Burns & Scalds

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Table of Contents

What is a burn or scald?

Burns are damage to the tissue of your body caused by heat, too much sun, chemicals or electricity. Scalds are caused by hot water or steam.

Burns and scalds can range from being a minor injury to a life-threatening emergency. It depends how deep and how large they are.

Burns & Scalds in Children

Burns and scalds are a leading cause of injury to young children, with toddlers most at risk because of their increased mobility and natural curiosity.

There are six main types of burns: scalds (caused by hot liquids, foods or steam), flame, contact (with hot objects e.g. heaters, or with very cold objects e.g. dry ice), friction (e.g. treadmill), chemical and electrical.

The main cause of burns in young children is scalds caused by hot foods and drinks, steam and liquids. Children are commonly scalded by hot food and drinks (e.g. tea, coffee, soups, noodles) that have been pulled down off benches. This can result in serious burns to the face, neck, chest, and shoulders.

All burns can be serious. Even small burns, depending on where they occur, can have long-term consequences for your child. Severe burns often require ongoing physiotherapy and multiple surgeries.

3 Types of Burns

A superficial burn, also known as a first-degree burn, affects the outer or top layer of skin only. It may be blistered, red and painful.

A partial thickness burn (second-degree burn) damages the first and second skin layers. It may be mottled red and white, dark red or pale yellow. It will be painful and is often blistered.

A full thickness burn (third-degree burn) reaches as far as the fat underneath the skin. It may look brown, black or white, and feel dry and leathery. A full thickness burn can destroy nerves, so you may not feel the pain.

What Causes Burns and Scalds?

The most common causes of burns are:

First Aid For Burns and Scalds: Key Steps

Call an ambulance by phoning 000 if a burn is severe, large or to the child’s face, hands, genitals or airway.

Go to your GP or your local hospital if you’re not sure how severe a burn is.

Then take the following first aid steps:

  1. Make sure the area is safe, and there’s no further risk of injury. Take the child to a safe place if possible.
  2. Take off any clothing (including nappies) or jewellery around the burn, but only if it’s not stuck to the skin and only if you can do so without causing more pain or injury. You might have to cut clothes to remove them.
  3. As soon as possible, hold the burned area under cool running water for a total of 20 minutes. This will reduce tissue damage and pain. This is useful for up to three hours after the burn. 
  4. When you’ve finished the water treatment or while you’re taking the child to see a doctor, cover the burn with a loose, light, non-sticky dressing like plastic wrap or a clear plastic bag.  However, do not keep plastic cling film on for more than an hour.
  5. Raise burned limbs.
  6. Cover your child with a blanket to keep them warm and just target the burn with the cool water.. This helps prevent hypothermia.

The key is to cool the burn for 20 minutes in total. You can cool the burn for a few minutes at a time for up to 3 hours after the burn happens. But don’t delay getting medical help if you think the burn is severe, or your child is upset or cold and you can’t cool the burn.

What Not To Do With Burns

  • Don’t peel off any clothing that’s stuck to the burn.
  • Don’t break any blisters.
  • Don’t apply ice, iced water, lotions, moisturisers, oil, ointments, butter or flour, creams or powders to the burn.  They seal heat in and cause more damage.
  • If the burn is large, don’t cool it for longer than 20 minutes. 

When to Get Medical Help For a Burn or Scald

Go to your GP or a hospital emergency department if the burn or scald:

  • is the size of a 20-cent piece or larger
  • is deep and looks white, even if the child doesn’t feel any pain
  • looks raw, angry or blistered
  • the skin looks leathery, or there are patches of brown, black or white
  • is causing severe pain or pain that won’t go away with pain relief medicine like paracetamol or ibuprofen.

Also get medical help if you’re not sure how bad the burn is.

When to Call an Ambulance for a Burn or Scald.

Call an ambulance if the burn or scald is:

  • on the face, hands or genitals
  • the burn involves the airway – that is, in the child’s nose, mouth or throat
  • larger than the size of the child’s forearm.
  • was caused by chemicals or electricity
  • the person is having trouble breathing

What Should I do While Waiting for an Ambulance?

First, remove the source of the burn:

  • If the person is on fire, drop them to the ground and roll them or cover them in a blanket to put out the flames.
  • If there is an electrical current, turn off the electricity.
  • If it’s a chemical burn, take off any contaminated clothing and wash the affected area of skin with plenty of water, continuing for up to 60 minutes. For dry chemicals, brush off the chemicals before putting the burnt area under water.
Take the child to a safe place if possible.

As soon as possible, put the burnt area under cool running water for at least 20 minutes: This is because hypothermia can happen quickly in children.

  • Don’t use ice (only apply water to the burnt area).
  • Remove any clothing, nappies or jewellery near the burn unless they are stuck to the burn.
  • Don’t remove anything that is stuck to the burn.

Cover the burn:

  • Use a light, loose, non-stick dressing. Use non-fluffy material. Plastic cling film is a good choice, however, do not keep plastic cling film on for more than an hour..
  • If the burn is to an arm or leg, raise it whenever possible to reduce swelling.

Some things to avoid:

  • Don’t touch the burn or apply ice.
  • Don’t put a child with burns into a bath full of cold water.
  • If blisters develop don’t pop them — see your doctor who will examine them and decide how best to treat.
  • Don’t use any ointments, creams, lotions or fat on a burn. They seal heat in and cause more damage.

How Should I Treat Burns and Scalds?

Most small burns will heal themselves in 10 to 12 days. If the burn does not have any blisters or broken skin, such as sunburn, a simple moisturiser such as sorbolene is the best treatment. For all other burns seek medical treatment for appropriate dressings from your pharmacist.

The treatment for serious burns includes:

If the wound gets worse, or if you are not up to date with tetanus injections, see your doctor.

Can Burns and Scalds be Prevented?

In the kitchen:

You can prevent burns and scalds by being careful when cooking:

  • Make sure all hot liquids are out of the reach of children and turn pot handles inwards on the stove.
  • Be careful not to give children food that is too hot — test it first.
  • Always supervise children in the kitchen and install a safety gate if possible, to keep toddlers out while you are cooking.

In the bathroom:

  • Fill a bath with cold water first, then add the hot water to get to the correct temperature.
  • Always test the water temperature before your child gets into a shower or bath.
  • The temperature of hot water delivered to basins, baths, and showers should not exceed 50°C (a licensed plumber can set the temperature correctly).
  •  

Around your home:

  • Take care with all electrical items. Unplug them when they’re not in use.
  • Always have working smoke detectors in the house and keep a fire extinguisher handy. All adults who live in or regularly visit your home (for example, babysitters) should know where you keep the fire extinguisher.
  • If you are using chemicals, always wear protective clothing and eyewear.
  • Install fixed firescreens or heater guards around open or glass-fronted fires and heaters.
  • Keep lighters, matches and open flames (e.g. candles, decorative alcohol-fuelled devices, ethanol burners) out of reach.
  • Always supervise children when camping. Keep your child away from campfires and coals and make sure they always wear shoes outside. Campfire coals can often still be hot from the day before – always use water (not sand) to extinguish them.
  • Treadmill – keep children away from treadmills while in use, remove the key and unplug from the wall when not in use. 

Complications of burns and scalds

Large or deep burns and scalds can become infected. This can lead to infection of the blood (sepsis).

Serious burns cause a loss of fluid from the body. They can also lead to dangerously low body temperature.

After a serious burn or scald heals, there may be scarring. This can also cause problems with skin bones and joints.

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