Burn Information for Families What you need to know

Burn
Information
for Families
What you need to know
Contents
Healthy skin
1
What is a burn?
1
How hot is too hot?
2
This booklet has been designed to
Burn classification
2
provide parents and children with a
The places you’ll go and people you’ll meet 3
basic understanding of a burn injury,
Specific treatments for burns
5
common treatments depending on
Pain control 6
severity and the hospitalization
Nutrition: Eating for healing
6
process when required. The staff at
Going home
8
Kosair Children’s Hospital works as
Preventing future burns
10
a team to provide your child with
Minor burn care
11
specialized care and expertise in the
Major burn care
11
event of a burn injury. The doctors,
Burn support and resources
12
nurses, therapists and other caregivers
Notes
13
you will meet during your visit work
together to get your child well as
quickly as possible while including you
in your child’s care every step of the
way. We hope the information in this
booklet will help you understand the
steps and services needed to ensure
your child heals and knows how to
avoid burns in the future. Every burn is
different, so if you have questions that
are not covered in this booklet, please
feel free to ask us.
1
Healthy skin
Believe it or not, skin is considered an organ. It is the largest
organ in the body, making up 15 percent of your total body
weight. The skin has numerous functions: It protects you from
injury and infection, prevents the loss of body fluids, helps
regulate your body’s temperature and provides sensory contact
with the environment. Children, being smaller than adults,
have a larger body surface area per pound of weight and
their skin is much thinner than adults, which can lead to
deeper injuries. The diagram below shows what normal skin
looks like.
The skin is made up of three layers, and each layer has a
specific function. The outermost layer is the epidermis, which
is very thin. It contains the pigment that gives your skin color.
The middle layer is the dermis, which contains the blood
vessels, lymph vessels, hair follicles, sweat glands, collagen
and nerves. This layer has pain and touch receptors. The
innermost and deepest layer of the skin is the subcutaneous
layer. It contains the collagen and fat cells that maintain
temperature and are the shock absorbers to prevent injury.
Burn facts
• Burns are one of the leading causes of accidental injury.
• Most burn injuries are scald burns.
• Approximately 116,600 children are treated for fire or
burn injuries each year in the United States.
• The majority of burns are preventable.
• Burns are one of the most expensive catastrophic injuries
to treat.
Types of burns
Burns occur when energy or heat is transferred from an object
to the body. There are many types of burns with different
levels of severity. Types of burns include thermal burns,
radiation burns, chemical burns and electrical burns.
Thermal burns
Thermal burns are from an external heat source, like a stove.
The heat source raises the temperature of the skin and tissue,
which causes the tissue cells to die. Sometimes the tissue is
charred. Examples of thermal burns include hot metal (curling
irons, oven doors, lids and pots), scalding liquids (boiling
water, soup, ramen noodles, coffee, tea), steam (from boiling
liquids, steam irons, steamers) and flames (candles, fires,
matches, lighters).
Radiation burns
These types of burns are caused by prolonged exposure to the
ultraviolet (UV) rays of the sun or other sources of radiation
(such as X-rays). This type of burn includes sunburn.
Sunburn is painful redness or blistering of the skin caused
by overexposure to the UV rays of the sun or a sunlamp.
Symptoms usually do not begin until 2 to 4 hours after the
damage has been done. Pain is controlled by ibuprofen for
48 hours. Aloe gel may be used for comfort and moisture.
Almost all people have experienced sunburn at some point
in their life.
Chemical burns
Chemical burns are caused by strong acids, detergents or
solvents that come into contact with the skin, eyes or throat.
Examples include toilet bowl cleaner, drain cleaners, car
battery acid and bleach.
What is a burn?
A burn is damage to your body’s skin and sometimes deeper
tissues caused by heat, chemicals, electricity, sunlight or
radiation. Most burn accidents occur in the home. Thermal
burns, especially scald burns, are the most common cause of
burns in children.
Electrical burns
Electrical burns result from contact with an electrical current
or lightning. After an electrical burn occurs, make sure contact
to the source of electricity is broken and the electrical source
is turned off. This type of burn may cause damage to the
heart because of the electrical changes it induces on the heart.
Always call 911 if this type of burn occurs.
2
How hot is too hot?
Burn classification
Most cooking activities
Burns are classified as superficial, partial thickness or full
thickness. The level of classification depends on how deeply
and severely the burn penetrates the skin and damages
underlying tissue.
Deep frying
500 degrees
Superficial burns
Baking
400 degrees
A superficial burn affects
only the epidermis, or the
outer layer of skin.
Frying
300 degrees
Crock pot
200 degrees
Boiling water
170 degrees
Scald burns
Appearance: It appears as
a red, painful and dry area
without blisters.
Common causes: Mild
sunburn or a “flash burn”
(sudden, brief burst of
heat).
Average healing time:
Usually heals within one
week. Tissue damage is minimal or rare, but it may cause
discoloration of the skin.
Common treatment: Ointments or lotions, such as Aquaphor
or cocoa butter, and acetaminophen. This type of burn usually
is not bandaged.
Partial-thickness burns
This type of burn is deeper, penetrating the epidermis and
affecting the second layer of skin, or dermis.
Appearance: It appears as red with blisters and may be
swollen and painful. Under the blisters, the burn is red and
moist. The skin appears beefy red at first and within a few
days turns white and pale as an eschar, or scab, develops.
Common causes: Hot
liquid (scald), flame or
contact with hot surface.
Average healing
time: Within 3 weeks
usually without much
scarring, but may cause a
permanent change in skin
color.
Common treatment: This
type of burn is usually
bandaged. Treatments
include Silvadene cream
(silver sulfadiazine),
antibiotic ointment and
dressing changes twice
daily.
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Full-thickness burns
“Just for Kids” Critical Care Center
This type of burn damages every layer of skin, including hair
follicles and nerves. Due to the deepness of damage, there may
not be any pain associated with this type of burn.
This is a special unit that cares for children who are very sick
or have very serious injuries. With a burn injury, your child
may be placed here so he/she can be closely monitored or
because he/she may require artificial ventilation. Each nurse in
this unit cares for only one or two patients at a time and can
provide close monitoring.
Appearance: Usually does
not have blisters and may
appear ivory or pearly
white and very dry and
leathery.
Common causes:
Scalding liquids, skin in
contact with a hot object
for an extended period of
time, flames from a fire
or from an electrical or
chemical source.
Average healing time:
Requires more than 3
weeks to heal, and most have scarring associated. This burn
may also need skin grafting to cover it.
Common treatment: Early cleaning and debriding (removing
the dead skin). Debridement may be done in the operating
room, in the tub or in the hospital room with sedation.
Patients may have an IV inserted to give fluids, nutrition
and antibiotics. Twice daily dressing changes are done with
Silvadene (silver sulfadiazine) or similar ointment. The wound
will be examined daily to monitor healing and growth of new
skin. A high-protein diet is given to promote healing. Patients
are given medicine for pain and monitored closely for pain
control. Physical and occupational therapy is usually necessary
to maintain function and motion in the area affected by the
burn. The burn may need grafting, or replacing dead skin with
skin taken from another area of the body.
4 West Burn Unit
The Burn Unit at Kosair Children’s Hospital is Kentucky’s
first and only burn unit exclusively for children. We care for
major and minor burn injuries, electrical injuries and patients
undergoing reconstructive plastic surgery after a burn.
The Burn Unit is close to the “Just for Kids” Critical Care
Center. This unit of the hospital has a large tub and other
equipment specifically designed to assist your child in the
event of a burn injury.
Specialty doctors
In addition to a primary attending physician, a specialty
doctor may be asked to see your child to evaluate the
treatment plan or assist because of where the burn injury is
located. These types of doctors include plastic surgeons or
hand doctors, and their expertise may be needed to obtain the
best cosmetic result after healing.
The places you’ll go and
people you’ll meet
In the event of a major burn, there are two areas of
Kosair Children’s Hospital your child may go: the
“Just for Kids” Critical Care Center or the Burn Unit
on 4 West. Both areas are fully equipped to manage
your child’s injury and have specially trained
nurses and physical therapists who will care for
your child as well as help you understand and
cope with what has happened. You will meet
many doctors, nurses and therapists who will
work as a team to help your child heal.
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Therapy
Pharmacy
A burn injury may have emotional effects in addition to
physical effects. Psychological evaluation and treatment
may be necessary to help your child deal with the stress and
anxiety associated with a burn. This team will help determine
if your child will need additional therapy once he/she goes
home. In addition, the team will work with you and your
child to teach you wound care techniques and exercises to
continue once you return home.
The Trauma/Burn Team has a pharmacist on staff who will
monitor your child’s medication needs while in the hospital.
The pharmacist will make sure your child’s pain is controlled,
anxiety is managed and side effects are minimized. We
do our best to ensure your child is comfortable and not
overmedicated. If you have questions, let your nurse know
you’d like to speak with the pharmacist regarding your child’s
medications and care.
Physical therapists
Physical therapists assist your child with activities that
encourage movement and stretching. After a burn your child
may need assistance to keep the injured part of the body
flexible and moving freely. The physical therapists will report
daily on how your child is doing with therapy.
Home health services
Occupational therapists
Occupational therapists assist your child in activities of daily
living, such as dressing, writing and eating. Through activities
and exercises, occupational therapists will work to restore or
improve these functions. They will teach exercises for home so
that you can help your child too. Occupational therapists will
report daily on how your child is doing with therapy.
Child life services
Child life therapists will visit your child to assist with play
time, provide distraction activities to assist with dressing
changes and help your child manage stress or anxiety. Because
burn injuries are very difficult on children, child life therapists
are available to help your child cope with the injury.
Pastoral care
At any point during your child’s hospital stay you may meet
a chaplain. It could be upon admission, during your stay
or even at discharge. You may also request to meet with a
chaplain at any time. They are available for support, prayers
and other spiritual needs while at the hospital.
Nutritionist
Your child will be evaluated by a nutritionist to help develop a
high-protein diet that aids in the burn injury healing process.
The nutritionist is a specially
trained individual who will
monitor your child’s eating
habits from admission to
discharge. The nutritionist
will track weight, all food
and drinks your child
consumes and will advise
on changes needed. The
nutritionist also will give
you a plan for eating at
home. If you have questions
about your child’s nutrition,
ask your nurse to contact
the nutritionist to come by
for a visit with you.
Home health services are contacted as needed should you
need help caring for your child at home. Home health services
usually include nursing care, physical therapy, medical
supplies, education and monitoring while you are adjusting
to home care. The specific service depends on insurance and
where you live. There are times when there is not a service
available in your area and you may need services provided at
your local hospital.
Social services
Social services consist of hospital social workers who are
available from admission to discharge to provide assistance
when challenges arise. Areas that they can assist with are
school absence, housing, work leave papers for parents and
help with obtaining medication if unable to afford. They will
visit you while your child is in the hospital, explain their role
and how they can assist you during your child’s hospital stay.
Hearts and Hands
Palliative Care Team
Depending on how severely
your child was burned, the
Hearts and Hands Palliative
Care Team may offer help to
you and your family. Pediatric
palliative care is medical care
that focuses on treating the
pain, symptoms and stress of
children and families facing
complex medical conditions. Their services include assistance
with symptom control; decision making among the patient,
family members and medical team; transition support; grief
and bereavement support; and education about palliative care
principles.
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Specific treatments for burns
Silvadene
Silvadene (silver sulfadiazine) is a
1 percent silver-based cream that
has antimicrobial properties. It
is an ointment applied in a thin
layer on the burned skin. It is
then covered and wrapped with
gauze. This type of treatment
is usually done twice a day until the skin heals. Your child
will get medication before Silvadene treatment, as it can be
uncomfortable, especially when the burn is new. Sometimes
this makes it difficult for parents to endure as well. To change
the dressings, the gauze is removed and the burn is cleaned
with water to remove dead skin and the Silvadene. As your
child heals, these treatments will become easier. Bacitracin
Bacitracin is a topical antibiotic ointment used primarily on
the face, because the skin on the face is very tender. Bacitracin
is applied after washing the face, usually two to three times
a day. It also may be used after the burn has healed but still
needs to be kept moist.
Acticoat
Acticoat is a silver-based dressing that
is placed over the burn, allowing the
wound to heal much like Silvadene
does. The difference is that this type of
dressing may stay on for up to seven
days. Acticoat dressings can be less
painful than Silvadene dressing changes.
Biobrane
Biobrane is another type of dressing that covers the wound so
it can heal. It is usually put on in the operating room after the
burn has been debrided and cleaned. It also may be used to
cover a skin graft donor site to protect it and allow it to heal.
Biobrane is usually stapled in place to protect the burn or graft
site. The staples are removed later.
Cadaver skin
This is human tissue removed from a cadaver, treated and
cleaned. It is then available for use in skin grafts to replace
skin that is lost. It is the most common material used in
skin grafts of burn patients who may not have enough skin
available for a graft. As the burn heals and makes its own new
skin, the cadaver skin eventually falls off.
Donor site
This is an area of the body that the physician chooses to take
skin from for grafting. The area usually is the upper thigh or
buttocks. The patient is taken to the operating room to remove
the donor skin. A clear dressing is applied over the donor site
to protect it. Usually this area heals very quickly as new skin
grows to cover the donor site.
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Pain control
Burn injuries can be very painful. We understand this
and begin giving pain medication as soon as your child is
admitted in the hospital. Your child has probably never had
to experience anything like this before. You will need to help
your child cope with the pain. Pain feels different to every
child, and every child responds differently to it and to pain
medication. Pain is always there, we just use medications to
lessen it and make it manageable. We have a lot of experience
in pain management, and we will do everything to help your
child remain comfortable.
Many parents worry that their child could become addicted
to pain medication. Your child will be given small amounts of
medication, just enough to control pain, and will not be taking
it for a long enough period to become addicted. If you have
questions or concerns about pain medicines, please ask your
child’s nurse or doctor.
IV pain medications
Morphine sulfate and fentanyl are given through an IV for
severe burns to help control pain during a dressing change.
They are used at the beginning of the hospitalization and
weaned throughout the child’s hospital stay until the child is
able to tolerate dressing changes on oral medications. All pain
medications cause drowsiness, nausea and/or vomiting.
Oral pain medications
Hydrocodone
Hydrocodone and acetaminophen (Lortab) is an oral
medication that is started when your child is eating normal
food and ready to be transitioned to oral medication. This
long-acting drug controls pain for about 3 to 4 hours. It needs
to be given with something in the stomach to prevent nausea.
This medication takes longer to work after it is given because
it needs to be digested by the stomach first. It comes in pill
and liquid forms.
Acetaminophen
Acetaminophen (Tylenol) is used for burn pain. It relieves
most mild pain without difficulty. It often works in
conjunction with other medications to help them be more
effective. It also may be given if your child has a fever.
Diphenhydramine or hydroxine
Itching is something that your child may complain of after
being burned. Sometimes it happens right away and other
times it may be months into healing. It can range from minor
irritation to something that interferes with daily activities.
There is no cure for the itching, but some medications can
help lessen it, like diphenhydramine (Benadryl) or hydroxine
(Atarax). Both of these medications make it easier to tolerate
but both also cause drowsiness. The best way to lessen itch is
with creams applied directly to the skin. Cold compresses also
may help.
Nutrition: Eating for healing
When a burn occurs, the body uses more calories to heal and
fight infection. Your child will need additional calories, protein
and vitamins to help strengthen the body and speed recovery.
Your child will be put on a diet of two to three times more
calories and protein than normal. Good nutrition lays the
foundation for your child to go home sooner.
Protein
Protein plays a major role in rebuilding muscle and skin
tissues. Protein is needed to produce extra energy for healing.
If the body doesn’t get enough protein, it will begin breaking
down muscle to produce energy. The best sources of protein
are lean meat, seafood, beans and dairy foods. Your child will
need one to two extra servings per day for healing.
Carbohydrates
Carbohydrates provide the majority of calories, or energy, the
body uses. Calories are turned into glucose, which will be a
source of energy for healing your child’s burns. Your child
will need to consume two to three times more calories than
normal.
Fat
Fat provides essential amino acids. However, adding too much
fat can actually weaken the immune system. Fat is found in
most fast food, chips and junk food. Your child will be given
the appropriate amount of fat while in the hospital. After your
child goes home, he/she needs to follow a balanced diet.
Vitamins
Your child will be given additional vitamins to assist the body
with healing. Vitamins reduce the damage burns cause and
work to promote wound healing. The most beneficial vitamins
for wound healing include a multivitamin, vitamin C, zinc and
vitamin E.
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During this time it may be difficult to get your child to
eat. This is a normal response to a burn. We will pay close
attention to what your child is eating to monitor his/her
needs. This may be done with a calorie count by writing down
everything the child eats or drinks during the day. The calorie
count will then be reviewed by a dietitian and adjustments
may be made. Your child may require supplemental food to
increase calories.
Ways to encourage your child to eat
and drink
1. Offer small amounts of healthy foods frequently
throughout the day, every 2 to 3 hours. Aim for five to six
small meals or snacks each day.
2. Encourage foods you feel your child can manage.
3. Offer familiar foods your child likes, but avoid less
nutritious foods like candy, burgers, fries and chips.
Best drinks for your child
• The best drinks to offer are those high in calories and
protein, like milk.
• If your child is younger than 1 year old, formula or breast
milk is best.
• For children older than 1 year offer:
¶¶ Milk drinks
4. Favorite foods and home-cooked meals can be supplied
from home.
5. Drinks, such as milk, are important when your child is
not eating much. Offer milk drinks regularly throughout
the day and at meal times and snack times.
–– Plain or flavored milk
6. Stay positive when offering food and drinks.
–– Whole milk
–– High-energy milk
7. Offer praise when your child eats or drinks, no matter
how small.
–– Milkshakes
8. Avoid battles and fights over food.
–– Soy milk
9. It is normal for your child not to eat much at this time.
¶¶ Fruit juices
¶¶ High-energy drinks (Gatorade or Powerade)
Best foods for your child
The best foods to offer are full of energy, protein and nutrients.
These include:
Dairy products
milk, yogurt, custard, ice cream, cheese
and soy products
red lean meats, chicken, fish, eggs,
Meats/proteins baked beans, lentils, chick peas,
hummus
Fruits
all types of fresh, canned or dried fruit
Vegetables
all types, potatoes, pumpkin, carrots,
broccoli and peas
Grains
all types of breads, cereals, rice and
pasta
Reasons why your child may not be able to
eat enough
1. The shock and trauma of the burn
2. Drowsiness from the drugs, pain and fear related to
dressing changes
3. Fasting periods awaiting surgical procedures
4. Stress of being in the hospital; unfamiliar surroundings,
people and food
If your child is not eating or drinking
enough, he/she may require a nasogastric
tube, which is inserted through the nose
into the stomach to provide supplemental
nutrition. A nasogastric tube (or
NG tube) does not interfere
with normal eating.
When the child begins
to eat enough, the tube
can be easily removed.
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Suggestions to make the transition home easier:
• Set up a daily routine that includes some of the things you
did with your child before the injury.
• Take one day at a time. Make simple goals each day and
celebrate when they are reached.
• Take care of yourself as the caregiver of your child. You
are an important part of your child fully recovering.
• The way your child comes through this situation will
largely be determined by the way in which you handle it.
In other words, your child will become stronger based on
your strength.
• Understand your child’s level of development and make
allowances based on it.
• Expect regression, anger and impatience as your child
adjusts to recovery.
• Talk with your child often. Be truthful in response to
questions. Tell your child how you feel about what has
happened. If your child is having trouble coping, sleeping
or is having nightmares, contact you pediatrician for help
and a referral.
Going home
When your child suffers a burn, it creates a major change
in your normal life. You will need to learn how to care for
your child while he/she is healing. We will teach you how
and when to change dressings. It is important that you learn
how to do this on your own. We understand this can be
difficult because you don’t want to cause your child any pain.
Sometimes you may get emotional and have difficulty staying
focused and in charge. The nursing staff understands what you
are feeling but will push you to do what needs to be done for
your child’s health. If you just cannot change the dressings,
you will need to find someone who can be available twice a
day to do it for you.
Prior to discharge, you will learn how to care for your child
at home. You will need to make sure your home is ready for
your child’s return. You should have a plan for managing
the dressing changes, a place to keep your supplies, a safe
place for the medications and activities to keep your child
entertained. The most important thing to remember is to keep
the burn clean so it does not become infected.
• Be sure to inform your child’s school and teacher. This
way they can inform you of any behavior problems,
homework issues or other problems occurring during the
school day. Your child may need to be seen by the school
counselor.
Signs your child may not be adjusting:
• Agitated behavior (thumb sucking, increased crying,
screaming)
• Increased or decreased eating, sleeping, urinating or
having bowel movements
• Separation anxiety, clinging behavior, refusing to sleep
alone or wanting to be held all the time
• Withdrawing from social situations
• Decreased self-confidence
• Insulting him-/herself
• Verbal or physical aggressiveness
• Repeated episodes of sadness
Adjusting to home
• Re-enacting traumatic events while playing
Returning home after a burn requires a period of adjustment
for you, your child and other family members. It is normal
for you and your child to experience a variety of feelings and
emotions. These include feeling scared, nervous or uneasy
leaving the hospital and the staff that has helped you.
• Difficulty concentrating
Remember, if you have questions or need assistance feel free
to call the hospital and ask to speak to someone. The phone
number is (502) 629-6000.
• Resentment and complaints of unfairness or blaming in
situations
• Behavior changes
• Complaints of physical ailments
• Increased dependence
• Difficulty with friends
• Unrealistic expectations of self and others
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• Concern with body image
Preventing contractures
• Frustration leading to rebellion
Contractures occur when the burn scar matures, thickens and
tightens, causing a drawing up of the tissue. This interferes
with movement and is a serious complication of a burn.
Contractures can be prevented by making sure your child is
moving and doing things independently. It is important to
encourage your child to perform daily activities, like dressing
and brushing his/her teeth, as much as possible. Even if it is
difficult and takes a long time to do them, allow your child to
keep trying to do them. Avoid the temptation to help or take
over. Celebrate when your child is able to complete an activity.
• Avoidance and denial to avoid addressing issues that arise
• Reluctance to trust or open self to others
• Feelings of hopelessness and meaningless of life
• Depression
• Low impulse control with easy frustration
• Drug and alcohol abuse
Any unusual or persistent behavior listed above should be
evaluated by a qualified mental health professional. For
assistance, contact the Bingham Child Guidance Center at
(502) 852-6941.
Wound care at home
After leaving the hospital, you will continue the same dressing
changes and burn care until you see the doctor during a
follow-up appointment. A burn needs close follow-up starting
with weekly visits to the doctor. As the burns heal, the time
between visits will become longer. The number of times
dressings need to be changed also will decrease as the burn
heals. Any dressing changes, further surgeries or therapies will
be guided by your doctor. The follow-up appointment number
is (502) 583-7337.
Preventing scars
Scars are thickened areas of tissue left after the burn has
healed. Most partial-thickness or full-thickness burns have
some scarring associated with healing. To prevent and reduce
scar formation your child may need to wear a pressure (Jobst)
garment. This is a tight-fitting garment worn over the burn
area to help reduce or prevent scarring. Your child is measured
by a physical therapist once the burn has healed completely.
Once the garments are made, you will be contacted to come to
the hospital for a fitting. At this visit you will learn how to put
on the garment and will be given a spare garment to be worn
when laundering the other one. These garments must be hand
washed, toweled dried and then hung up to dry completely.
It is very important that your child wears the garment 23
hours a day. It is only to be taken off for bathing. Your child’s
doctor will advise you on how long the garment must be worn
based on how the wound is healing.
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Another way to prevent contractures is for your child to wear
a splint that holds the limb in flexion or a stretched position.
A splint should be worn on top of the pressure garment.
Range of motion exercises also help prevent contractures.
These exercises keep the muscles and joints flexible. A
physical therapist will teach you and your child specific
exercises prior to you leaving the hospital so that you can
continue them at home. These special exercises help keep the
scar area stretched. It’s important to do the exercises even if
your child does not like to do them or does not want to do
them. They will help prevent problems in the future.
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Preventing future burns
Families who experience a burn injury are affected physically,
emotionally and economically. The pain, disruption in routine
and separation affect every family member’s life. Such an
injury doesn’t go away; it can last a lifetime.
Consider these facts:
• Every day across the U.S., hundreds of children are taken
to emergency rooms with scald burns caused by contact
with hot liquids, steam or foods.
• Approximately 65 percent of children under age 4
hospitalized for burn injuries were scalded by hot liquids.
• Ninety-five percent of scald burns occur in homes.
• Fire kills more than 600 children ages 14 and under each
year, and injures about 3,000 more.
• Nearly 50 percent of children injured in fires or
fire-related incidents are under age 5.
• More than 60 percent of residential fires that cause the
death of a child occur in homes without smoke detectors.
Cooking safety tips
• Young children are at high risk for being burned by hot
food and liquids. Keep children away from cooking areas
by enforcing a “child-free zone” of 3 feet around the stove
and microwave.
• When young children are present, use the stove’s back
burners whenever possible.
• Never hold a child while cooking, drinking or carrying
hot foods or liquids.
Tips for keeping your home safe
• Keep young children at least 3 feet away from any place
where hot food or drink is being prepared or carried, such
as around the microwave.
Heating safety tips
• Never use your oven to heat your home.
• Keep hot foods and liquids away from the edges of tables
and counters.
• Never allow children to play near a fireplace,
wood-burning stove, space heater or other heating
source. Establish a 3-foot safety zone around all
heat sources.
• Have your chimney or wood stove inspected and cleaned
annually by a certified chimney specialist, and use a metal
mesh screen when burning a fire in your fireplace.
• Teach children that hot things can burn them, and when
old enough teach them to cook safely. Supervise them
closely.
Bathroom safety tips
• Never leave an infant or child alone in a bathtub or sink.
Take the child out of the water and with you if you need
to leave the room for any reason.
• Follow manufacturer instructions when alternative heat
sources, such as wood stoves and kerosene heaters, are
used. Kerosene heaters may be prohibited by local fire
marshals.
• Check the temperature of a child’s bath water. Use a
bathtub thermometer to help you make sure the water is
no warmer than 100 degrees Fahrenheit. Water that seems
cool enough to you may be too hot for a child.
• Use fire-resistant materials on walls around wood stoves.
Store fuels in proper containers, and keep them out of the
reach of children and away from combustible materials.
• Turn the water on in the sink for your child to brush
his/her teeth or wash hands to help prevent accidental
scalding.
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Be prepared
• Keep your family safe by installing smoke and carbon
monoxide alarms on every level of your home and inside
and outside sleeping areas. In at least 23 percent of all
fatal residential fires, no smoke alarms were present.
• Test smoke alarm batteries every month and change them
at least once a year.
• Make an escape plan with your family and agree on a
common meeting place outside; practice a home fire drill
on a regular basis.
• If there is a fire, call 911 once you are safely outside.
Minor burn care
If a minor burn occurs at home, follow these steps:
• If the skin is unbroken, run cool water over the burn or
soak it in a cool water bath (not ice water). Keep the area
submerged for at least 5 minutes.
• Calm and reassure the person.
• After rinsing or soaking, cover the burn with a dry, sterile
bandage or clean dressing.
• Protect the burn from pressure and friction.
• Families can further reduce their risk of injury or death by
installing residential sprinkler systems.
• Over-the-counter ibuprofen or acetaminophen can help
relieve pain and swelling. Do not give aspirin to children
under age 12.
• Practice safe fire behaviors and know what to do in an
emergency to give your family extra seconds to escape.
• Apply a clean, cold wet towel to reduce pain.
• Turn down the temperature of your water heater or install
a hot water control on your faucets. Set your water heater
to no higher than 120 degrees Fahrenheit.
• Talk to your child’s care provider about practicing safety
during bathing and preparing food.
• Keep children away from radiators, wood stoves and
ovens.
• Keep a fire extinguisher in the kitchen and check it yearly.
• Be careful using candles, space heaters and curling irons.
Teach your children these important safety tips to
prevent scald burns:
• Do not touch handles of pots and pans on the kitchen
stove, countertop or table.
• Once the skin has cooled, moisturizing lotion can aid
in healing.
Minor burns will usually heal without further treatment.
However, if a partial-thickness burn is more than 2 to 3 inches
in diameter or is located on the hands, feet or face or over a
joint, seek medical attention for further treatment. The person
also may need a tetanus booster.
Major burn care
If someone is on fire:
• Have the person stop, drop and roll to put out the flames.
If necessary, wrap the person in a blanket or other thick
material to smother the flames.
• Douse the person with water.
• Do not touch any sink or bathtub faucet.
• Call 911 immediately.
• Tell your parent or baby sitter if bathtub water is too hot
or if food or liquids are too hot.
• Make sure the person is no longer in contact with
smoldering materials.
• Do not play in the kitchen while someone is cooking.
• Do not remove burned clothing that is stuck to the skin.
• Make sure the person is breathing. If the person is not
breathing, open the airway and start rescue breathing.
• Cover the burned area with dry, sterile bandages or a
clean cloth. A sheet will do if the burn is large. Do not
apply any ointments and avoid breaking any blisters.
• Elevate the body part that is burned above the level of the
heart. Continue to monitor heart rate and breathing until
EMS arrives.
K O S A I R C H I L D R E N ’ S H O S P I TA L
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Burn support and resources
Medical care
Kosair Children’s Hospital
231 E. Chestnut St.
Louisville, KY 40202
(502) 629-6000
University Pediatric Surgery Associates PSC
(502) 583-7337
Need a pediatrician?
Call (502) 629-1234 for a free referral.
Behavioral care
Bingham Child Guidance Center
(502) 852-6941
Websites
Kosair Children’s Hospital
KosairChildrens.com
Kosair Children’s Hospital Coping Club
www.copingclub.com
Burn Survivor Resource Center
www. burnsurvivor.com
National Institutes of Health
www.nih.gov
Burn Resource Centre
www.burnresource.com
Phoenix Society for Burn Survivors
www.phoenix-society.org
Prevention 1st
www.prevention1st.org
U N I V E R S I T Y P E D I AT R I C S U R G E R Y A S S O C I AT E S P S C
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Notes
K O S A I R C H I L D R E N ’ S H O S P I TA L
231 E. Chestnut St. • Louisville, KY 40202 • KosairChildrens.com
©Norton Healthcare 3/12 KCH-4944