Keeping Kids Safe: A Guide to Burn Prevention

Parental vigilance is the best way to keep children safe from burns, a common injury for kids. Possible burns are not limited to injuries from fireplaces, camp fires or fireworks. Risks include chemicals, electric cords, hot foods and hot water from the tap. Allan Pang, M.D., is a Texas Tech Physicians surgeon who specializes in burn, wound, trauma and critical care, and has been on this podcast before with great advice. He answers our questions about what we can do to prevent children from getting burns and what to do in case a child sustains a burn. 

Transcript

Melissa Whitfield  0:10 
Hello and welcome back to Texas Tech Health Check from Texas Tech University Health Sciences Center. I'm your host, Melissa Whitfield. We want you to get healthy and stay healthy with help from evidence based advice from our physicians, health care providers and researchers. Burns are a common injury among children, but it doesn't have to be that way. Parents and caregivers just need to always be mindful of potential hazards around the kiddos. Burns don't just happen around fireplaces, fireworks or campfires. Dr Alan Pang, Texas Tech Physicians, surgeon who specializes in burn wound, trauma and critical care, is back for this episode with advice on how we can protect our children from burns, which includes injuries from hot food or hot water during a bath. Chemicals, common households small appliances, electric cords and other potential dangers. Most importantly, Dr Pang recommends seeking immediate medical attention for your child in case they have been burned you

Melissa Whitfield  1:28 
Dr Pang, welcome back to our podcast.

Dr. Alan Pang  1:30 
Thank you for having again.

Melissa Whitfield  1:31 
How are you?

Dr. Alan Pang  1:32 
I'm well, how are you?

Melissa Whitfield  1:33 
I'm doing fine. Thank you so much. Can you remind our listeners a little bit about yourself and just tell us what you do here at the Health Sciences Center.

Dr. Alan Pang  1:41 
Yeah. So I'm one of the assistant professors in the department of surgery in the division of trauma, critical care and burns. I practice as a burn surgeon in my day to day.

Melissa Whitfield  1:52 
And today you're here to talk to us about children's burns. And as I said earlier, when we were talking, I don't think about children's burns because I don't have any little ones at home. Usually, I just think about Fourth of July or when we're cooking. But there are all sorts of situations where kids could get burns. Can you go over some of the most common types of burns and causes that you've seen in children, and are they mostly the little little ones or the older children?

Dr. Alan Pang  2:19 
Yeah, of course. You know, I'm very fortunate to have a two year old at home. You know, I love my little Grace, but they are often mostly the smaller children. You know that curiosity really gets the best of them sometimes. And it's really a lot of things that we as adults kind of take for granted that are the things that can hurt children. The most common type of burn for children is a scald burn. So whether that's in the kitchen, when we're cooking, there's always hot water or hot food, as you know, or even in the bathtub, you know, we always strive to have that correct water temperature, but there's just so much that can go wrong with that, whether it's an accident turn of the knob or perhaps our water heater is set too hot. But aside from those common burns, there are so many dangers around every household, just things like chemicals, which we all have in our sink under for our cleaners and stuff. Those chemicals can cause some terrible burns, and kids are kind of prone to seeing what it tastes like, and that's also dangerous things like electrical injuries, especially during Christmas time. But really, any time we have cords hanging out, small children are actually known to chew on those cords and can get electrical burns of their mouth. So these are all kind of these common things that we all have in our houses that can really hurt our kids.

Melissa Whitfield  3:37 
One of the areas you mentioned was in the kitchen, and we might be concerned with them touching a hot pan or having some hot water spilled on them, but there are other hazards, and not just to the skin. Can you explain how steam, which can also be found in irons and cleaners, like you mentioned, vaporizers and pots? How can those cause burns as well?

Dr. Alan Pang  3:56 
Yeah, I think that's a really good point, obviously. Like you said, you know, we have hot water and things that can pour on our children and that can, you know, scald them. But some things to think about are, you know, foods are hot, right? If you have a big pot of, you know, beans and rice and you spill, not kidding, and sit on their skin and burn them even worse, and those can be deeper burns. Specifically, what you're talking about with steam. The steam is obviously water that's so hot that's become vapor, and so it's a very high temperature, we often don't expect it, and it can burn our skin and cause second and third degree burns as well, especially if there's an extended exposure. And like you mentioned, very aptly, steam has not just been cooking. You know, we have all these things around the house, like irons and steam cleaners and things like that that can also expose our kids to steam, so can be very dangerous, can cause very bad burns.

Melissa Whitfield  4:44 
What are some other overlooked household hazards that can cause burns in children, such as, as you had mentioned earlier, electrical and food and chemical?

Dr. Alan Pang  4:53 
Yeah, I mean electrical, I think, is a big one. Classically in our textbooks, we learn about kids chewing on those Christmas lights, because everyone has Christmas lights up, and it's an added risk. But really can happen at any time there's cords. A child that's kind of at that level of height and sees a cord they want to chew on, they just have to get through that plastic or that rubber, and then they can actually cause some really bad electrical injury to the corner of their mouth is classically where that is. You know, electrical injuries are very different, because it causes a process called electroporation, which I won't bore you with the details, but it can cause a continued injury for days, if not weeks, at a time. So important to avoid that. The other thing we have, like I mentioned before, all those cleaning chemicals, some of them are acids, some of them are alkali. The alkali ones are actually much worse. The acid ones cause a burn that probably will cause surgery to be needed, but usually they just stop injuring the skin once they make contact. But the alkali ones, things like Drano, can cause continued injury and the tissues below the contact point, which is why they're dangerous. And you know, it's important for me to mention that if kids drink any of these things, that's just a disaster. And if they're playing with it, usually they're going to drink some.

Melissa Whitfield  4:53 
Our weather here, although today is a very windy day, it is that we have a lot of sunshine today. Can you talk to us a little bit about outdoor burns and how how hot is too hot for a child when it comes to playground equipment and the car seat and also sunburns?

Dr. Alan Pang  6:27 
Yeah? I mean, you're absolutely right. It's very hot here in the summer, especially, and even lately, and so really, you know, it's just like with your water heater. You know, they always suggest, we always suggest, to set the water heater at 120 degrees Fahrenheit or lower, because that temperature can burn children's skin quite quickly. And you can imagine that, you know, sometimes we see on the television that it's so hot that you can cook an egg on the sidewalk or even on the slide at the park like that's much hotter than 120 degrees, right? So it's always important, you know, as a parent, to go touch those things, make sure they're safe to play on. You know, I always do the foot test, you know, if I'm going on a walk and there's concrete outside and it's hot and, you know, obviously kids should be wearing shoes, but I always touch my foot to the pavement to make sure it's not going to burn, you know, my kid. So just kind of being cognizant of how hot it is outside, you know, watching your kids closely and making sure that, you know, if they fall down, you pick them up. You know, they're not making extended contact with hot metals or hot concrete. It's really just keeping a close eye. You know, really, even though it can burn them quite quickly, it really does take a little time for a really bad injury to occur. So I think if we stay vigilant as parents, we can do a lot in preventing those injuries. Now, if it's just 120 degrees out, should probably not just go outside.

Melissa Whitfield  7:50 
That's good advice always. So how are burn injuries and children different from those in adults?

Dr. Alan Pang  7:57 
You know, children are not really like small adults, but in the case of skin, it kind of is, right? Our skin takes time to mature. So our skin is thinner at two points in our life, from the ages of zero to two, our skin is still getting thicker, still getting stronger, easier to burn thinner skin, right? Same thing on the other side of our lifetime, above the age of 60 to 65 our skin becomes about the same thickness as when we're children. So really those two age ranges, our skin is thinner. It takes much less to hurt our skin. We've seen sunburns that become second degree burns in fair skinned children. So there certainly are those increased risks, because when we're kids, our skin is just unfortunately, thinner and more fragile.

Melissa Whitfield  8:43 
What should parents keep on hand to treat their children's burns?

Dr. Alan Pang  8:47 
So whenever we have a burn in our children, you know, we value our children so much. You know, I would just always suggest going to the to the physician, you know, going to urgent care, getting it checked out in terms of what you could carry, there's really nothing in terms of ointments or medications that could kind of sway a burn one way or the other in the long run, what's most important is to see that provider and getting get it assessed, ideally at a burn center like we have here in Lubbock. But you know, important ways kind of to treat it in the moment when it's happened. If you have some cool water and a small burn, you can run some cool water over and making sure not to get your child to hypothermic. You don't want them too cold. But it would be nice to remove the source of heat. So if they spill hot water, boiling water, on their on their clothes, take the clothes off if it's not too large of a body surface area, if it's just one area, like a forearm or your upper arm, or a little part of the torso, where you can target some colder water, run it under some cold water to cool down a little, but otherwise just a clean dressing, and then come to the urgent care or come to the burn center. Let us take a look, and we'll make sure to take care of you.

Melissa Whitfield  9:55 
What if parents either don't know their child has a burn or just kind of brush it off. How do parents know that the burn has become infected, and what happens if it remains untreated?

Dr. Alan Pang  10:05 
Yeah, so infections, usually you'll see some purulence or some pus. You'll see some changes to the skin. It'll get soupy or grimy. Sometimes there's like a yellow kind of grime to it. Usually it takes a couple days in the least of an untreated burn to have that happen, some more signs of severe infection would be if we have fevers and chills and we can't keep water or food down, we're vomiting, or if we're peeing less, it means that we're not perfusing our organs well enough. By that point, we're pretty far down the road. So in that case, it's a medical emergency, I would encourage you to come straight to the hospital. But those those changes on the skin, things like pus and grimines and that yellow sheen, can all mean infection. So those are the things to keep an eye out on. Immediate medical therapy is always the best thing for burns, some of the bad outcomes that could happen and the setting of an infection, there's always the chance that you get admitted to the hospital and get really sick from burns if they're infected, and that would be unfortunate, but kind of long term, even if you heal from the burns, you can have some long term outcomes, such as contractures, that's where you have such tight scar tissue that you can't use certain joints that you use, like elbows or wrists, you can't extend or flex as much as you used to, and that really is based on how long it takes for your wound to heal, or if you get an infection and then it heals, that can make that worse. Other long term outcomes are disfigurement. You know, scars can be unsightly. You know, otherwise scarring, hypertrophic scarring, specifically, can also be very painful or itchy and discolored. And you know, for for a child, you know that's the rest of your life, growing up with some kind of visual disfigurement can be very damaging to their self esteem, aside from all of the physical impairments that you can also suffer from.

Melissa Whitfield  11:59 
Is there anything else that you would like to add?

Dr. Alan Pang  12:03 
Yeah. I mean, I think parental supervision is always the most important thing. If we all stay vigilant and keep an eye on our kids, a lot of these things can be prevented when we're cooking. Make sure we know where our kids are. Make sure they understand that stoves are hot and hot water is not to be messed with. You know, watching our kids in the bath some of the most common stories we hear, we turned around for a second, and this is what happened. Can be truly devastating, and people's lives can change in a moment. They may seem trivial, but it really I cannot emphasize how important it is for us as parents to keep a very close eye on our children. Otherwise, just making sure, things like having those plug caps for the for your plugs, to make sure kids can't stick their finger in there, making sure our cords are stored well, making sure our chemicals are locked away. Those are the important things that can help prevent a kid from playing with things that they're not supposed to be playing with.

Melissa Whitfield  13:02 
Well, this is all great advice. Thank you very much, Dr Pang for coming back on our podcast and talking to us about this.

Dr. Alan Pang  13:07 
Thank you for having me. I'm always happy to be here.

Melissa Whitfield  13:09 
Can't wait to have you back. Thank you.

Melissa Whitfield  13:13 
Thanks for listening to Texas Tech Health Check. Make sure to subscribe or follow wherever you listen to podcasts. This information is not intended to be a substitute for professional medical advice. Always seek immediate medical advice from your physician or your health care provider for questions regarding your health or medical condition. Texas Tech Health Check is brought to you by Texas Tech University Health Sciences Center and produced by TR Castillo, Suzanna Cisneros, Mark Hendricks, Kay Williams and me, Melissa Whitfield.