Burns & scalds - what to do?

In Germany, burn injuries are among the most common accident consequences in childhood. Usually it meets children up to the age of 5 years. And here too - as in the case of poisoning, for example - the household is the most dangerous place: 80 percent of these accidents happen on the "home stove". The dangers that threaten here are often underestimated: water, for example, does not have to be 100 degrees to damage the skin. Even temperatures around 50 degrees are enough for a burn. A temperature of 54 degrees Celsius leads to a third degree of scalding in an adult after 31 seconds - in an infant already after 10 seconds.

Scalding is especially common

Although three-quarters of all heat-related injuries are scalding (for example, water, steam, tea, coffee), dry heat (eg, open fire, hot surfaces), electric power (electrical accidents), and radiation (sun, radioactivity) also play a role when children get hurt. It can also be inhaled hot or toxic fumes.

Special danger threatens with large-scale burns, which are accompanied by vascular damage. The loss of fluid from the blood vessels into the tissue, together with the severe pain can lead to shock. You should therefore be treated as soon as possible by a doctor.

What happens during a combustion?

Mild burns are characterized by redness, pain and blistering. More severe burns cause very painful blisters.

The blistering is caused by the fact that the blood capillaries of the skin are damaged by the heat and become permeable to blood plasma. The uppermost layer of skin lifts off from the surface due to the blood fluid.

Signs of burns and scalds

There are two criteria for assessing the severity of a burn or scald:

  1. Extension: What percentage of the body surface are affected by the burn? The body is divided into regions of nine percent each (head 9%, trunk front and back 18%, arms 9% each, legs 18% each, anal genital region 1%). This rule is slightly modified and also applicable to children: Head and neck are set at 16%, arms at 9%, legs at 17% and front and at the back of the trunk at 16% each. For infants, the rule of thumb is: The palm, including the finger, corresponds to one percent of the body surface. Children are already at risk of death if 8% of their skin is burned, in adults 15% or more.
  2. Depth of damage: The more skin layers are affected, the higher the degree of burn.

Depending on the severity of the burn, the injuries are divided into burns of 1st, 2nd and 3rd degree:

  • 1st degree burns: redness of affected skin areas, severe pain, swelling may occur.
  • 2nd degree burn: redness with blistering or white, weeping wound surfaces.
  • 3rd degree burns: dry, thick, leathery skin, the skin may be whitish to brownish, the affected tissue is dead and there is no sensation of pain (the outskirts, on the other hand, are very painful).

First Aid - what to do?

If less than five percent of the skin is damaged by first degree burns, or if the second degree of burn is not greater than the child's hand, the damage can be treated by itself, for example with special gels (for example Fenestil) or ointments. All other burns must be treated by a doctor.

  • Extinguish: suffocate the flames with blankets (caution, use heat-resistant materials) or by rolling the child on the floor or wipe them with water or a fire extinguisher (never turn the head, breathing may be impaired).
  • Cooling: If smaller parts of the body are affected, they can be cooled for pain relief (under running lukewarm water or with cool compresses, only for a few minutes). Do not use ice cubes or cold water (risk of hypothermia and tissue damage). In infants, when the trunk is affected, or when the burned area is large, the area should not be cooled, especially if it burns on the trunk of the body - there is a risk that the child (especially the small child or baby) will cool down.
  • Call emergency call: Do not drive your child to the hospital yourself, but call the rescue service. This ensures an early and optimal supply.
  • Do not open or puncture the blister. They protect the injured tissue and dry off after a while.
  • Home remedies such as flour, powder, butter and oil are taboo for major burns or open wounds, as they may complicate the evaluation and treatment of the wound in the doctor and may promote infections. Ointments or gels should also be used after a doctor has assessed the injury.
  • Do not cover burns with fluffy materials (such as cotton wool), they can stick to the wound. Better are sterile compresses or patches with aluminum coating.
  • Comfort child (for example with a cuddly toy distract something) and keep warm. The best way to do this is to use the rescue blanket from the first-aid kit (silver side inwards, not too tight), as this exerts no pressure on burnt body parts. Alternatively, a light blanket can be used.

Even in adults, there is a risk of hypothermia when burned or scalded skin is cooled too long or too strong. Therefore, only minor burns or scalds should be cooled. Do not use ice-cold water, but hand-warm water.

For minor burns or scalds

  • Scalding: Immediately remove clothing (using scissors if necessary) to prevent heat build-up and "afterburning".
  • Combustion: Remove clothing only if it does not adhere, otherwise skin injuries will result.
  • Cool under running (not too cold!) Water for few minutes and make sure that the child does not cool down (just cool the burned area, not the whole body). Moist wipes can be used on the face for cooling - be sure to keep the airways clear.
  • If there are no blisters, do not cover the affected part of the body but disinfect and leave to heal in the air. Otherwise clean cover the wound, preferably with a sterile bandage towel from the first aid kit.

For larger burns or scalds

  • Scald: remove clothing quickly but gently.
  • Combustion: Leave clothing on the body, because it is usually burned into the wound. The removal would lead to skin injuries.
  • Do not refrigerate burned areas, otherwise the child may overcool.
  • Cover the affected area sterile. The best is a sterile Metalline-Brandtuch. It does not stick to the wound and gets the heat.
  • Call ambulance!
  • Beware of burns on the face: If the child has inhaled smoke, the mucous membranes may swell, causing respiratory distress. Therefore, the following applies: Inform ambulance service, do not cover burn wounds, sit upright (makes breathing easier), check breathing regularly.
  • Caution, respiratory or circulatory problems may occur after extensive burns. Therefore, watch the child closely until the arrival of the rescue service and control breathing and awareness.

Prevent burns and scalds

Include the following 10 tips to prevent burns and scalds in children:

  1. Most commonly, children draw scalds when they pull pots of hot food or boiling water off the stove. Therefore, attach a safety screen.
  2. Make sure that the child can not pull down devices such as kettles, irons etc. by the cable.
  3. Children should not play alone at the tap.
  4. Bathing: First let the cold water run in and then the warm one. Before you can start bathing, you should check the temperature with a bath thermometer.
  5. After heating, check the temperature of the milk or vial contents before feeding your child. Especially in the microwave heated food can be unevenly warm.
  6. When carrying your baby in your arms, do not drink hot drinks at the same time. He could beat the cup out of your hand by an uncontrolled movement.
  7. Always keep matches and lighters childproof. In order not to make things unnecessarily interesting, elucidation in older children uses more than prohibitions.
  8. Do not leave children alone with burning candles.
  9. Children's clothing: avoid synthetic fibers; they can be easily flammable.
  10. Barbecue: Never pour liquid fire accelerators (methylated spirits, alcohol, gasoline) on fire pits. It comes easily to deflagrations with extremely high temperatures.
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