Unfortunately, one of the most frequent accidents involving children that occur in the home is burning caused by spilling of hot liquid.
Your immediate reaction will limit the damage to the child’s skin.
• Stop whatever is causing the burning immediately. This may mean removing the child from the specific cause of burning, extinguishing the fire with water, or throwing a blanket or a towel over the fire, or using a fire extinguisher. It is particularly important not to expose yourself to the risk of burning, if you are the only person able to help the child.
• As far as clothing and other objects are concerned: if they are not stuck to the child’s skin, and can easily be taken off, remove them from the area of the burn. HOWEVER, if they are stuck to the child’s skin, DO NOT remove them, because greater damage may be caused.
• Put the burned area of skin under running lukewarm or cool, NOT ice-cold, water, as quickly as possible, within 30 minutes of the burn, or even if 3 hours have passed. Keep the burn under water for at least 10 minutes, ideally for half an hour. DO NOT put butter, yogurt, or ice on the burn.
• DO NOT burst any blisters.
• Keep the limb with the burn, hand, or foot, elevated.
• At the same time, keep the child warm by wrapping him in a blanket – without covering the area of the burn – particularly if cooling a large area of skin with water, to prevent hypothermia.
• Then, cover the area of the burn with a piece of transparent kitchen film, like a piece of skin, and not by winding it round the arm or leg. Alternatively, you could apply a piece of sterile gauze, but not tightly, or wound around the burn.
• Give the child paracetamol or anti-inflammatory medication for the pain
• Go to the hospital immediately if:
o the burn covers a large area – anything bigger than the child’s hand.
o the burn is deep, and the skin looks white or black.
o the burn has caused blisters, and is on the face, hands, or feet, or in the genital area.
o the burn was caused by chemicals or electricity
o the burn is accompanied by inhalation of substances or smoke, or there is a burn in the respiratory tract
o the burn looks infected – is weeping, painful, swollen, red.
• If the child has red, hot, and painful skin caused by exposure to the sun, move him into the shade immediately.
• Place the child under cool running water, or in the bathtub.
• Apply simple moisturizing cream to the area, NOT oil, or butter. Aloe vera or calamine lotions help.
• Give the child pain medication if necessary.
• Give the child plenty of fluids.
• If the child shows symptoms of heatstroke (dizziness, tachycardia, vomiting, increased body temperature), seek medical help.
Stelios Papaventsis MBBS MRCPCH DCH IBCLC 2014