Newsletters

Healthy Child Fall/Winter 2006

Children And Scald Burns

Kathe M. Conlon, BSN, RN, CEM
Community Outreach, Saint Barnabas Burn Foundation

Each year more than 400 patients are admitted to The Burn Center at Saint Barnabas Medical Center for serious burn injury. Another 500-600 require care on an outpatient basis. Approximately 40 percent of all patients are children, under the age of 5 years, mostly scalded from hot liquids.

These numbers are not unique to our The Burn Center. National statistics show that burns remain the third leading cause of traumatic injury in the United States, many occurring in the home environment. Although these statistics can be frightening, with a little prevention, they can also easily be avoided.

A burn occurs when skin comes in contact with high heat; the higher the temperature and longer the exposure, the greater the damage. Since young children have skin much thinner than adult skin, this age group is particularly vulnerable. A hot cup of tea or a steaming bath, while dangerous to an adult, is devastating to a young child.

What to do if a burn occurs
If your infant or toddler does get burned, the choices you make in those first few minutes may save a lifetime of concern.

Cool the area immediately.Use a wet cloth or towel, or gently pour water over the burned area. Clothing should be quickly removed as it holds in heat and continues to burn. Never use ice, butter or any other home remedies. They do not work and often worsen the burn.

Next, assess the severity of the burn. Besides age, other risk factors must be considered:

Depth: First degree is when the outer layers of skin are injured. The skin is pink, warm to the touch but remains intact. Sunburn is a good example. Second degree is when heat penetrates deeper into the skin. Blisters form or “break open” giving the appearance of skin peeling off. Exposed areas are shiny, moist and painful due to exposed nerve endings. Second degree burns eventually heal as the uninjured cells located underneath the burn regenerate. A Third degree burn is most serious of all because all the skin layers have been damaged and there are no cells left to grow back. These burns often appear dry and may be described as “painless” because nerve ending have been burned away. Although burned skin may actually look somewhat normal, don’t be deceived, the damage is real.

Extent: The size of a burn is estimated according to the size of the person’s hand. A burn equal to or larger than the surface of their hand that is Second or Third degree is considered serious.

Location: Because all wounds generally heal inwardly, when a burn involves a joint this leads to a tightening and stiffness. Scaring is also of great concern.

For all burns, consult your pediatrician or take your child to the nearest emergency department. Serious burns should be referred to a burn center. To reach The Burn Center at Saint Barnabas, please call (973) 322-5924.

The Burn Center at Saint Barnabas is New Jersey’s only certified burn treatment facility. With 12 intensive care beds and an 18-bed Step-down unit for less critically injured patients, The Burn Center is one of the largest in the U. S. and Canada. To arrange educational programs or make a donation, contact Saint Barnabas Burn Foundation at (973) 322-8071 or visit www.njburncenter.com

What can you do to reduce the risk of burn injury in children? The burn team at Saint Barnabas recommends the following:

• Keep all hot foods, especially liquids, away from curious hands. Center them in the middle of a table or on back of a counter, keeping cords and pot handles turned inward.
  
  
• Limit the use of table cloths, place mats or anything toddlers (especially those just learning to walk) may grab onto, causing hot items to splash down.
  
  
• Never carry a child while holding hot liquids.
  
  
• Teach even very young children to stand back, or place them securely in a high chair when carrying hot foods from the stove or oven.
  
  
• Always test bath water. A good safety tip is to position toddlers facing away from faucets. They will be less likely to reach out and turn them on.
  
  
• Set hot water heaters to 120 degrees. This setting greatly reduces the risk of burns, yet still leaves plenty of hot water for bathing, appliances or other household needs. If you live in an apartment building, discuss this with your landlord. By law, temperature setting may not be higher than 130 degrees.
  
  
• Consider purchasing anti-scald valves or bath thermometers, available at most home centers.

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