In Germany, burn injuries are among the most common consequences of accidents in childhood. Mostly it hits children up to the age of 5. And also here – as for example also with poisonings – the household is the most dangerous place: Because 80 per cent of these accidents happen at the “domestic stove”. The dangers that threaten here are often underestimated: Water, for example, does not have to be 100 degrees hot to damage the skin. Temperatures of around 50 degrees are already sufficient for a burn. A temperature of 54 degrees Celsius causes a third-degree scald in an adult after 31 seconds – in a toddler after just 10 seconds.
Scalds are particularly common
Although three-quarters of all heat-related injuries are scalds (for example, water, steam, tea, coffee), dry heat (for example, open fires, hot surfaces), electric current (electrical accidents), and radiation exposure (sun, radioactivity) also play a role in harming children. However, hot or toxic vapors can also be inhaled. Particular danger is posed by extensive burns associated with vascular damage. The loss of fluid from the blood vessels into the tissue, together with the severe pain, can lead to shock. They should therefore be treated by a doctor as soon as possible.
What happens during a burn?
Mild burns are characterized by redness, pain and mild blistering. More severe burns result in very painful blisters. The blistering occurs because the blood capillaries of the skin are damaged by the heat and become permeable to blood plasma. The top layer of skin lifts from the underlying surface due to the blood fluid.
Signs of burns and scalds
There are two criteria for assessing the severity of a burn or scald:
- Extent: what percentage of the body surface is affected by the burn? The rule of nine is used for this in adults: the body is divided into regions of nine percent each (head 9%, torso front and back 18% each, arms 9% each, legs 18% each, anal-genital region 1%). This rule can also be applied to children in a slightly modified form: Here, the head and neck are set at 16%, arms at 9% each, legs at 17% each, and front and back of the torso at 16% each. For infants, the rule of thumb is: the palm of the hand, including the fingers, corresponds to one percent of the body surface. In children, there is already danger to life when 8% of the skin is burned, in adults this applies from 15%.
- Depth of damage: The more skin layers are affected, the higher the degree of burn.
Depending on the severity of the burn, injuries are divided into 1st degree, 2nd degree and 3rd degree burns:
- Burn 1st degree: redness of the affected areas of the skin, severe pain, there may be swelling.
- Burn 2nd degree: redness with blistering or white, weeping wound areas.
- Burn 3rd degree: dry thick leathery skin, the skin may be whitish to brownish discoloration, the affected tissue is dead and there without pain sensation (the outer areas, however, hurt a lot).
First aid – what to do?
If less than five percent of the skin is damaged by first-degree burns or if the second-degree burn is not larger than the child’s hand, the damage can be treated yourself, for example, with special gels (for example, Fenestil) or ointments. All other burns must be treated by a doctor.
- Extinguishing: Smother the flames with blankets (be careful, use heat-resistant materials) or by rolling the child on the floor or extinguish with water or a fire extinguisher (never aim at the head, breathing could be affected).
- Cooling: If smaller body parts are affected, these can be cooled for pain relief (under running lukewarm water or with cool compresses, each only for a few minutes). Do not use ice cubes or excessively cold water for this purpose (risk of hypothermia and tissue damage). In infants, if the trunk is affected or if the burned area is large, the area should not be cooled, especially in the case of burns on the trunk of the body – there is a risk that the child (especially the small child or infant) will cool down.
- Dial 911: Do not drive your child to the hospital yourself, but call emergency services. This ensures early and best possible care.
- Do not open or puncture burn blisters. They protect the injured tissue and dry up after some time by itself.
- Home remedies such as flour, powder, butter and oil are taboo for larger burns or open wounds, as they can complicate the assessment and treatment of the wound at the doctor and promote infections. Ointments or gels should also be used only after a doctor has assessed the injury.
- Do not cover burns with fluffy materials (such as absorbent cotton), they can stick to the wound. Sterile compresses or plasters with aluminum coating are better.
- Comfort child (for example, with a cuddly toy something to distract) and keep warm. The best way to do this is to use the emergency blanket from the first aid kit (silver side inward, not too tight), as this does not exert pressure on burned body parts. Alternatively, a light blanket can also be used.
Even in adults, there is a risk of hypothermia if burned or scalded skin areas are cooled for too long or too much. Therefore, only minor burns or scalds should be cooled. Do not use ice-cold water under any circumstances, but lukewarm water.
For minor burns or scalds
- Scald: Immediately remove clothing carefully (with scissors if necessary) to prevent heat buildup and “afterburn”.
- Burn: Remove clothing only if it does not stick, because otherwise skin injuries occur.
- Cool under running (not too cold!) Water for a few minutes and make sure that the child does not cool down (only cool the burned area, not the whole body). On the face, damp cloths can be used for cooling – make sure to keep the airways clear.
- If no blisters are present, do not cover affected body part, but disinfect and let it heal in the air. Otherwise, cover wound cleanly, preferably with a sterile bandage cloth from the first aid kit.
For more extensive burns or scalds.
- Scalding: remove clothing quickly but carefully.
- Burn: leave clothing on the body, because it is usually burned into the wound. Removal would lead to skin injuries.
- Burned areas do not cool, otherwise the child could hypothermia.
- Cover the affected area sterile. The best way to do this is a sterile Metalline burn cloth. It does not stick to the wound and maintains the heat.
- Call emergency services!
- Be careful with burns on the face: if the child has inhaled smoke, the mucous membranes can swell, causing respiratory distress. Therefore: notify emergency services, do not cover burns, upright sitting position (facilitates breathing), regularly check breathing.
- Caution, after extensive burns may be respiratory or circulatory problems. Therefore, observe the child closely until the arrival of emergency services and check breathing and consciousness.
Prevent burns and scalds
Take the following 10 tips to heart to prevent burns and scalds in children:
- Most often, children get scalded when they pull pots of hot food or boiling water off the stove. Therefore, they attach a safety grid.
- Make sure that the child can not pull down appliances such as kettles, irons, etc. to him by the cord.
- Children should not play alone at the tap.
- Bathing: Let the cold water run in first and only then the warm. Before the bathing fun can start, you should check the temperature with a bath thermometer.
- Checked after heating the temperature of milk or jar contents before feeding your child. Especially food heated in the microwave can be unevenly warm.
- If you are carrying your infant in your arms, do not have hot drinks at the same time. He could knock the cup out of your hand by an uncontrolled movement.
- Always keep matches and lighters childproof. In order not to make things unnecessarily interesting, uses with older children education more than prohibitions.
- Do not leave children alone with burning candles.
- Children’s clothing: avoid synthetic fibers; they can be highly flammable.
- Barbecues: Never pour liquid fire accelerants (methylated spirits, alcohol, gasoline) on fireplaces. It comes thereby easily to deflagrations with extremely high temperatures.
