I haven’t posted an article for some time due to a burn I sustained on my hand. As is the case with most accidents, it happened when my mind momentarily left me and I instinctively reached out to grab something hot. The problem was compounded when at the moment my mind registered the crazy pain, (again, not thinking) I put my burning finger into my mouth. I then promptly burned my mouth on the still burning object stuck to my hand. While the whole experience probably only took 15 seconds before I managed to generate an intelligent plan and get myself to the kitchen sink with cold water, the damage was done. I had a second degree burn the length of my finger (and a burning mouth). I spent the whole night with my finger on a cold pack and experiencing new-found empathy for my burn patients. So what can you do when your child sustains a burn?

Take immediate action with a burn

Get the burning object away/off the child (e.g., get the burning iron that has fallen on the child off, or grab the curling iron from the child’s hand).
Put the burned body part in cold water (for a small child, this is usually a hand). Inevitably, your child will be screaming. Continue to hold the burned part in the stream of cold water at the sink. Most burns happen at your house and a sink is the quickest way to get the immediate burning to stop.
Assess the damage while staying under running water (i.e., the cold of the water will help with the immediate pain).

Degrees of burn

First degree burns are typically red and limited to the top layer of skin (the epidermis). Don’t be fooled by the name, first degree burns can really hurt.
Second degree burns (partial thickness burns) involve deeper layers of the skin. They are often marked by swelling and blistering of the skin. These burns are crazy painful. The blisters can appear within minutes (as in my case) or within hours.
Third degree burns (full thickness burns) are the deepest of the burns. They happen when skin is burned off (think white or black charred skin) and affect deeper tissues in the body. Supposedly, the skin may be numb with third degree burns, but I’m not so sure I believe that (I have to think it hurts). The burns look terrible and often have other degrees of burns associated with them.
Fourth degree burns (deepest and most severe). These burns are often life threatening and destroy all layers of skin, bones, muscles, and tendons.

Treatment of burns

The treatment approach entirely depends on the degree of burns, amount of involvement, and location of the burn.

First degree burns are usually treated by cooling the area and managing pain (e.g., Tylenol).
Second degree burns may need an antibiotic ointment (often Silver Sulfadiazine, a.k.a. Silvadene, which is a prescription cream) to help prevent infection. Pain management is a big part of treatment.
Third degree burns usually need IV antibiotics, IV fluids, and skin grafting. All third degree burns should have the care of a medical doctor.
Fourth degree burns also need the immediate care of a medical team at a properly equipped hospital.

DO NOT tips

Do NOT put butter on burns (it will trap the heat) and make it worse.
Do NOT pop blisters. (The blister is the best wound cover the body can make, better than anything we can make in medicine.)

Seek medical care if

The burn involves a large amount of area
The burn is deep
The burn is over a sensitive or very involved body part (e.g., private body parts, hands, face, etc.)
The pain is severe and uncontrollable
Your parent instinct tells you this is bad

Hopefully, you’ll never have to deal with any burns in your children. But if your house is anything like the Wonnacott’s house, chances are you will. Good luck!

A colleague recently told me that he thought there was no such thing as an accident, that everything is preventable in some way or another (e.g., the drunk could have been prevented from driving, the pool could have been covered, the rough housing game stopped before someone got hurt). While I’m not sure I entirely agree with his stance, I can certainly see his point that many accidents can be prevented. Short of putting your kids in a bubble suit, there are a many hazards that are easily addressed.

Here are the top five causes of accidental home injuries.

Water hazards:

Anything deep enough to cover a small child’s nose; typically 1-2 inches, is a drowning hazard.

Bathtubs: Never leave a child unattended in the bathtub (even for a minute), make sure the tub is completely drained after use.
Buckets, pails, ice chests (with melted ice): Any amount of standing water. Kids bend over to play and fall head first (because they are top heavy) and then get stuck. Make sure these items are emptied after use.
Swimming pools, hot tubs, and spas: Keep covered and locked when not in use. A four-sided, lockable fence also adds a layer of protection.
Water features/fountains: While pretty, they are huge drowning risks. Don’t have them on or exposed unless an adult is directly supervising.
Other waters (irrigation ditches, lakes, rivers, wells, etc.): These are particularly difficult for you to control. Sometimes the best way is to fence the child in rather than attempt to fence the area off.

Falls:

Stairs: For the early crawler/walker, stair gates are a good place to start. When a child is just learning to navigate the stairs, directly supervise the child going up and down. Also ensure that there are handrails on all stairs and that the stairs are well lit. Lastly, keep the stairs clear of clutter (a trip hazard).
Walkers: Baby walkers are a huge hazard (especially falling down stairs) and shouldn’t be used.
Windows: Kids like to climb onto window ledges and push on/lean on screens. The screens give way and kids fall out windows. Either keep windows shut/locked or install window guards.
Play equipment: Kids can easily lose their grip/balance on slides, swings, monkey bars, etc. Ensure the material under the equipment allows for a soft landing. See article on trampoline safety: IS YOUR TRAMPOLINE A SUPER FUN DEATH TRAP?
Hard floors: Pose a slipping risk for stocking feet. Your young child may be better off in bare feet.
Large furniture: Unattended children transform into monkeys in minutes. Kids can climb bookshelves, tables, etc. Secure any large furniture to the walls (e.g., big dressers, book shelves).

Poisoning:

Make sure the number to poison control is programmed in your phone (1-800-222-1222) see article POISON CONTROL AND PREVENTION.

Cleaners and chemicals should be kept well out of reach of children. I thought I was doing great in this area (all the cleaners are on a top shelf in a closet) until I found my 2 year old unwrapping the dishwasher tablets under my kitchen sink the other day. I was lucky she didn’t attempt to eat them. They now reside on the top shelf of my pantry.
Medicines and vitamins. Most medicines are not safe/intended for children. Keep them well out of reach of children (and preferably locked). Never leave a bottle of medication open and unattended (even if for only a second). Also keep kids vitamins out of children’s reach (while eating one is safe, eating a whole bottle is another story).
Products in the wrong bottle. Never relocate cleaners/chemicals into bottles that served another use (like a drink bottle).
Plants. Many household plants are poisonous if eaten. Keep them out of reach or forego them for this stage of life with young children.

Fires/burns:

Water heaters: Should be set to 120 degrees or lower to prevent scalding water burns.
Don’t have candles (even if they smell good) burning within reach of a child.
Pots/pans: Don’t walk away from a pot in use. Kids can reach and pull anything on them in a second.
Cooking with a baby: A surprising number of burns happen when mom is holding a baby and cooking at the same time. A child will reach out at just the wrong time or a foot will drop against a hot pot, etc.
Irons/curling irons/flat irons: Don’t let them heat up or cool down with dangling cords. Don’t leave them unattended.
Whenever possible use back burners. Take care to keep small children away from hot surfaces.
Hot foods. Parents don’t usually give children food or drinks that are too hot. The accident happens when the parent is holding a child, eating the hot food/drink and spills it on the child. So, don’t hold the child while eating hot food.

Choking /suffocation:

Bedding: Extra blankets and pillows cause a suffocation hazard to small children. Don’t let a child under 2 years of age sleep with a pillow.
Choke foods are smooth and round: Foods like grapes and hotdogs are common offenders. Cut up food into small pieces while your child is young (younger than 2 years) and not completely reliable about chewing well.
Plastic bags: A seemingly harmless item can easily cause suffocation. Keep them out of reach of kids.
Airtight spaces: Kids love to climb into anything and everything. If the item has a limited amount of air (e.g., like a freezer), then consider putting a lock on it to prevent suffocation.
Little toys. Any “bite-sized” toy or item poses a choking risk for the small child who likes to put everything in his/her mouth. It is another reason to get after older children for leaving out the Legos.
Items that can cause strangulation:
1. Window blind cords: Tie them up, ensure they don’t end in a loop, or replace them with a cordless design.
2. Pacifier strings: Don’t use them. I know the pacifier may drop, but better to clean it than have your child strangulated.
3. Drawstrings on clothing (e.g., hoodies)
4. Ribbons
5. Necklaces: Don’t put them on your infant (or only for the 1-minute, supervised picture).
6. Headbands: Don’t put them on your infant (or only for the 1-minute, supervised picture). Headbands can slip down around your infant’s neck.
7. Anything a child can get his/her head stuck in (e.g., furniture, playground equipment, etc.).
8. Electrical cords: Extra cords are a huge potential disaster for young children (from pulling appliances on top of the child, to electrical burns, to strangulation). Keep them out of reach.

One last plug…while it may not be in the top 5 causes of accidents, no article on home safety would be complete without a nod to gun safety. I am not making commentary on whether an individual should or shouldn’t have a gun, but guns and children don’t mix. Make sure all guns are locked in a safe (preferably with a biometric lock).

Ben Franklin’s famous quote: “An ounce of prevention is worth a pound of cure,” is as true today as was nearly 300 years ago. Stay vigilant and keep your child safe.

Tag: burns

Real Tips for Treating A Burn