Parenting • Feb 24, 2014

Why I Built a House Without a Fireplace—stories from a pediatric burn expert

Full disclosure: my kids have been burned before.  Under my watchful pediatrician eyes, they accidentally touched a hot tray of cookies out of the oven, or placed their hand over steam from a hot pot.  I know how fast it can happen, with the most attentive caregiver.  I am a pediatrician who specializes in sedation, and I spend most of my working days sedating children for burn care.  Burns are some of the most painful and most common pediatric injuries.   With a few easy tricks, you can prevent most burns.  I’m going to break this down by burn type and age group.

Scald Burns – Little kids get scald burns from spilled hot drinks; big kids get scald burns from Kids-Burnscooking hot liquids in the microwave.  The most common scald injury I see in pre-teens and teens is from Ramen noodles.  Basically these are kids preparing food in the microwave unsupervised, not realizing how hot the bowl can get, and spilling the hot liquid on themselves. Always keep hot liquids and food away from small children and out of their reach.  Turn pot handles toward the back of the stove when cooking. Be especially careful at parties where distractions occur.  Keep in mind if the burn is from food or oil, the burn can be very deep and may not show the damage to the skin for up to 72 hours after the burn occurred.  Keep a watchful eye on the injured skin and visit your doctor when necessary.  Also turn down your water heater to 120 or less and do not let children bathe unsupervised.

Contact Burns – The most common contact burns in young children are from irons and hair straighteners.  Other common causes are oven doors, household heaters, and barbeque grills.  The most common contact burn over the age of 5 is fireworks.    Leave the fireworks to the professionals.  Fireworks are unpredictable and should never be given to children to play with.  And watch those hot playground slides on a sunny day in the summer!

Flame Burns – Is your teen old enough to use a lighter and fuel safely?  Probably not.  The most common flame burns are from teenagers playing with lighters and fuel.  Educate teenagers about the dangers of lighting fires.  Do not leave lighters or candles lit and in the reach of children.

Friction BurnsNever let children play around exercise equipment, specifically treadmills.  Educate tweens and teens about the proper use of treadmills.

Radiation Burns (aka Sunburns) –Every year kids are hospitalized for sunburn.  I recommend a water resistant sunblock with an SPF 50 with UVA and UVB protection applied at least 30 minutes before sun exposure.  Clothes/items can be worn to block the sun’s harmful rays, like UV protectant swim shirts, hats, and sunglasses.  Avoid prolonged sun exposure during the peak times from 10a-4pm, seek shade often, and don’t forget you can get a burn on shady days. Remember to coat those precious eyelids, scalp, lips, ears, and hands/feet with SPF.  Apply sunblock every 2 hours while in the outdoors and/or swimming.  Educate teenagers about the need for SPF and to choose a spray tan instead of a tanning bed (they will thank you when they are 40!).  My favorites are Coppertone Water Babies SPF 55 stick for the face/hair and Bullfrog SPF 50 spray for kids for the body.  Everything I use on my kids I use on myself (important to model good sun protection behavior). Also remember pink skin=burned skin so move indoors when pinkish… can take up to 12 hours to see the full effect of a sunburn so it may look worse later that evening or in the morning.

Chemical Burns – Detergent “pods” for dishwashers and laundry look like candy but can kill.  I found my 2 year old just in time before he sank his teeth into one of those pillowy pods!   The detergent inside can cause a chemical burn to the skin and/or digestive tract.

Electrical Burns – These are usually from touching an electric cable.  Keep all cords away from small children and repair any cords which may be exposed.  There are not many things that will fit in an outlet but a curious child will find a way.  Keep your bobby pins, paper clips, etc. away from young children and use child proof outlet covers.

So, you have listened to all of my advice and 3 minutes later your 2 year old pulls over your cup of coffee on himself.  Let me tell you what to do when your child sustains a burn (no judgment):

  • First degree burns will cause pain, redness and some swelling.  For these burns, run cool water over or apply a cool, damp cloth to the burn for 5 minutes.  Then cover the burn with a clean dressing and check the area daily until healed.  These will usually heal within a few days.  Acetaminophen and Ibuprofen may be helpful for the pain.
  • Second degree burns are first degree burns plus blistering.  Cool the area of burn with water as above, being careful to not disrupt any blisters.  Seek medical care to evaluate the damage to the skin within the first 24 hours.
  • Third degree burns will look like second degree and may be numb or look whitish or blackened.  Cover these burns with a dry dressing and always seek immediate medical care for these burns.  Do not remove any material that is stuck to the skin.

Lastly, change smoke detectors in your home regularly, make sure you have a fire extinguisher, and practice fire escape routes in your home as a family.

If you have a child with a burn and would like more help, or if you’d like information from our Safety Stop experts on child-proofing your home, call 314-454-KIDS.  The Pediatric Ambulatory Wound Service (PAWS) at St. Louis Children’s Hospital specializes in providing burn and other wound care, with excellent pediatric sedation and pain control.  


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