• Dr Claudine DeMunter

Burns & Scalds

Updated: Nov 7, 2019

Every day children under the age of five, which is the most vulnerable age, are admitted to hospital with serious burns. A burn can be caused by dry heat, by an iron or fire. Steam and hot liquids can cause scalds. Burns cause red, peeling skin, blisters, swelling, white or charred skin. Superficial burns are very painful. Full thickness burns are painless as the nerves are equally burnt. Minor burns affecting the outer layer of skin will heal in around 14 days leaving minimal scarring. If you have a severe burn you will need specialist care as they can take months or years to heal and leave scars. In some cases surgery and skin grafts may be necessary.


If your child gets burnt, there are immediate actions to take to reduce any further damage. There are also situations when you will need to seek medical care even if you think the burn is minor.


Preventing burns and scalds:

Hot liquids: at 60°C water can burn skin in two seconds. At 70°C it takes less than a second. On average hot water comes out of the tap at more than 60°C.

Bath: always run cold water first before adding hot water. Test the water before you put your child in the bath, if it feels hot for you it will be too hot for your child. Never leave a child unsupervised in the bathroom even for a moment. It is good to install thermostatic mixing valves in the hot-water systems as they help control water temperature.

In general: Do not leave your child under 5 years old alone and keep your child out of the kitchen if possible. Make sure your child does not have access to hot drinks, kettles, pans, oven doors, electric wires, matches, lighters and candles.


Immediate treatment of burns and scalds:

  • Move your child away from the heat source

  • Cool the burn with cool running water for 20 minutes. Do not use iced water, creams or greasy substances such as butter.

  • Remove any clothing, jewellery, baby nappies. Do not remove anything that is stuck to the skin.

  • Make sure your child stays warm but do not cover the burn with fabric or material which may stick.

  • Cover the burn with clingfilm: place a layer over the burn and avoid wrapping it around a limb.

  • Use painkillers such as paracetamol or ibuprofen to treat any pain.

  • If the face or eyes are burnt, sit your child up as much as possible as this helps to reduce swelling.

  • Keep the burn clean and do not burst any blisters that form.


Electrical burns:

If your child has been injured by a domestic-voltage source (up to 220-240 volts), switch off the power supply and remove your child from the electrical source using a material that doesn't conduct electricity, such as a wooden stick or wooden chair. Do not approach if your child is connected to a high-voltage source (1,000 volts or more) - switch off power supply if possible and call 999.


Chemical burns:

Domestic cleaners are powerful chemicals which commonly cause burns, in particular bleach and washing soda. All detergents can burn, especially if taken into the mouth, or splashed on the skin or eyes.


Put on appropriate protective clothing e.g. rubber gloves and remove any contaminated clothing from your child. If the chemical is dry, brush it off the skin. Use lots of cold running water to remove any traces of the chemical from the burnt area, or wash out the mouth or eyes.


Sunburn:

Move into the shade or preferably inside. Give a cool bath or shower to cool down the burnt area of skin. Apply after sun lotion to the affected area. Don't use greasy or oily products. If there is any pain, give paracetamol or ibuprofen. Keep your child well hydrated by drinking plenty or water. Watch out for signs of heat exhaustion or heat stroke (dizziness, a rapid pulse or vomiting). This is a medical emergency.


When to get medical attention after the initial care:

If your child is under 5 years old, it is better to show the burn to a doctor, even if you think it is minor. For all chemical and electrical burns, all large or deep burns (bigger than your child's own palm), burns that cause white or charred skin, burns on the face, hands, arms, feet, legs or genitals that cause blisters; if your child has breathed in smoke or fumes (as the effect of this is that it may give late serious signs with difficulty breathing); if your child has a medical condition affecting the heart, lung, liver, diabetes or the immune system, go to your nearest Accident & Emergency Department.


Further Advice: British Burn Association on

STOP, DROP, ROLL - when clothing catches fire

COOL. CALL, COVER - first aid for burns