Parenting • Oct 12, 2011

Burns: Prevention and Treatment

As a hospitalist physician at St. Louis Children’s Hospital, I often work in the PAWS unit, which is our burn center. We provide sedation and pain management for the children who are undergoing burn care, so we see many bad burns. Almost all of the burns we see are preventable. We commonly see burns caused by hot liquids such as soup, ramen noodles, grease, or hot water. Campfire and firework injuries are also common. During the summer, we often see children with severe sunburns.

 Burn Prevention

  1. Some of the worst burns we encounter are caused when children pull hot liquids off of the stove, counter or table. When cooking, place pots and pans on the back burners and turn handles so they cannot be reached by children. Leave cups or mugs of hot liquid (coffee, tea, etc.) out of reach. Avoid placing hot items on tableclothes, as young children might use the tablecloth to pull themselves up.
  2. Turn down the temperature on your water heater to 125 degrees. Young children may be burned by contact with hot water in the bathtub or when washing their hands.
  3. Use sunscreen. The best sunscreens for children have an SPF of 15 or above, protect broad spectrum UVA and UVB protection, are water-resistant, and easy to apply. And sunscreen should be reapplied at least every 2 hours.
  4. DO NOT heat infant bottles in the microwave.
  5. Educate children about the dangers of fireworks and campfires. Campfire ashes can remain hot for hours after the fire is out.
  6. Install grounded electrical sockets.
  7. Make sure to change the batteries in your smoke detectors twice a year. It is easy to remember doing it when you change your clock in the spring and fall.
  8. Keep a dry chemical fire extinguisher available in the home. Teach family members how to use it.

Burn Severity

  1. First Degree Burn – The skin may be red or pink but does not blister.
  2. Second Degree Burn (Partial thickness) – Burns that blister are considered 2nd degree, including sunburns.
  3. Third Degree Burn (Full thickness) – Severe burns in which the skin appears white or tan and yellow drainage. These burns usually require special care and skin grafting.

Burn Treatment

First, remove the heat source by removing any wet or smoldering clothing, and cool the skin by rinsing in cool, clean water.

Minor burns:  First degree burns usually heal without any further care. Small second degree burns should be dressed with antibiotic ointment and sterile bandages. Blistered burns should be examined by a physician. Control pain with over the counter pain medicines such as acetaminophen or ibuprofen.

Serious Burns: Larger second degree and all third degree burns, particularly those covering joints, will require medical care. Blistered skin is usually removed and the burns are dressed daily with antibiotic ointment and/or specialized burn dressings. Serious burns that cover joints often require physical therapy. These burns may take weeks to heal and might require skin grafting.

For all burns, monitor closely for signs of infection. And burn injuries are susceptible to tetanus, so make sure your child has an up to date tetanus immunization (every 5-10 years).

If you have any questions about burns, please call our pediatric answer line at 314.454.KIDS.