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
. Babies and young children are especially susceptible -
they're curious, small, and have sensitive skin that needs
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.
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
- 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).
, the mildest of the three, are limited to the top layer of
- 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.
are more serious and involve the skin layers beneath the top
- 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.
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.
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
- The burn is on the face, scalp, hands, joint surfaces, or
- 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 (
cold) water over the burned area (if water isn't available,
any cold, drinkable fluid can be used)
hold a clean, cold compress on the burn for approximately 3 to 5
do not use ice, as it may cause the burn to take longer
- 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:
emergency medical care
, then follow these steps until medical personnel arrive:
- Keep your child lying down with the burned area
- 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
For Flame Burns:
- Extinguish the flames by having your child roll on the
- Cover him or her with a blanket or jacket.
- Remove smoldering clothing and any jewelry around the burned
- 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
- 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
- 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
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.
Although you can't keep your child free from injuries all
the time, taking some simple precautions
reduce the chances that your child will be burned in your own
- 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
- 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.
- Set the thermostat on your hot water heater to 120Âº
Fahrenheit (49Âº 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 120Âº Fahrenheit (49Âº
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.
- Turn pot handles toward the back of the stove every time you
- Block access to the stove as much as possible.
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.
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.
hold a baby or small child while cooking.
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.
Mary Mondozzi, MSN, RN CPNP
Date reviewed: April 2006
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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