Burns And Scalds in Children

Learn to recognise the severity of burns and scalds, and what kind of burn treatment to administer at home before seeking medical treatment.

Injuries from burns and scalds can affect your child for life. Taking a few simple precautions in your home can protect your child from such injuries. At the same time, here are some first-aid tips for you to help your child should he/she sustain a burn or scald.

Difference Between Burns and Scalds

Both can result in damage to the skin, flesh or body tissue, but are caused by different factors.

A burn is generally caused by:

  • Dry heat like fire or electricity.
  • Corrosive substances such as chemicals.
  • Ultra-violet light, especially from the sun’s rays (sunburn).
  • Friction, extreme cold and radiation.

Scalding is typically caused by:

  • Wet heat such as boiling water, hot liquids, steam and other hot gases.

Most scalds are considered first or second-degree burns.

Types of Burns

Generally, there are a few types of burns that your child may sustain, which vary in the extent of damage to your child's skin.

Superficial Burns

Superficial burns affect the top layer of the skin (i.e the epidermis) only. The skin looks red, swollen and is mildly painful. The top layer of skin may peel a day or so after the burn but the underlying skin is healthy. It does not usually blister or scar. A good example is a mild sunburn. It is considered the mildest among the types of burns.

Superficial Partial-thickness Burns

Partial-thickness burns cause deeper damage (i.e the epidermis and the superficial part of the dermis). The skin forms blisters and is painful and red. However, some of the deeper layers of skin (the dermis) is unharmed. This means the skin usually heals well, sometimes without scarring if the burn is not too extensive.

Thick Partial-thickness Burns

These burns extend even deeper into the dermis. They almost always blister, are wet or waxy dry and are painful to pressure only. The skin can sometimes appear white or pale and can feel tense and there might be reduced sensation to touch. These burns are more likely to cause scarring.

Full Thickness Burns

Full-thickness burns damage all layers of skin. The skin is white or charred black. There may be little or no pain, as the nerve endings are destroyed. These often require skin grafting.

Electrical Burns

Electrical burns are skin burns that happen when electricity comes in contact with the body's surface. It can be caused by several sources including electrical appliances at home. When electricity comes into contact with the skin, it can travel through the body and can cause damage inside the body, to tissues and organs, even if there is little damage to the skin.  

Chemical Burns

Chemical burns are tissue damage caused by strong acids, drain cleaners, pain thinners, gasoline and many other substances.

How to Manage Burns

First Aid for Burns and Scalds in Children

Minor burns and scalds usually heal without treatment, but more severe burns could require hospitalisation to prevent infection or further complication.

How to Treat a Burn

To treat a general burn, follow the first aid guide below:

  1. Remove the heat source.
  2. Remove any piece of clothing from your child's burnt area immediately. However, do not pull off clothing that is stuck to the skin. This may cause skin damage.
  3. Run cool water over the burnt area for 20 minutes until the pain subsides. Do not use ice.
  4. Loosely cover the burn with a sterile gauze bandage.
  5. Do not touch or burst any blisters.

Give your child an age-appropriate dose of paracetamol for pain relief if needed and if your child has no history of allergy to paracetamol.

Do NOT do the following:

  • Prick any blisters. It is better to leave them intact until medically assessed, to lessen the risk of infection
  • Apply creams, ointments, oils, grease etc. (the exception is for mild sunburn. A moisturiser cream may help to soothe this)
  • Put on an adhesive, sticky or fluffy dressing.

See a doctor or nurse 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. Blisters usually mean a partial thickness burn and it may be best to see the doctor.
  • If the affected area is large, deep, very painful, numb or black,
  • If feeling unwell or unsure of the severity of the burn.

Go straight to the Emergency Department or call an ambulance for the following:

  • Electrical or chemical burns
  • Full-thickness burns – even small ones. These burns cause white or charred skin.
  • Partial-thickness burns (i.e., burns which cause blisters) on the face, hands, arms, feet, legs or genitals. 
  • Any burn that is larger than the size of the hand of the person affected.
  • If you suspect breathing in smoke or fumes (smoke inhalation) has occurred. The effects on the lungs from smoke inhalation may be delayed by a few hours so your child may appear ok at first. Symptoms such as sore throat, cough, wheeze, singed nasal hair, facial burns or breathlessness may suggest there may have been smoke inhalation.
    Identifying the type of burn is crucial in administrating the right kind of burn treatment.

Preventing Burns And Scalds

Protect your child from burns and scalds in the home by taking these steps:

  • Keep matchsticks and lighters out of reach, on the top shelf of a cabinet or locked away in a cupboard. Do not let children play with them.
  • Avoid using tablecloths as your child could tug at them. Any hot food and liquids placed on the table may then spill over and scald your child. Consider placemats instead.
  • Keep your children out of the kitchen when you are cooking. Preferably, use the back burners of the stove when cooking in the presence of children. For pots and pans left on the stove, turn their handles inwards, so your child cannot pull and overturn them. Install stove guards.
  • Ensure that your thermos flask caps are closed securely, so your children cannot tilt the flask and spill hot liquids on themselves. Always use thermos flasks that have safety locks.
  • Keep your children away when you are ironing. After ironing, make sure that the iron and its cord are stored properly to prevent your child from pulling the cord and/or toppling the iron.
  • Always add hot water to cold water before you bathe your child. This way, even if your child playfully jumps into the basin or tub while you are not watching, the child will not get scalded by the hot water.

Remember to instruct your child's caregiver to observe these safety tips too.

Disclaimer: The information provided in this article is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical condition.

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