From the May 2017 issue

Kids and Burns: What You Should Know and How to Treat Them

Getting a burn is a painful and often traumatic experience for anyone – especially for a child.

In the stress of the incident, parents are frequently left scrambling for how to respond. Put ice on the burn? Try a “home remedy” like butter? Head to the ER or call the pediatrician?

It’s best for parents to be prepared with a plan before they ever need it – and most of all, to try to prevent childhood burns from occurring in the first place.

“The majority of the burns we see are preventable,” says Dr. Christina Shanti, the chief of pediatric surgery at Children’s Hospital of Michigan and the program director of the hospital’s Burn Center.

It’s often a matter of supervision, she says, but sometimes the culprit isn’t what you’d expect. In addition to burns from common things like spilled drinks, fireplaces and backyard fire pits, other sources of burns among kids include touching straightening irons, taking food out of the microwave and even bathing in water that’s too hot. Other times, parents don’t realize their kids have been experimenting with fire until a burn occurs.

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“Some kids are just inherently inquisitive about flames and fire in general,” Dr. Shanti says. “We see quite a bit of serious burns with kids playing with candles, lighters, or trying to do some kind of experiments or challenges that they read about on the Internet.”

Chemical burns are another unexpected risk and could be as close by as under your kitchen sink.

“Chemical burns are serious burns and they need to be managed at home immediately by irrigation,” she says, encouraging parents to first wash this type of burn with as much water as possible before heading to the doctor. “If they haven’t done that at home, the chemical is actually already causing a deeper burn.”

For other types of burns, the best thing a parent can do is simply cover the affected area with something clean like a sheet and then seek medical advice. There’s no need to put ice or cold water on it – the cold could even make things worse – and you should skip any “home remedies” you’ve heard about.

“If they keep the area clean and covered, that will control the pain,” Dr. Shanti says. “An antibiotic ointment like Neosporin is acceptable for a burn that begins to blister, but all these other home remedies are just not proven to work.”

That includes things like butter, egg yolk, toothpaste or mustard, says Dr. Justin Klein, a pediatric surgeon and the associate director of the Children’s Hospital of Michigan burn unit.

“You name it, it’s probably been put on a burn,” he says. “None of those things are going to help in the long term and some of those things could even be detrimental.”

Burns are categorized by degree; a first-degree burn is only on the surface and causes reddening of the skin like with a sunburn, Dr. Klein says.

“It’s painful at the time, but it doesn’t require medical treatment,” he explains. “Once the skin blisters from a burn, that’s automatically a second-degree burn.”

A burn that goes deeper, through the dermis, it becomes a third-degree burn.

“The most common cause of burns in kids is scald injuries,” from things like hot tap water, spilled coffee or other food and beverages, Dr. Klein says. “The majority of the burns we see from scald injuries tend to fall into the category of second-degree burns.”

If you’re not sure whether your child has a first- or second-degree burn – and understandably, most parents aren’t – it’s best to head to the doctor, Dr. Shanti notes. Even small burns can be more serious than they appear.

“If it’s on the face or if it’s over joints or it’s in the genitalia area or somewhere functionally important, a small burn – if it doesn’t receive appropriate care – can result in significant long-term complications,” she says. “Any burn should receive attention, whether they seek attention in the pediatrician’s office or seek attention in the ER.”

Don’t worry about whether it will seem like you’re overreacting. “We never think that. What we worry about is the delay in seeking care,” she adds.

The Children’s Hospital of Michigan Burn Center, which sees about 600 new patients each year, is one of only a few pediatric burn centers across the country to be verified by the American Burn Association and the Committee on Trauma of the American College of Surgeons.

“We’re the only verified pediatric burn center in Michigan,” Dr. Klein points out.

At the burn center, patients work with specialized nurses and doctors along with physical therapists, occupational therapists and social workers to address all of the child’s needs related to the burn. Treatment includes appropriate dressings for the burn, medications, skin grafts and other surgical options.

Scars left behind by burns – both mentally and sometimes physically – are a reminder of why it’s so important to try to prevent them.

“Most of the things we do see are truly just accidents, bad luck,” Dr. Klein says.

So it’s critical that parents take as many precautions as they can, like keeping hot items away from counter edges and turning down the water heater’s temperature to 120 degrees Fahrenheit or lower.

“Honestly, we see a lot of kids that get burned while being bathed in the sink,” he says. “Somebody turns on another sink or flushes the toilet, that changes the water temperature, or the baby kicks the faucet itself and it turns the water hot. It doesn’t take long to burn them.”

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