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Safety and Wellness > Safety Resources > First Aid

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From kids washing up under a too-hot faucet to an accidental tipping of a coffee cup, burns are a potential hazard in every home. In fact, burns, especially scalds from hot water and liquids, are some of the most common childhood accidents . Babies and young children are especially susceptible - they're curious, small, and have sensitive skin that needs extra protection.

Although some minor burns aren't cause for concern and can be safely treated at home, other more serious burns require medical care. But taking some simple precautions to make your home safer can prevent many burns.

Common Causes

The first step in helping to prevent your child from being burned is to understand the common causes of burns in children:

• scalds, the number-one culprit (from steam, hot bath water, tipped-over coffee cups, cooking fluids, etc.)
• contact with flames or hot objects (from the stove, fireplace, curling iron, etc.)
• chemical burns (from swallowing things, like drain cleaner or watch batteries, or spilling chemicals, such as bleach, onto the skin)
• electrical burns (from biting on electrical cords or sticking fingers or objects in electrical outlets, etc.)
• overexposure to the sun

Types of Burns

Burns are often categorized as first-, second-, or third-degree burns, depending on how badly the skin is damaged. Each of the injuries above can cause any of these three types of burn. But both the type of burn and its cause will determine how the burn is treated. All burns should be treated quickly to reduce the temperature of the burned area and reduce damage to the skin and underlying tissue (if the burn is severe).

First-degree burns , the mildest of the three, are limited to the top layer of skin:

• Signs and symptoms: These burns produce redness, pain, and minor swelling. The skin is dry without blisters.
• Healing time: Healing time is about 3 to 6 days; the superficial skin layer over the burn may peel off in 1 or 2 days.

Second-degree burns are more serious and involve the skin layers beneath the top layer:

• Signs and symptoms: These burns produce blisters, severe pain, and redness. The blisters sometimes break open and the area is wet looking with a bright pink to cherry red color.
• Healing time: Healing time varies depending on the severity of the burn.

Third-degree burns are the most serious type of burn and involve all the layers of the skin and underlying tissue:

• Signs and symptoms: The surface appears dry and can look waxy white, leathery, brown, or charred. There may be little or no pain or the area may feel numb at first because of nerve damage.
• Healing time: Healing time depends on the severity of the burn. Deep second- and third-degree burns (called full-thickness burns) will likely need to be treated with skin grafts, in which healthy skin is taken from another part of the body and surgically placed over the burn wound to help the area heal.

What to Do

Seek Medical Help Immediately When:

• You think your child has a second- or third-degree burn.
• The burned area is large, even if it seems like a minor burn. For any burn that appears to cover more than 10% of the body, call for medical assistance. And don't use wet compresses because they can cause the child's body temperature to drop. Instead, cover the area with a clean, soft cloth or towel.
• The burn comes from a fire, an electrical wire or socket, or chemicals.
• The burn is on the face, scalp, hands, joint surfaces, or genitals.
• The burn looks infected (with swelling, pus, increasing redness, or red streaking of the skin near the wound).

For First-Degree Burns:

• Remove the child from the heat source.
• Remove clothing from the burned area immediately.
• Run cool ( not cold) water over the burned area (if water isn't available, any cold, drinkable fluid can be used) or hold a clean, cold compress on the burn for approximately 3 to 5 minutes ( do not use ice, as it may cause the burn to take longer to heal ).
• Do not apply butter, grease, powder, or any other remedies to the burn, as these increase the risk of infection.
• If the burned area is small, loosely cover it with a sterile gauze pad or bandage.
• Give your child acetaminophen or ibuprofen for pain.
• If the area affected is small (the size of a quarter or smaller), keep the area clean and continue to use cool compresses and a loose dressing over the next 24 hours. You can also apply antibiotic cream two to three times a day, although this isn't absolutely necessary.

For Second- and Third-Degree Burns:

• Seek emergency medical care , then follow these steps until medical personnel arrive:
  • Keep your child lying down with the burned area elevated.
  • Follow the instructions for first-degree burns.
  • Remove all jewelry and clothing from around the burn (in case there's any swelling after the injury), except for clothing that's stuck to the skin. If you're having difficulty removing clothing, you may need to cut it off or wait until medical assistance arrives.
  • Do not break any blisters.
  • Apply cool water over the area for at least 3 to 5 minutes, then cover the area with a clean white cloth or sheet until help arrives.

For Flame Burns:

• Extinguish the flames by having your child roll on the ground.
• Cover him or her with a blanket or jacket.
• Remove smoldering clothing and any jewelry around the burned area.
• Call for medical assistance, then follow instructions for second- and third-degree burns.

For Electrical and Chemical Burns:

• Make sure the child is not in contact with the electrical source before touching him or her or you may also get shocked.
• Flush the burned area with lots of running water for 5 minutes or more. If the burned area is large, use a tub, shower, buckets of water, or a garden hose.
• Do not remove any of your child's clothing before you've begun flushing the burn with water. As you continue flushing the burn, you can then remove clothing from the burned area.
• If the burned area is small, flush for another 10 to 20 minutes, apply a sterile gauze pad or bandage, and call your child's doctor.
• Chemical burns to the mouth or eyes require immediate medical evaluation after thorough flushing with water.

Although both chemical and electrical burns might not always be visible, they can be serious because of potential damage to the child's internal organs. Symptoms may vary, depending on the type and severity of the burn and what caused it and may include abdominal pain.

If you think your child may have swallowed a chemical substance or an object that could be harmful (for instance, a watch battery) first call poison control and then the emergency department. It is helpful to know what chemical product the child has swallowed or has been exposed to. You may need to take it with you to the hospital. It's a good idea to have the number for poison control, (800) 222-1222, in an easily accessible place, such as on the refrigerator.

Preventing Burns

Although you can't keep your child free from injuries all the time, taking some simple precautions can reduce the chances that your child will be burned in your own home.

In General

• Keep matches, lighters, chemicals, and lit candles out of your child's reach.
• Put child-safety covers on all electrical outlets.
• Get rid of equipment and appliances with old or frayed cords and extension cords that look damaged.
• If you need to use a humidifier or vaporizer, use a cool-mist model rather than a hot-steam one.
• Choose sleepwear that's labeled flame retardant (either polyester or treated cotton). Cotton sweatshirts or pants that aren't labeled as sleepwear generally aren't flame retardant.
• Make sure older children are especially careful when using irons or curling irons.
• Prevent house fires by making sure you have a smoke alarm on every level of your home and in each bedroom. Check these monthly and change the batteries twice a year.
• Don't smoke inside, especially when you are tired, taking medications that can make you drowsy, or in bed.
• Don't use fireworks or sparklers.

Bathroom

• Set the thermostat on your hot water heater to 120º Fahrenheit (49º Celsius) or lower, or use the "low-medium setting." A child can be scalded in 2 to 3 seconds if the temperature is only 5 degrees higher than 120º Fahrenheit (49º Celsius). If you're unable to control the water temperature (if you live in an apartment, for example), install an anti-scald device, which is relatively inexpensive and can be installed you or by a plumber.
• Always test bath water with your elbow before putting your child in it.
• Always turn the cold water on first and turn it off last when running water in the bathtub or sink.
• Turn children away from the faucet or fixtures so they are less likely to play with them and turn on the hot water.

Kitchen/Dining Room

• Turn pot handles toward the back of the stove every time you cook.
• Block access to the stove as much as possible.
• Never let a child use a walker in the kitchen (the American Academy of Pediatrics strongly discourages the use of walkers overall).
• Avoid using tablecloths or large placemats. A small child can pull on them and overturn a hot drink or plate of food.
• Keep hot drinks and foods out of reach of children.
• Never drink hot beverages or soup with a child sitting on your lap or carry hot liquids or dishes around your child. If you have to walk with hot liquid in the kitchen (like a pot of soup or cup of coffee), make sure you know where your child is, so you don't trip over him or her.
• Never hold a baby or small child while cooking.
• Never warm baby bottles in the microwave oven. The liquid may heat unevenly, resulting in pockets of breast milk or formula that can scald your baby's mouth.
• Screen fireplaces and wood-burning stoves. Radiators and electric baseboard heaters may need to be screened as well.

Outside/In the Car

• Use playground equipment with caution. If it's very hot outside, use the equipment only in the morning, when it's had a chance to cool down during the night.
• Remove your child's safety seat or stroller from the hot sun when not in use because children can get burns from hot vinyl and metal. If you must leave your car seat or stroller in the sun, cover it with a blanket or towel.
• Before leaving your parked car on a hot day, hide the seatbelts' metal latch plates in the seats to prevent the sun from hitting them directly.

Reviewed by: Mary Mondozzi, MSN, RN CPNP
Date reviewed: April 2006