Preventing and treating burn wounds
The unthinkable can happen so quickly. Here's how to handle it if your child has an accident. 
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Preventing burns

Who is at risk?

According to Charlene van Tonder from Safe-Kids (a company offering first aid courses in Cape Town), burning with a hot liquid like water or oil is one of the most common causes of household burns among babies, toddlers and young children. 

"Many babies are burnt while their mothers drink hot tea and coffee while breastfeeding," she says, adding that when toddlers starts to walk or pull themselves up against things, they are often burnt by pulling over cups of hot coffee or tea. 

"Children of any age can be burnt in the kitchen when they accidentally bump into their parents, spilling hot contents over themselves. Often children climb into the bath when a parent has run only the hot water. Burns are not specific to any age."

During the winter months, heaters often cause burn wounds and in many homes candles, fires and braais are often the cause of serious burn wounds, she says. 

Take all the necessary precautions

Charlene adds that you need to teach your kids about safety from an early age too. "Teach them what items are hot, that they should never play with fire, and what will happen if they do," she says.

That said, accidents can and will always happen, especially with small children who might not have it all figured out yet. There are, however, certain things you can do at home to make your child's environment a safer place to be.

  • Lower the temperature of the geyser.
  • Never leave matches or lighters within the reach of children.
  • Invest in a fire extinguisher. 
  • Don't carry hot liquids or food near your child. 
  • Never leave your child alone in the bathroom or kitchen. 
  • When cooking, use back burners and turn pot handles inwards.
  • Use safety covers on electrical outlets to prevent electrical burns and keep electrical cords out of reach. 
  • Be careful when using portable heaters, irons and domestic appliances. Be extra careful around open fires and braais.

What to do if your child is burned

Should your child suffer a burn, there are certain things that you should and shouldn't do to help him or her immediately. By giving immediate first aid you can lessen the severity of the burn. Prompt medical attention to serious burns can help prevent scarring, disability, and deformity. For example:

  • First and foremost, you need to cool the burn down. So don't try to get your child'd clothes off. Rather cool them (and the burn) down first with water. 
  • If the clothes are on fire, you need to put them out. Splash only water from the face downwards (never upwards as this can cause the fire to flare up). If the clothes are burned from hot water, then again, leave them on and cool them down under a cold tap for ten minutes.
  • Once the clothes and burn have cooled down, you can try to get them off by cutting (never ripping or pulling) them off your child. 
  • Then smear the burn with a gel-based burn dressing (such as Burnshield) and cover with sterile dressings. If you weren't able to get the clothes off (which if often the case), then apply Burnshield to whatever naked skin that you can see, and rush your child to the hospital where the clothes will be surgically removed and Burnshield will be applied to the remaining burns.

When to call an ambulance

  • Severe burns must always be taken to hospital immediately if the skin is blistered or the burn wound is larger than the palm of the child's hand. This is a major burn.
  • Inhalation burns that have been caused by smoke should be treated immediately as this affects your child's face, hands, feet and genitals need medical assessment.
  • Electric shocks can cause internal injuries, and therefore your child should always be taken to hospital.
  • If a burn wound appears infected or remains painful, it should be seen to. 
"It is highly recommended that all parents attend a Basic First Aid course,"says Charlene. "In an emergency, managing the first few minutes is vital, until an ambulance arrives, or you are able to get to hospital. Should your child stop breathing, you will need to perform CPR (cardiopulmonary resuscitation) and learning this skill can make all the difference in an emergency."

What not to do

  • Never put any creams, lotions, butter, eggs, Vaseline, ice or anything else on the burn as this will only cause infection and will have to be scraped off at the hospital.
  • Don't breathe, cough, or blow on the burn.
  • Don't touch blistered or dead skin.
  • Do not remove the clothes unnecessarily, especially if they are stuck to the skin. This can cause the skin to rip off and create even more damage and scarring later on. 
  • Never put a child with severe burns into a cold bath as this could send him or her into shock. 

Types of burn wounds

Superficial burn (first degree)

This is purely a surface burn where the skin appears red and is painful. An example is sunburn.

Partial thickness burn (second degree)

Damage includes dermis and epidermis. The skin is red, blistered and painful, for example a burn from hot water. 

Full thickness burn (third degree)

All the layers of the skin are damaged. The skin appears pale, waxy and charred. Surprisingly, this burn is often not painful, as most of the nerve endings have been damaged. The patient is very cold as the protection from the environment (provided by the skin) has been damaged, for example, by being burnt by fire.

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