Preventing burns and scalds in children

What are burns and scalds?

Burns and scalds are injuries to your skin caused by heat, electricity, chemicals and radiation. Children can also be burnt by contact with very cold things. Many burns happen in the home and can be prevented.

Your child can be burnt when their skin touches a dry heat, such as:

• a hot surface — for example a stove or iron
• electricity
• friction — for example a treadmill or rope

Your child can be scalded when their skin touches wet heat, such as:

• water in a hot bath
• steam from a boiling kettle
• boiling water or hot drinks

Scalds are more common in young children. Burns are more common in older children and teenagers. Whether your child has a burn or scald, their injury is generally called a burn.

Burns can affect your child’s:

• skin
• eyes
• respiratory system (airways and lungs)
• other body parts

The severity of your child’s burn can range from a minor injury (where you can treat them at home) to a severe or life-threatening injury (where you need to take them to hospital for treatment).

What are the different types of burns?

Burns can be grouped by:

• how much of your child’s body has been burnt — this is known as total body surface area (TBSA) and calculated as a percentage
• the location of your child’s burn — which part of their body was burnt
• what caused your child’s burn
• how deep your child’s burn is — how many layers of skin were damaged

The depth of your child’s burn can be described as:

• superficial burns (first degree burns) — only the outermost layer of skin has been affected. Superficial burns heal without leaving a scar.
• partial-thickness burns (second degree burns) — the outer layer and inner layers of skin are injured
• full thickness burns (third degree burns) — all layers of skin have been damaged. Muscles or bones may also be burnt. Your child might need surgery.

What are the symptoms of burns and scalds?

If your child has been burnt, their symptoms depend on how deep their burn is:

• Superficial burns — the skin looks moist and red.
• Partial thickness burns — there are painful blisters on the skin.
• Full thickness burns — the skin may look dry, clear, black, pale or leathery. These are not always painful, and there is no feeling over the burnt skin. The skin does not blanche (does not turn white when pressed).

Your child may have a mix of different levels of burn in the one injury.

Superficial burns are usually more painful than full thickness burns. This is because full thickness burns may have caused nerve damage and affect your child’s ability to feel pain.

Other symptoms your child may have include:

• trouble breathing, if they inhaled smoke
• fever, swelling or pus if their burn becomes infected after a few days
• signs of shock — pale skin, fast heartbeat and fainting

When should I call an ambulance or go to the emergency department?

You should call for an ambulance if:

• your child has burns to their throat or airways, or is having trouble breathing
• your child has burns on their face, nasal hairs, eyebrows, eyelashes or soot on their nose or mouth
• your child has burns on their hands, feet, perineum (area between the anus and genitals), genitals or major joints
• your child has an electrical or chemical burn
• your child’s burn is deep — even if they are not in pain
• you are worried about your child or unsure how serious their burn is

All infants and children who have been burnt will need to be checked by a doctor.

If the burn is serious or your child is obviously unwell, call triple zero (000) for an ambulance. The operator will tell you what to do until help arrives.

What should I do while waiting for the ambulance?

While you wait for an ambulance, make sure it is safe for you to approach your child and then you should begin the following first aid treatment:

• Stop your child from being burnt — Stop, Drop, Cover and Roll:
  • If your child is on fire — smother any flames with a blanket.
  • If your child has an electrical burn — if safe, turn off the power supply without touching your child.
  • If your child has a chemical burn — take off any clothing that has come into contact with the chemical as quickly as possible, and wash the affected area with water.
• Move your child to a safe place as quickly as possible.
• Check if your child is breathing normally. Keep their airways open. Check if your child has any other injuries.
• Cool your child’s burn for at least 20 minutes with cool running water. You can do this for up to 3 hours after they were burnt.
• Remove any jewellery or clothes that are not attached to your child’s skin. If they are stuck to the burn, do not remove them.
• Cover any burnt skin with a loose, non-stick dressing. For example, cling film. Do not use cling film on your child’s face.
• Make sure your child is warm. Cover unburnt areas. Small children can quickly develop hypothermia.

Your aim is to:

• stop the burning process as quickly as possible
• cool the burn
• cover the burn

Inhalation burns

If you are worried your child has inhaled (breathed in) hot gases or smoke:

• if safe, take your child to fresh air
• keep your child’s airways open and check they are breathing normally

Do not assume your child is OK just because they look like they are breathing normally, are talking and get up on their own. Some gases can cause lung damage 24 hours after your child was exposed. See a doctor as soon as possible.

Chemical burns

If your child has had a chemical burn, your aim is to dilute the chemical as quickly as possible. Here are some tips:

• Avoid contact with any chemical or contaminated equipment.
• Check the instructions on the chemical’s packaging for any specific treatment needed.
• Call the Poisons Information Centre for more advice.

Do not apply cling wrap or hydrogel dressings on chemical burns

Do not use another chemical to try to neutralise an acid or base burn

What should I avoid if my child has been burnt?

Do not peel off clothing or anything stuck to the burn

Do not use ice or ice water to cool your child’s burn

Do not pop any blisters

Do not put any lotions, ointments, creams or powders on their burn

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

What causes burns and scalds?

Your child can be burnt or scalded by:

• contact with fire and flames
• contact with hot drinks, steam and bathwater
• contact with hot surfaces such as a stove, iron, heater or hair straightener
• electricity such as from a lightning strike or power point
• sunburn or radiation
• chemicals such as cleaning products spilling on their skin or swallowing button batteries and chemicals
• friction such as from ropes or a treadmill

Many burns in young children happen at home.

How are burns and scalds diagnosed?

If your child has been burnt, their doctor will diagnose how severe it is by:

• assessing how deep the burn is — it may not be possible to check how deep your child’s burns are until 2 to 3 days after they were injured
• assessing what percentage of your child’s body has been burnt — they will use a special chart to measure this

Often, to complete their assessment, your child’s clothes will need to be removed.

How are burns and scalds treated?

Depending on how deep and widespread your child’s burn is, they may be treated at home or at the hospital. Treatment usually includes:

• cleaning and dressing the wounds
• making sure they stay hydrated
• managing pain with medicines and distractions such as music, television, toys or breastfeeding
• psychological support to help your child cope with the pain, and the impact that their injury has on their life

In serious cases, your child may need surgery. A team of healthcare professionals, including doctors, nurses, dietitians, physiotherapists and occupational therapists will work together to help your child. Your child’s recovery and rehabilitation can take many months.

Read more about the treatment of burns and scalds in children.

What are the complications of burns and scalds?

The complications of burns and scalds depend on the type and severity of the injury. Some complications can happen straight away and others develop later, as your child is recovering.

Immediate life-threatening complications of serious burns include breathing difficulties (if your child has inhaled smoke or has burns on their chest) or shock.

Other complications your child can develop later on include:

• infection or sepsis (which is the body's extreme response to an infection)
• mental health complications (for example, anxiety, depression or post-traumatic stress disorder)
• contracture of your child’s joints (where muscles, tendons and skin tighten or shorten causing a deformity that affects how your child moves)

Can burns and scalds be prevented?

Burns and scalds can happen around young children. Keeping a close watch on them helps reduce the risk. There are also practical steps you can take to help prevent these injuries.

Keeping your kitchen and dining areas safe

When you are in the kitchen or have hot food and drinks, be sure to always supervise your child.

Tips for your kitchen:

• Keep hot drinks, hot liquids and chemicals out of your child’s reach.
• Store appliances such as microwaves and kettles and their cords out of your child’s reach.
• Refill your kettle with cold water after using it.
• Avoid cooking or drinking hot drinks while holding or breastfeeding your baby.
• Use the back burners on your stove rather than the front ones.
• Turn pot handles towards the wall so your child cannot reach them.
• Keep children’s play areas out of the kitchen — consider a child safety gate to keep your child out of the kitchen while you’re cooking.

Tips when eating:

• Check the temperature of all foods and hot drinks before you serve them.
• Never give your child a hot drink — drinks for children should be warm or cool.
• Stir microwaved food well to distribute the hot spots.
• Use placemats rather than tablecloths, to prevent your child from grabbing a tablecloth and pulling hot food onto themselves.

Keeping the bathroom safe

Always supervise children in the bathroom — never leave them alone. If you need to leave the bathroom, take your child with you.

Many hot tap water scalds occur in the home. They are often caused by bathwater heated to unsafe temperatures.

When bathing or showering your child:

• turn on the cold water first
• turn the hot tap off first
• make sure the water is warm, not hot
• always test the water first with your wrist or elbow or use a bath thermometer
• supervise your child and keep them within arm’s reach
• install tap covers to prevent young children turning on the hot water tap

Keeping your bedrooms safe

Here are some tips to help keep kids safe from burns in bedrooms:

• Turn heaters off once your children are in bed.
• If your child can get out of bed themselves, take the heater out of the room or install a guard around the heater.
• Keep clothes and toys well away from heaters.
• Buy your children well-fitting sleepwear with a ‘low fire danger’ label.
• Keep bedside lamps out of your child’s reach.
• Don’t use electric blankets on children’s beds.

Keeping your living area safe

In living spaces, be sure to:

• place guards or screens in front of fireplaces
• keep lighters, matches and candles out of your child’s reach
• wait until your child is asleep in their bedroom before doing any ironing

You should also be sure to check that your smoke alarms are working and up to date.

• Test them every month by pressing the test button.
• Replace the batteries in your smoke alarms every year.
• Replace smoke alarms every 10 years.

Keeping your garage and outdoor areas safe

If you are camping, make sure your children wear shoes. Keep them away from campfires and hot coals.

Make sure you:

• don’t use accelerants to light fires near children
• don’t leave fires unattended
• watch children around barbecues and fires
• secure outdoor gas heaters so they can’t fall over
• keep children away from lawn mowers

Be sure to check the temperature of metal objects in hot weather so your child does not burn themselves, such as:

• play equipment, especially slides
• seat belt buckles in the car
• metal outdoor furniture or handrails

Resources and support

• Visit the Royal Children’s Hospital to learn more about burns prevention and first aid.
• Learn more about burn injuries amongst children on the Sydney Children’s Hospitals Network website.
• If you have children or look after children, it’s a good idea to know some basic first aid and how to do resuscitation. You can do first aid courses with the Australian Red Cross, St John Ambulance Australia and Royal Life Saving Australia.

Languages other than English

• The Royal Children’s Hospital have translated their burns prevention poster into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Perth Children’s Hospital has a factsheet all about children’s burns for Aboriginal and/or Torres Strait Islander people.