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Scalds

Every day, 300 young children with burn injuries are taken to emergency rooms.

These injuries are not caused by fire, but by hot liquids, steam or foods. Scald burns, not contact burns (burns from fire) are more common among young children.

The Regional Pediatric Trauma and Emergency Center at The Children's Medical Center of Dayton admitted 142 children with burn-related injuries in 2007. Of those treated, 43 percent suffered scalds from hot water or food. Hot tap water accounts for nearly 1 in 4 of all scald burns among children and is associated with more deaths and hospitalizations than any other hot liquid burns.

"Water scalds are extremely painful, but burns from hot food can be even more devastating," says Cindy Asher, RN, clinical nurse specialist, at Dayton Children’s. "We’ve treated children who have taken hot foods, such as noodles, out of a microwave and the bowl tipped onto them. Noodles tend to sit on the victim causing a deeper, more serious burn."

"Children, especially those 4 and younger, do not perceive danger. They are very curious about their environment and explore their environment by touching and tasting. Small children often lack the ability to escape a life-threatening situation," adds Asher.

Most scald burns can be prevented. Children should know that the kitchen and bathroom can be dangerous and they will need to be extra careful when in those areas.

In the kitchen

Keep hot foods and drinks away from the edge of tables and counters. Do not put them on a tablecloth that little hands can yank.
If you're holding something hot, don't hold your child too.
When you cook, keep your child away from the stove. Tell children that when you are cooking, you are not to be bothered.
Turn pot handles toward the back of the stove. If possible, use rear burners.
Watch for dangling appliance cords.
Don’t use the microwave for snacks if children cannot be supervised.
Test heated food and liquids before serving children.

In the bathroom

Test how hot your hot water is. Turn on the hot water at the tub faucet. Let it run for three to five minutes. Measure the temperature with a hot water gauge or mercury thermometer. (Liquid crystal bath thermometers are available for a few dollars.)
For safe bathing, set the water heater's thermostat to low, warm, or 120 F. Wait a day. Test the water again. Repeat, if necessary. Your clothes and dishes will get clean at this setting!
Install anti-scald devices in your shower and bathtub fixtures that stop the water flow when the temperature exceeds 120 F.
Always check the water temperature before placing your child in the tub. A child's skin burns more easily than an adult's.
Supervise kids in the tub. Young children can turn the hot water on by themselves. Older children can scald a younger child.

Actively supervise. Simply being in the same room with a child is not necessarily supervising. A young child in the same room as hot surfaces, hot liquids or open flames should be under constant, close supervision of an adult paying undivided attention.

"Burns can be devastating to children, babies and toddlers because they have thinner skin than older children and adults. Their skin burns easier and more deeply when exposed to a hot surface or liquid," says Asher. "A child exposed to hot tap water at 140 degrees Fahrenheit for three seconds will sustain a third-degree burn, an injury requiring hospitalization and skin grafts."

Four types of burns

First-degree or superficial burns are the least serious and most common. These burns cause tenderness, soreness or pain and skin redness. They are minor and heal quickly. An example of this type of burn is sunburn.
Second-degree or partial thickness burns extend into a deeper layer of skin. These burns are painful and leave the skin blotchy white, pink or red, and cause swelling or blisters that may ooze fluid. These burns should be examined by a health care provider for treatment.
Third degree or full thickness burns extend through all layers of the skin and may injure tissue beneath the skin so the skin is not capable of healing itself. The skin is leathery and dry and has white, brown, and charcoal-gray or deep red appearance. There may be little or no pain. These burns are severe injuries and medical treatment is needed right away.
Fourth-degree burns involve both skin and underlying structures such as muscle and bone. These burns may occur with electrical burns and may be more severe than they appear. They may cause serious complications and medical treatment is needed right away.

First aid for burns from cooking, hot liquids or foods

Remove the hot, wet clothing - don’t forget to check and remove an infant’s diaper if it has absorbed hot liquids.
Cool the burned area immediately with room-temperature tap water.
Do not use ice or very cold water. Ice or very cold water will further damage burned skin.
Cooling should only take a few minutes. Do not over-cool the area. Carefully touch the burned area. When the burned area is the temperature of the unburned skin, you have cooled enough.
Gently dry the area and cover burn with a clean, dry bandage or towel.
Do not use butter, first aid ointment or burn cream. These items tend to retain heat and cause more pain.
Do not underestimate the seriousness of a burn. Get medical help. Have the child seen by a physician at the hospital or in the office.
Keep the burned victim warm while you transport them to hospital or wait for emergency services to arrive. Cover with a blanket. Burned skin loses body heat rapidly - even in warmer months.
If your child’s doctor thinks the burn is not too serious, he or she may show you how to clean and care for it at home using medicated ointments and dressings.

About our expert

Cindy Asher, RN, is a clinical nurse specialist at Dayton Children’s. She earned her Bachelor of Science degree in nursing from Wright State University and her Master of Science degree in nursing from the University of Cincinnati. Cindy is a board member of the Society of Pediatric Nurses and Association of Pediatric Surgical Nurses. She is a certified Pediatric Advanced Life Support regional faculty member and is certified as an Advanced Burn Life Support Provider. Cindy has worked at Dayton Children’s since 1989.

Other resources

American Burn Association - www.ameriburn.org
Safe Kids Worldwide - www.safekids.org
Home Safety Council - www.homesafetycouncil.org/

Kohl's a Minute for Kids