What is the first aid for burns in children? (+ what helps)

Burns in children

Burns are classified as thermal injuries. They are injuries to the skin caused by heat, chemicals, electricity or radiation. Their extent depends on the temperature and time of exposure to the harmful substance.

Manifestations range from redness to irreversible tissue destruction.

When to seek medical attention and when to call emergency services?

In order to be able to properly provide first aid and assess their severity, we will familiarize ourselves with at least the basic issues.

Tip: For more detailed information, see the article on burns.

The most common cause of burns in children is scalding. Children are everywhere and little hands can reach where they shouldn't. A tipped over cup of tea, coffee, kettle or pot on the stove. By the age of 2, they are the cause of 90% of all burns.

From the age of 2-5 years we also see contact burns - irons, cookers, heating elements and low voltage burns, various objects in electrical sockets.

Burns caused by burning - playing with matches, lighting unfamiliar flammable liquids, carelessness when using candles - start to occur from 5-10 years of age. In fires in enclosed spaces, they tend to be associated with inhalation of combustion products.

In older children, burns caused by high-voltage electrical currents, e.g. from playing on disused railway carriages, climbing on overhead wires or high-voltage poles, are on the increase.

Severity of burns

The severity of burns is assessed according to several factors. Children's age has its own specificities. Children's skin is thinner than that of adults, so the heat penetrates more deeply. The immune system of children under 3 years of age is still developing, which also plays a significant role.

It is evaluated:

• the extent of the burned area
• depth of burn
• age
• location of the burned area
• mechanism of injury, other associated injuries, if any
• pre-injury disease

Extent of burns

Adults are evaluated by the rule of nines. Probably most of us have encountered it in our lives. The extent of burns is determined by the percentage of total body surface area. Children have different proportions than adults. As they grow, the percentages change, which is quite difficult to remember.

The easiest thing to learn is that the palm of the affected child's outstretched fingers represents about 1% of the body surface area.

The smaller the child, the percentages also decrease, which can lead to serious complications. In children, no burn is rated as minor. In severe and critical burns, there is a risk of developing burn shock.

The table shows the severity of burns in children

Depth of burn

We distinguish

• Superficial burns of grade I and IIa - Heal without scarring. The skin is damaged but the hair follicles, sweat and sebaceous glands are preserved.
• Deep burns of IIb and III degree - The skin is damaged in all layers, as well as the subcutaneous tissue, muscles and bones. A scar develops. The larger it is, the more severe the burn.

Age

Lower age of the child = lower percentage of burned area leading to severe complications.

Localization of the burned area

Burns to the face, neck, both arms, legs, genitalia and perineum (the area between the genitalia and the anus) are considered severe localization.

Mechanism of injury and associated injuries

In the assessment, we must also take into account how the injury occurred and not underestimate the situation. It happens that the affected child looks well immediately after the injury but suddenly deteriorates rapidly.

This may be due to an alarm (adrenergic) reaction.

For example, an explosion and burning in a confined space is often associated with fatal complications. It is always necessary to think about possible inhalation trauma - upper and lower respiratory tract affected by heat and combustion fumes.

Diseases before the accident

Ongoing and chronic diseases can significantly affect the response to treatment, e.g. in diabetics.

First aid for burns

Almost all of us have been burned at home. A small reddening on a small area without blistering is painful, but not threatening.

For minor burns, we visit a doctor, e.g. a surgical clinic.

For severe burns, we do not wait and call the emergency services. Any such injury should be treated professionally as soon as possible. A child with a severe burn injury belongs in a specialist unit that can provide adequate treatment.

In the first moments after the injury, it is important to give the correct first aid. And how to proceed?

Avoid exposure to heat

When scalded, it is important to remove clothing as soon as possible and cool the affected areas with water.

During a burn, it is important to prevent movement and escape. Place the casualty on the ground, away from flames and smoke. Ensure that the flames do not affect the face and respiratory tract. Wrap the casualty in a wool blanket by rolling him slowly on the ground.

If water is available, pour water on the victim, douse the flames. This will also cool the skin and objects around the victim.

Take off the clothing at the site of the burn. Do not remove the burned fabric. Remember to remove rings and other ornaments.

Call the emergency services

If we are alone, we must call immediately after avoiding contact with the heat. Upon arrival, the crew will provide professional care and then transport for treatment.

Cooling

The aim is to prevent the damage and swelling from deepening. It also provides pain relief, which reduces the body's stress response. A burn that has occurred in a stressful situation prior to the injury is more difficult to treat.

Cool only the less extensive areas, specifically the face, neck, hands, buttocks and genitals, preferably with water at 8 degrees Celsius.

We don't use ice packs. They cause vasoconstriction, which can deepen the affected area.

In children, do not cool more than 5% of the body surface. Do not cool larger areas. There is a risk of serious complications due to hypothermia - cardiac rhythm disturbances and even circulatory arrest.

It also increases the risk of exacerbating shock.

Avoid contamination

Cover the affected areas sterilely with bandages or drapes, or cover larger areas with an ironed sheet. This prevents infection and airflow, which causes intense pain in superficial burns.

For first aid, limit the handling of the affected area. Local treatment belongs in a specialised department.

We do not use ointment, dressings, tight bandages, cellulose cotton wool, acutol or various home recipes.

We do not puncture or cut blisters.

Inhalation trauma

If the child is burning in a confined space and inhaling combustion fumes, we bring the child out to fresh air as soon as possible. If he or she is not breathing, we begin cardiopulmonary resuscitation.

Electrocution

We know the voltage:

• Low
• High

Current:

• DC
• AC

Both of these factors determine the severity of injury and prognosis.

The cause of low-voltage injuries is usually household appliances. Low-voltage alternating current is very dangerous. Immediate death can occur from arrhythmia (heart rhythm disturbance) or from asphyxia in tetanic respiratory muscle shrinkage.

Involuntary movements can occur, leading to falls.

The condition of being unable to disengage from the electrical circuit is accompanied by inability to speak and pain.

Burns are produced at the points of current crossing, penetrating deeply.

They are not always present after electrocution.

Deep burns are often associated with other injuries, e.g. falls from height.

First aid is specific in the beginning:

• Take care of your own safety, watch your stepping - approach with small, shuffling steps.
• interrupt the electric current by switching off, short-circuiting
• break the child's contact with the voltage, if he is part of an electric arc, free him with a non-conductive object, a stick
• if the basic vital signs stop, start cardiopulmonary resuscitation
• local treatment of burns and other injuries, most often fractures

Lightning strike

First aid is almost the same as for electrocution. It is the effect of voltage, heat and pressure waves.

Lichtenberg flowers may appear on the skin. These are tree-like images that form at the site of the strike.

They disappear within 10 days.

Let's take a look at all the summer problems together:
Our health in summer - sun, heat, injuries and illnesses