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Burns

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

The number of children who have been burned has fallen over the last 10-20 years. However, burns are still frequent among small children. Half of all burns are caused by scalding from boiling water, hot coffee, hot food or hotplate – all taking place in the kitchen. Another frequent cause of burns is open fire.

The temperature at a scalding is surprisingly low. 54 degrees warm water cause deep burns in only 30 seconds. However, also water just 44 degrees warm can, through longer exposure, damage the child.

Burns are divided into degrees depending on how deep the damage is:

1st degree burn
Only reaches the upper layer of the skin. Appears by redness in the skin and pains. A typical example is sunburn.

2nd degree burn
Reaches all layers of the skin. Appears by pains, redness, swelling of the skin and blisters. The blisters are cavities filled with fluid right beneath the skin – like bubbles on the skin. A typical example is scalding with hot coffee or tea.

3rd degree burn
Reaches below the skin – into fat and muscle. Appears by a crust that can be white or brown that covers a deep wound. There is no redness or blisters. A 3rd degree burn doesn’t hurt because the nerves are destroyed. A typical example is a burn from open fire or boiling water.

1st degree burns do not cause prolonged nuisances. Besides from smarting in the area for 1 to 2 days there are no nuisances. A 2nd degree burn heals in 2 to 3 weeks depending on how big and deep the burn is. The deep 2nd degree burns heals with a scar while the more superficial burns heal without a scar. A 3rd degree burn cannot heal, either skin graft must be performed or the wound shrinks with severe scarring as a consequence.

Click here to read about how you evaluate your child

What can you do?

After every burn you must immediately pour with cold water for at least 1 hour. Often, 1 hour is not enough. You should in fact keep pouring water over it, until the pains have disappeared. Most children testify that there is no pain as long as the burn is under water but that it hurts, when there is no cold water covering the area. You must continue to pour with water until the child says that it does not hurt even when there is no water covering the area. If it is a burn on the hand or the foot, you can put the foot or the hand into a bowl of cold water. In other cases, you can pour water with the shower head or put a cold water compress on the burned area.

If the burn is so big or deep that you decide to go to the emergency room, it is important to put cold water on the burn on the way to the emergency room. Cold tap water or seawater is appropriate for this use. When you have finished pouring water on the area – when the child says it has stopped hurting – you must cover the burn with a compress.

Contact the doctor tomorrow

If, after a few days after the burn, warmth, redness, soreness and swelling around the burn arise. This can indicate an inflammation that must be treated.

It is important that the child is vaccinated for tetanus.

Contact the doctor immediately

If the burn is very big, if there are big blisters or if the skin has torn. In other words, in case of all 2nd and 3rd degree burns.

If the child is less than 1 year old, you must always contact the doctor in the case of a burn.