Treating burns and scalds in children

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.

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 it's a burn or scald, the 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 to a severe or life-threatening injury. You can treat minor burns with self-care at home, but your child needs medical care in hospital to treat severe or serious burns.

What are the different types of burns?

Burns can be grouped by:

• how much of your child's body is burnt — this is known as total body surface area (TBSA) and calculated as a percentage
• 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 are damaged by the burn.

The depth of your child's burn can be categorised as:

• superficial burns (first degree burns) — only the outermost layer of skin has been affected. Superficial burns usually 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 and bones may also be burnt. Your child might need surgery.

Symptoms of burns and scalds depend on how deep the 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

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 severe 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 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 — remove any contaminated clothing 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

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.

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.

Depending on how deep and widespread your child's burn is, they may be treated at home or at the hospital.

Treatment of minor burns at home

If your child's burn is superficial and only covers a small area of their body, they can be treated at home.

First aid is important to stop the burn from getting worse. As soon as possible, cool the burnt area with cool running water for around 20 minutes. This can help for up to 3 hours after the burn.

Do not use ice — it can damage the skin even more.

If you're using a tap or hose, let the water run for a bit first to make sure it's not too hot or too cold. If you don't have access to running water, you can spray the area with cool water or use a clean wet cloth (make sure it stays cool).

While cooling the burn, it's important to keep the rest of the body warm. Small children can become too cold (hypothermia). Cover areas of skin that haven't been burnt and watch for signs of your child getting cold.

Remove any jewellery near the burnt area and cut away any clothing, unless it's stuck to the skin.

If your child's burn is not healing as expected, their doctor may refer them to a wound specialist or burns clinic to assess and treat their burn.

Treatment of serious burns in hospital

If your child's burn is severe or widespread, they may need treatment in hospital, which may include:

• pain relief — especially before wound dressing changes
• wound and blister debridement — the wound will be cleaned and any blisters removed or drained
• wound dressings — wounds will be covered with a special bandage
• surgery — sometimes skin grafts are needed
• intravenous (IV) fluids — extra fluids help recovery from a burn
• nutrition support — your health team may recommend extra nutrients and special foods to help them recover

Your child's treatment depends on how severe their burn is and what parts of their body have been burnt.

A team of many healthcare professionals, including doctors, nurses, dietitians, physiotherapists and occupational therapists will work together to help your child recover.

Your child's recovery and rehabilitation can take many months.

Psychological support can help them cope with their pain and with the impact of being badly injured from a burn or scald.

If your child has a burn, they may develop complications depending on how serious the burn is. Some complications can happen straight away, while others develop later during recovery.

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).

You can help reduce the risk of your child being burnt. If you have a young child at home, there is always a chance of burns — whether in the kitchen, bathroom or even the bedroom. Always supervise young children to help keep them safe.

Read more about preventing burns and scalds in children.

• Learn more about burn injuries amongst children on the Sydney Children's Hospitals Network website.
• Read about burns prevention and first aid on the Royal Children's Hospital website.
• If you have children or look after children, it is 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.