When she was young, my sister melted a pile of plastic cups on one of the stove plates — she was curious and, naturally, my father was furious. His anger worked: all stove experiments were henceforth avoided and we kept well away from plug sockets, matches and fires too. Just to be safe.

Children are naturally inquisitive and it takes a matter of seconds for a potentially fatal burn accident to occur. Thousands of South African children are burnt each year and many of these children die as a result of their injuries.

Before your child becomes one of these statistics, implement some preventative measures in your home and become familiar with the procedures you should follow if your child does get burnt. We went to Asha Parbhoo, Head of the Department of Physiotherapy at Red Cross Children’s Hospital for advice on the steps you should follow if your child is burnt. In the case of burns, a swift and informed reaction could make all the difference.

Understanding burns

The most common burns among children are scald or fluid burns (tea, coffee, hot water) and these tend to occur in the kitchen or bathroom. Flame burns occur less frequently, but are a major cause of burn deaths. They tend to be more serious and leave permanent scars.

Electrical burns, which range in severity and can be caused by any electrical appliance from an electric beater to an electric fence, are treated slightly differently to flame or scald burns. Chemical burns can be caused by corrosive cleaning agents such as sulphuric acid and caustic soda, and require a specific treatment.

Contact burns, which cover anything from irons to kettles to toasters, occur most regularly in children in the one to three age group. They tend to be the result of infants touching or falling on objects.

Burns range in severity from superficial burns (first degree) to full-thickness burns (third degree). Superficial burns, which are the least severe, only affect the surface (epidermis) of the skin and have the appearance of sunburn. Although painful, these burns should heal within a couple of days with no scarring.

Superficial-partial or full-partial-thickness burns, which damage the epidermis and some of the dermis, tend to be very painful as they affect a number of nerve endings. If the burn blisters it is regarded as a superficial-partial burn and if the skin is broken, it is regarded as a full-partial-thickness burn. They should heal within a week or two if they don’t become infected. These burns might leave a scar, however it will be minimal.

Full-thickness burns are the most dangerous. These damage the entire epidermis and dermis, leaving no cells for healing. The burn might appear charred or white and may not initially) be very painful because the nerves have been damaged. Often burns like this require skin grafting and the scarring is significant as the wound contracts to cover the damaged area.

An important point to bear in mind, when it comes to burns is that your child will probably suffer from dehydration. Even in the ‘mild’ case of sunburn, which usually covers a large area of the body, your child is likely to become dehydrated.

Safety precautions

Scalds

  • Make sure your young child is supervised.

  • If your children are old enough, teach them the risks of hot liquids and open flames.

  • Always fill a bath with cold water first and never leave your child alone in the bath (they might turn on the hot tap and be unable to close it)

  • Never drink a hot drink with a child on your lap.

  • Don’t use overhanging tablecloths which your child might pull at.

  • Keep children at a safe distance while you cook.

    • Flames

  • Keep candles, matches and lighters away from children.

  • Never pour inflammable liquids onto a fire.

  • Supervise children near fires/braais.

  • Have safety equipment like a fire extinguisher and a bucket of sand in an easily accessible place in your house.

  • Keep your heater in a safe place where it can’t be knocked over.

  • Teach your children to ‘stop, drop and roll’ if their clothing catches alight.

    • Electrical

  • Hands must be dry when handling electrical appliances.

  • Don’t overload and electrical system with too many double adapters.

  • Replace frayed cords and make sure plugs are wired correctly

  • Teach your children about the dangers of electricity.

  • Use socket plugs.

  • Don’t let your children play never electric fences or climb trees near overhead electric wires.

    • Chemical

  • Keep all chemicals and cleaning agents out of reach of your children.

    • Treating burns

    Obviously not all burns require hospitalization, however, when it comes to children and burns, it is better to err on the side of caution. It’s a good idea to call an ambulance or get to hospital if:

  • The child is an infant or baby

  • The burn is extensive (palm sized or bigger).

  • The burn is severe (if you are uncertain, assume that it is).

  • The burn is caused by chemicals or electricity.

  • The child is in shock. Shock is characterized by pale or clammy skin, weakness, blue lips and fingernails and a decrease in alertness.

  • The face, hands, feet, genitalia or creases of joints are burnt.

    • In the case of a fluid, flame or contact burn, follow the procedure below whilst waiting for the ambulance or before taking your child to hospital. Do this immediately after the burn has occurred.

  • If possible remove the child’s clothing. Don’t remove if it is stuck to the skin, which is often the case if the child has sustained a fire burn.

  • Run cold water over the burn for approximately ten minutes (or until the pain subsides). Don’t apply toothpaste, shoe polish, butter or any other ointment to the burn as it may cause the heat from the burn to be retained. Don’t use ice as this is too harsh for the burnt skin.

  • Cover the burn with a clean cloth. If the wound is open, apply a cool wet cloth to the burnt area and keep the cloth moist for 30 minutes. Don’t let it dry out as it will stick to the burn. After this you can apply a dry cloth. If the burn is extensive, you can use a clean sheet. Don’t wrap the child in a wool blanket as the wool may become stuck to the burn.
  • Take the child to hospital or the doctor.

    • Your child may be bleeding from the site of the burn. If this is the case, apply pressure to the area until the bleeding subsides. Be careful not to wrap bandages too tightly, especially around a limb.

    If the burn is obviously a minor first degree burn, you can apply burnshield and cover the burn with the dry gauze bandage after following steps one and two.

    If you child has been burnt on the neck or in the crease of a joint (armpit, elbow, behind the knee), make sure that they keep the burn extended. The burn will be very painful, however your child must not hang his or her head forward (or bend his arm etc) as the burn will contract, restricting your child’s movement permanently.

    In the case of an electrical burn, make sure that you turn the source of the electricity off before touching the child. Move the child away from the electricity using an insulated (wood or rubber) item. If the electrical shock was severe, it might be necessary to check that your child is breathing and if not, to begin CPR. Cover the burn in a clean dry cloth and go to the hospital.

    Electrical burns have a point of entry on the skin, but burn internally, which means that you may not initially notice the severity of the burn. It is important to take your child to the doctor or hospital regardless of how mild the burn might appear to be.

    If your child has a chemical burn, you need to remove his or her clothing without spreading the chemical to other parts of the body. If necessary cut the clothing off. Like electrical burns, the full extent of a chemical burn is not initially apparent. Not all chemical burns should be washed with water and so it is best to phone a hospital emergency line before running cold water over the burn.