General Burn Information
Burn Injury Statistics
Child Safety: Preventing Burns
A Guide for Patients
General Burn Information
Burns are divided into three categories according to their severity. First-degree burns are the mildest and cause redness and perhaps slight swelling of the skin (like most sunburns). Second-degree burns cause blistering and considerable swelling. Third-degree burns may appear white or charred, and cause serious injury not just to the surface but also to the deeper skin layers.
A burn injury usually results from an energy transfer from a heat source to the body. There are many types of burns caused by thermal, radiation, chemical, or electrical contact.
Why are burns dangerous?
- Burns damage skin, muscle, bones, and organs.
- When the skin is burned, it can't protect the body against germs, prevent the loss of body fluid, or keep the body at a normal temperature.
What are the different types of burns?
There are many different causes of serious burns in children, including sunburn, hot water scalds, and those due to fire, electrical contact or chemicals. All of these can cause permanent injury and scarring to the skin.
- thermal burns - burns due to external heat sources which raise the temperature of the skin and tissues and cause tissue cell death or charring. Hot metals, scalding liquids, steam, and flames, when coming in contact with the skin, can cause thermal burns.
- radiation burns -burns due to prolonged exposure to ultraviolet rays of the sun, or to other sources of radiation such as x-ray.
- chemical burns - burns due to strong acids or alkaloids coming into contact with the skin and/or eyes.
- electrical burns - burns due to a contact with an alternating current, such as open wiring or being struck by lightening.
Burn Injury Statistics
- On average in the United States in 2000, someone died in a fire every 2 hours, and someone was injured every 23 minutes (Karter 2001).
- One person is either burned or scalded every 25 seconds in the U.S.
- Scald burns are the leading cause of accidental death in the home for children from birth to age four and are 40% of the burn injuries for children up to age 14. Burns and fires are the third leading cause of accidental death for adults.
- Each year in the United States, 1.1 million burn injuries require medical attention (American Burn Association, 2002).
- Approximately 50,000 of these require hospitalization;
- Approximately 20,000 have major burns involving at least 25 percent of their total body surface;
- Approximately 4,500 of these people die.
- Over 250,000 children each year in the U.S. (ages 0-17) are burned seriously enough to require medical attention.
- Fires and burns are the fifth-leading cause of unintentional injury-related deaths among children ages 14 and under.
- 40,000 children are hospitalized each year due to burn injuries.
- Over 1,000 die from fire and burn injuries.
- Children, ages newborn to two-years-old, are most frequently admitted for emergency burn care in a hospital. The kitchen is the most frequent area in the home where burn injuries occur for children newborn to four.
- Burns are one of the most expensive catastrophic injuries to treat. For example, a burn of 30% of total body area can cost as much as $200,000 in initial hospitalization costs and for physicians fees. For extensive burns, there are additional significant costs which will include costs for repeat admission for reconstruction and for rehabilitation.
- Nearly 75 percent of all burns in children are preventable.
Child Safety: Preventing Burns
Nearly 75% of all burns in children are preventable. So what prevention steps can parents take?
In the Kitchen:
- While cooking, keep young children in a high chair or playpen, at a safe distance from hot surfaces, hot liquids and other kitchen hazards.
- Use extra caution if you use a deep fat cooker or fryer when children are around.
- Keep appliance cords away from edge of counters, and keep them unplugged and disconnected when not being used.
- Keep pot handles turned in so pots cannot be pulled or knocked off the stove.
- Do not put baby walkers where they can reach the stove.
- When heating food for a young child, sample the food for temperature safety before feeding it to the child.
- Keep children away from the microwave and other heating appliances when removing hot food.
- Heating baby formula or milk in bottles with disposable plastic linings may be dangerous because the liner may burst. Using a baby bottle warmer may provide a safer way to heat baby bottles.
- Do not hold a child in your arms while removing items from the microwave.
Matches and Lighters:
- Don't leave cigarettes, matches or lighters unattended and keep them out of sight and out of reach of young children.
- Children should be taught that cigarettes, matches and lighters are not toys and they should never play with them.
Babies and toddlers find out about the world through their sense of touch. One of the first things they learn is that some things can be painfully hot. Many items, such as stoves and radiators, are cool at some times and hot at others -- which complicates the lesson.
And then there's fire. It dances and flickers so enticingly. Surely something so pretty can't be harmful. And it can be created, like magic, with matches and lighters.
Each year, thousands of house fires are caused by children playing with matches or lighters. Even worse, instead of escaping the house, many young children tend to hide under a bed or in a closet during house fires -- especially fires they've started.
But there are ways to protect your children from fires and burns. Keeping one step ahead of their natural curiosity is the key to success.
Many ordinary things in your home – bath water, electrical outlets, even some food – can burn your child. Follow these tips to keep your little ones safer.
- Reduce water temperature. Set the thermostat on your hot water heater to 120 F or lower. Generally, a child's bath water should be no hotter than 100 degrees Fahrenheit. Don't let children play with the water faucets. They may turn on the hot water and scald themselves.
Hot Water Causes Third Degree Burns…
- …in 1 second at 156°
- …in 2 seconds at 149°
- …in 5 seconds at 140°
- …in 15 seconds at 133°.
- Avoid hot spills. Don't drink or carry hot beverages or soup while holding a child. Turn the handles of your pots and pans inward on the stove. Avoid using a tablecloth with toddlers around. If they pull the tablecloth, hot or heavy items could fall on them.
- Establish a 'No Zone.' The area in front of your stove can become a kid-free zone, marked with yellow tape or a piece of bright carpet. Also, don't store cookies near the stove, to reduce the risk of children climbing onto the stove to get a treat.
- Unplug irons. Items designed to get hot, such as curling irons and clothes irons, should be unplugged when not in use. Keep the cords out of children's reach.
- Test food temperature. Microwaves have a tendency to heat things unevenly. For example, the jelly inside a doughnut can be scalding while the pastry is only warm. Liquids heated in a microwave may be much hotter than their containers. Sample microwaved food to make sure it's not too hot before giving it to your children.
- Screen heat sources. Place safety screens around fireplaces, wood stoves, space heaters, radiators and baseboard heaters.
- Cool mist vs. steam. Choose a cool-mist humidifier instead of a steam vaporizer. The steam from the vaporizer can burn a child if he or she gets too close.
- Childproof outlets. Place plastic plugs in electrical outlets to prevent children from inserting metal objects such as forks or keys, which can result in electrical burns.
- Watch barbecue grills. Never leave a grill unattended when children are near.
- Check metal slides. Metal playground equipment, especially slides, can become hot enough to cause burns. Very young children are most at risk because they typically don't pull away from hot surfaces as quickly as older children do.
- Feel car seats. Before you place a child in a car seat, check the temperature of the seat. Hot straps or buckles can cause burns. If you park in direct sunlight, cover the car seat with a towel or blanket.
- Forgo fireworks. Firecrackers, rockets and sparklers cause most of the injuries associated with fireworks and children. A sparkler burns at more than 1,000 F. The safest way to enjoy fireworks is to leave them to the trained professionals.
Playing with Fire
Children have a natural curiosity about fire. By the age of 12, half of all children have played with fire. Child-play home fires tend to begin in bedrooms where children are left without supervision. Nearly a third of the fires that kill children start when children play with fire. Follow these tips to protect your children from their own curiosity:
- Lock away matches and lighters. Store matches and lighters out of sight and out of reach, preferably in a locked cabinet or drawer. Because wooden "strike-anywhere" matches are so easy to light, avoid keeping them in your home. Use book matches instead.
- Lighters aren't toys. Never use a lighter as a toy to amuse a child. Instruct young children not to touch any matches or lighters that they find, but to quickly tell an adult.
- Teach fire safety. Older children should be taught how to use matches safely. In many cases, a child's curiosity is satisfied if he or she is entrusted to use matches in appropriate situations. Children must promise to use fire only in the presence of a parent.
- Seek burned matches. Check under beds and in closets for burned matches, evidence that your child is playing with fire. Some children who start fires have a history of fire setting. Many fire departments offer counseling programs for children who set fires.
Prevent Home Fires
Fires and burns cause more than 4,000 deaths and more than 50,000 hospitalizations every year. More than half of all fatal fires occur in the home. Children under the age of 6 are more than twice as likely to die in a fire as the rest of the population.
All sorts of things can cause residential fires – everything from cigarettes and candles to space heaters and wood stoves. Prevent home fires by taking the following steps:
- Be careful with cigarettes. Residential fires caused by cigarettes are the leading cause of fire-related death. Quitting smoking can protect both your health and your home. Until you quit, use deep ashtrays and flood cigarette ashes with water before putting them in the trash. Both for the sake of safety and health, never smoke inside your home or car, and especially not in bed.
- Supervise young children. In addition to possibly playing with fire, unattended children can accidentally start fires by attempting to cook or by using a heater or electrical appliance in the wrong way.
- Use space heaters with care. Keep the heater at least three feet away from bedding, drapes, furniture, or other flammable materials. Never leave a space heater on when you go to sleep or leave the room. Be aware that fuel-burning space heaters can also cause carbon monoxide poisoning.
- Enjoy candles cautiously. Before you leave a room where candles are burning, make sure you extinguish them completely, and don't leave a candle burning when you fall asleep. Use sturdy candleholders on uncluttered surfaces in places where children or pets can't knock them over.
A Guide for Patients: Burn Injuries
The University of Iowa Hospitals and Clinics has written a guide for burn patients. It provides an excellent overview of burns and gives details about what a burn victim can expect during his or her hospitalization.
Virtual Hospital: A Guide for Patients: Burn Injuries