The basics on burns in children

Posted: November 30, 2022

While nationally there has been a steady decrease in pediatric burns, it's important for parents and guardians to stay vigilant when it comes to burn protection in children. Fire safety education and regulation around flammability of children's clothing and toys are steps in the right direction, but prevention is truly the key to decreasing pediatric burns. Knowing the types of burns and what to do are key for prevention and minimizing scars.

Burn risks are often found right around home

"Scalds from things like coffee spills and boiling water, falling into fire pits and touching the glass on pellet stoves or fireplaces are three of the most common injuries we see in toddlers," said Dr. Brad Morrow plastic surgeon with Marshfield Children's. Toddlers are naturally curious and want to explore, making it important to keep them away from potentially hot and dangerous objects. In adolescents, flame burns are more common. This may be a result of playing with or around fire, falling into fire pits and injuries from fireworks. Cooking without supervision also may cause scald burns. "Stay alert when kids are around potential sources of burns. Keep hot liquids away from the edge of the countertop where a toddler could pull it down. Baby gates in front of fireplaces are a good option to help limit the potential of falling into or touching them. If you're having a campfire with small children, remain vigilant to help ensure the child doesn't accidentally fall into a low-lying pit," Dr. Morrow said. [caption id="attachment_16863" align="alignright" width="450"] Prevention is truly the key to decreasing pediatric burns.[/caption]

First-, second- and third-degree burns differ in appearance and treatment

What you should do when your child has a burn depends on how severe the burn is. Burn severity has three levels. Knowing the difference and how to efficiently care for each is vital.

• First-degree burns look red, but do not blister. They may be painful and are comparable to a bad sunburn.
• Second-degree burns appear red and will likely develop blisters. These blisters may be clear and weepy, or whiter with swelling. The burn likely will be painful.
• Third-degree burns appear white and charred. They also may look dry and have black or brown coloring.

"Seek medical attention for second-degree burns and higher," Dr. Morrow said. The American Burn Association recommends evaluation by a burn provider for these burns and for any burns to the face, hands, feet, genitalia or over any major joints. "Initial burn assessment can be difficult to gauge the full extent. Sometimes burns require 48 hours to show the true effect. Oftentimes, they will look worse 48 hours after the injury," Dr. Morrow said. If you are worried, or not sure of the severity of the burn, contact your pediatrician.

Minor heat-induced or thermal burns can sometimes be treated at home

A heat-induced (thermal) burn is when skin comes in contact with any heat source. This includes hot pans, a fire or hot liquid. "A small, minor burn could be treated at home," Dr. Morrow said. "However, the recommendation would be to be evaluated by a burn professional if there is any blistering. A small, non-blistering burn could be treated by applying Vaseline to the area twice per day." Any large burns or burns to sensitive areas of the body need to be treated by a medical provider immediately.

Seek medical attention for all electrical burns

Electrical burns are serious and cannot be treated at home. Any electrical burn where the skin looks charred or leathery, burned away or has no feeling needs medical attention immediately. "These burns can cause internal damage, including damage to the muscle of the heart," Dr. Morrow said. "Children with electrical burns should be monitored at a certified burn center."

Will the burn cause scarring?

Quick action and care are important in treating burns. If burns don't blister, they typically will heal without scarring. The deeper or more severe the burn, the greater chance it will scar. To help minimize scarring, keep burns covered until they have healed with new skin. "Typically burns that heal within two weeks will not leave any marks. Time is often the best medicine for scar healing," Dr. Morrow said.