Burns are one of the most common accidents that can befall a child, so it is vital that the people in your setting not only know how to prevent them in the first place, but understand how to treat them with first aid if they do occur. Burns and scalds are slightly different but they both result in damage to the skin usually caused by heat. A burn is caused by dry heat, such as an iron, fire of touching something hot such as a kettle or curling irons. A scald is caused by something wet such as hot water, steam or hot tea/coffee. Both can be very painful and result in blistering or peeling of the skin, swelling and white or charred skin which can leave permanent scars.

Many young children do not know that touching hot things can hurt them, so it is imperative that you teach them to stay away from potentially dangerous things, such as kettles, cups and fires.

Both burns and scalds are treated in the same way and you should ensure that all your staff know how to treat them with first aid.

First aid for burns and scalds

  • Make sure the person is away from the heat source and is at no further risk. Ensure that no one else is at risk either.
  • Cool the burn with cool or lukewarm running water for 20 minutes. Do not user ice, iced water or any creams or greasy substances like butter or honey. These can cause further damage when trying to remove them later.
  • Remove any clothing or jewellery that is near the burnt area of skin, including nappies but DO NOT remove anything that is stuck to the skin as this can cause further damage or bleeding.
  • Keep the person warm using a blanket or coats, to help avoid the person going into shock, but be very careful not to catch or rub the burnt area.
  • Cover the burn using cling film or a clean plastic bag to help prevent infection. Be gentle when applying this. The cling film will not stick to the burn.
  • If allowed, painkillers such as paracetamol or ibuprofen may be administered to alleviate pain, but this will depend on your setting’s permissions on administering medicines and you should always check with parents regarding this if in doubt.

Acid or chemical burns

Some burns can be caused by corrosive chemicals such as acids. If this is the case, you should dial 999, carefully and safely remove any residue of the chemical and contaminated clothing and rinse the infected area with as much water as possible.

Burns to the face and/or eyes

If the infected area is in the eyes or on the face, try to sit the person up rather than lying them down as this helps to reduce swelling due to the upright position.

When to seek medical attention

With most minor burns, it is often possible to treat these at home or in the setting provided that the burn is not serious and the correct first aid (as above) has been applied in time. You should:

Always keep the burn clean

Never burst any blisters that form on the skin

Seek professional medical attention in the burn gets worse or the person suffers any side effects and ALWAYS SEEK MEDICAL ADVICE FOR CHILDREN AND BABIES after applying first aid

Always go to A&E for:

  • chemical and electrical burns of any kind
  • large or deep burns – which means something larger than the injured person’s hand
  • burns that cause white or charred skin of any size
  • burns that cause blisters on the face, hands, arms, feet, legs or genitals
  • where a person has inhaled smoke or fumes
  • people at greater risk from the effects of burns and this includes children under 5 and pregnant women

Remember to call 999 if burns are severe or if the person goes into shock. Shock is a life-threatening condition which occurs as the body begins to shut down various organs to preserve life, resulting insufficient oxygen supply to certain parts of the body.

Categorising burns

Burns are assessed and categorised by how seriously the skin is damaged and which of the 3 layers of skin are affected: the outer epidermis layer; the dermis which is just beneath the epidermis and contains nerve endings, sweat glands, hair follicles and blood capillaries; or the deep subcutaneous fat layer, the subcutis.

Depending on the extent of the damage, the burn will result in different symptoms and be classified as a:

  • Superficial epidermal burn
  • Deep dermal or partial thickness burn
  • Superficial dermal burn
  • Full thickness burn

Prevention is always better than cure

Last month we celebrated Child Safety Week and there are many charities and associations which can help give advice on how to reduce your risk of burns and scalds just by being more aware of the dangers and keeping little people out of harms way.

Remember to:

  • Keep children out of areas where there are hot things are, e.g. kitchens – use safety gates
  • Keep hot handles turned inwards and away from surface edges and use short or curly leads on kettles so children cannot reach up and pull them
  • Use the back rings on a cooker if possible
  • Keep hot drinks away from children – better to use a cup with a lid to minimise any spills in case of accidents
  • Always test the bath water using your elbow and never leave children alone even for a moment
  • Fit thermostatic valves to control water temperature
  • Fit fireguards to all fires/heaters
  • Do not pick up children whilst carrying a hot drink
  • Do not allow children to drink hot drinks through a straw
  • Test the heat of food and bottles before offering them to a child
  • Keep all matches, lighters, and lit candles out of sight and out of the reach of children – in locked cupboards

For further advice:

See the NHS website on burns and scalds

Contact the Red Cross

Call NHS 111

Go to a walk-in or minor injuries unit

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