Burn First Aid / Premiers soins pour les brûlures

The most common type of burn that we see in the pediatric population are the scald burns. Sixty to seventy percent of our kids are scalded by some kind of hot liquid at home. Soup, coffee, tea, most commonly at home, but can be at parties and restaurants, and it happens usually in the blink of an eye. And parents think that they should just keep the clothes on because they think that if they remove the clothes they might actually take off the skin with the clothes. The unfortunate situation is that– If it stays in the socks or the diaper, or whatever is against the skin, it will deepen the injury because it holds the heat, so the clothing needs to be removed. That’s very simple to do. And then the next thing is that the burn needs to be cooled. And the cooling happens over a period of twenty minutes, and either room temperature or a little bit cooler than room temperature water– not cold and no ice whatsoever, as ice can actually make the burn deeper as well. And if you don’t have running cool water you can also just use cool towels and keep the burn covered for twenty minutes. So the point of applying cool water for the 20 minutes after your child is sustains any kind of burn injury is to stop the burning process. So by doing this you can actually affect the outcome of this burn. We’ve had children that come to the hospital and minimal first aid is done, and this burn actually may change in the first couple days and become a very deep second-degree or a third-degree full-thickness burn. In some instances we can improve the outcome of this burn, by applying appropriate first aid such as cool water. And it’s symptomatic. If you’ve ever burned yourself and you put it under cool water, it will immediately lessen the pain, and it helps stop the burning. So the result of that simple, preventative measure will sometimes allow a burn that may have been very deep to actually not be so deep, and it might heal a little bit sooner. So it’s simple, and it can be done in most homes. Children are very mischievous, they’re curious, and they want to get into everything, and it’s really important that we do not leave children unattended around hot beverages, cooking, around campfires, around hot fireplaces. So it’s really important to be monitoring your children in these situations. When you’re cooking it’s really important to turn those pot handles away so the children cannot reach them. As children are reaching certain milestones, they can reach that counter, they can reach for that cup of hot coffee or hot tea, and when they see that steam it’s very exciting to them and they want to see what’s going on. So it’s really important to– if you do drink hot water, hot tea, hot coffee, to also keep this in some kind of container where you can put a lid on that’s tight, and this will prevent you children from being scalded. So when we talk about burns and we talk about burn first aid, we go on the assumption that the burns are superficial enough, meaning they haven’t burned deep enough into the skin, that they’re small enough that we can control the pain of the children, that they’re in an area that’s easy for them to dress and for the parents to still handle that child, and as long as all of those things are in place, probably they don’t need to go running off to the hospital or emergency room at one o’clock in the morning, and it could be seen over the next twenty-four or forty-eight hours. But burn injuries are difficult to tell at the time of the injury how deep they are, And our recommendation usually is that at some point over the first seventy-two hours that they’re actually seen by someone who’s a little bit more knowledgeable, and has experience with burn injuries.

1 comment

  1. At last – the correct advice being provided on YouTube for burn management. With a little bit of luck and perseverance we may yet see a standard model of burn 1st aid eventuate. At the moment its a mess. Did you guys realize for example, the American Burn Association, the CDC and the American Heart Association 1st Aid Guidelines all suggest different time frames for cooling? – ABA 5mins for "minor" burns, CDC 10-15mins with wet compresses/immersion and 10 minutes from the AHA. So where did kidshealth get their info?.

    For those interested the 2o minute cooling duration is the only duration supported in clinical studies. 2 from 2009/2010 Yuan and Cuttle, and these were confirmed by 2 cohort studies – Wood 2016 and Harish in 2018. The RCT by Choi 2016 also compared running water cooling vs hydrogels and spray cooling. Guess which one came out on top??

    For those interested just a couple below.

    Cuttle L, Kempf M, Liu P-Y, Kravchuk O & Kimble RM. The optimal duration and delay of first aid treatments for deep partial thickness burn injuries. Burns. 2010;36;673-679.
    Harish V, Tiwari N, Fisher OM, Li Z, Maitz PKM. First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients. Burns. 2018; Oct 15. pii: S0305-4179(18)30846-5.

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