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Should Your Child See a Doctor?

Burns

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Definition

  • A burn is a heat (thermal), chemical or electrical injury to the skin

First Aid Advice For Burns From Heat 

  • Immediately (don't take time to remove clothing) put the burned part in cold tap water or pour cold water over it for 10 minutes.
  • For burns on the face, apply a cold wet washcloth. (Reason: lessen the depth of the burn and relieve pain).

First Aid Advice For Burns FromChemicals 

  • Remove any contaminated clothing.
  • Flush the chemical off the skin with warm water for 10 minutes. For large areas, use a shower.

Severity of Burns: 

  • 1st degree - Reddened skin without blisters
  • 2nd degree - Reddened skin with blisters (Heals from the bottom up, not from the edges. Takes 2 to 3 weeks.) Small closed blisters contain protective chemicals, serve as a dressing and reduce pain.
  • 3rd degree - Deep burns with white or charred skin. Skin sensation is absent. Usually needs a skin graft to prevent bad scarring if it is larger than a quarter (1 inch) in size. (Heals from the edges)

When to Call Your Doctor for Burns

Call 911 If…

 
  • If your child has a large 2nd or 3rd degree burn
  • Difficulty breathing with burn to the face
  • Difficult to awaken or acting confused

Call Your Doctor Now (night or day) If

  • You think your child has a serious burn
  • Blister is present (EXCEPTION: small closed blister less than ½ inch size)
  • Eye or eyelid burn
  • Burn completely circles an arm or leg
  • Center of the burn is white or charred
  • Electrical current burn
  • Explosion or gun powder caused the burn
  • Acid or alkali burn
  • Chemical burn that causes a blister
  • House fire burn
  • Severe pain persists over 2 hours after pain medicine
  • Burn looks infected

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Burn isn't healed after 10 days

Parent Care at Home If

  • Minor heat or chemical burn and you don't think your child needs to be seen

Home Care Advice for 1st Degree Burns or Small Blisters

  1. Pain Medicine: For pain, apply cold compresses and give acetaminophen (e.g., Tylenol) or ibuprofen for a few days.
  2. Cleansing: Wash the area gently with warm water. Avoid soap unless the burn is dirty. (Reason: Soaps can slow healing).
  3. Closed Blisters: Don't open any small closed blisters - the outer skin protects the burn from infection.
  4. Antibiotic Ointment: For any broken blisters, apply an antibiotic ointment such as Polysporin (no prescription needed). Then cover it with a Band-Aid. Change the dressing every other day. Use warm water and 1 or 2 gentle wipes with a wet washcloth to remove any surface debris.
  5. Expected Course: It will probably hurt for 2 days and peel like a sunburn in about a week. Fortunately, first- and second-degree burns don't leave scars.
  6. Call Your Doctor If:
    • Severe pain persists over 2 hours after pain medicine given
    • Burn starts to look infected (pus, red streaks, increased tenderness)
    • Burn isn't healed after 10 days
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


References

  1. Hansbrough JF and Hansbrough W. Pediatric burns. Pediatr Rev. 1999;20:117-124.
  2. Kai-Yang L, Zhao-Fan X, Luo-Man Z, et al. Epidemiology of pediatric burns requiring hospitalization in China: A literature review of retrospective studies. Pediatrics. 2008;122(1):132-142.
  3. Klein GL, Herndon DN. Burns. Pediatr Rev. 2004;25(12):411-416.
  4. Rodgers GL. Reducing the toll of childhood burns. Contemp Pediatr. 2000;17(4):152-173.
  5. Schiller W. Burn management in children. Pediatr Ann. 1996;25:431-438.
  6. Smith ML. Pediatric burns: Management of thermal, electrical and chemical burns and burn-like dermatologic conditions. Pediatr Ann. 2000;29:367-378.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/13/2010 6:54:11 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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