film or a clean plastic bag and leave it on until seen by a doctor or nurse. Apply cling film in layers rather than round like a bandage to prevent it causing pressure if the burnt area swells.
- Paracetamol or ibuprofen may help to ease pain for small burns.
Do not
- Use very cold water or ice.
- Prick any blisters.
- Apply creams, ointments, oils, grease, etc. (The exception is for mild sunburn. A moisturiser cream or calamine lotion may help to soothe this.)
- Put on an adhesive, sticky, or fluffy dressing.
Home care, or should I get medical help?
- Go to hospital if you are unsure about what to do after a burn.
- However, you may be happy to manage small, mild (superficial) burns at home. Mild sunburn, small mild burns, or mild scalds are best left uncovered. They will heal quicker if left to the fresh air. Even a small blister is best left uncovered to heal.
- If the blister bursts, you can use a dry, non-adhesive, non-fluffy sterile dressing. This will soak up the weeping blister, and stop dirt and germs getting into the wound.
Go to hospital as soon as possible if:
- The burn becomes infected. Infection causes a spreading redness from the burn which becomes more painful.
- You are not up to date with tetanus immunisation.
- Blisters occur. You may be happy to deal with a small burn with a small blister. However, a blister means a partial thickness burn, and it may be best to see a doctor.
Must go straight to hospital (after cooling with water and first aid) for the following:
- Electrical burns.
- Full thickness burns, even small ones. These are burns that cause white or charred skin.
- Partial thickness burns on the face, hands, arms, feet, legs, or genitals. These are burns that cause blisters.
- Any burn that is larger than the size of the hand of the person affected.
- Cover the burn with cling film or a clean plastic bag before going to casualty.