Preventing burn injuries to children

Dr Toity Deave, associate professor for family and child health from the Centre for Child and Adolescent Health at the University of the West of England, Bristol, gives an insight into ongoing efforts to reduce burn injuries to young children.

hot_drink“I never realised that it would be as bad as that. If only I had known.”

How many times have parents said that to emergency department staff, to burns specialists or to their health visitors?

In the UK, we drink so much tea and coffee but are generally unaware that a hot drink can scald a child even up to 15 minutes after it has been made. Therefore, if a child pulls it down over itself, the liquid will spread over the trunk, shoulders and arms. Because their skin is 14 times thinner than ours as adults, they will be scalded much more quickly than us and will have an extensive injury. As someone with a health visiting background, I can’t help but want to do something to raise awareness.

How many more children need to be injured before there is a national hot drinks awareness week with, for example, coffee shops doing their bit to educate their customers and ensure that they support the “hot drinks pledge”?baby_hands

Prevention is key, but adequate and appropriate first aid prevents further tissue damage and subsequent morbidity. It is amazing to learn that running under cool water for 20 minutes (yes, 20 minutes; believe me, that feels like a long time!), even up to 1-3 hours post-injury, will help the healing and reduce scarring.

“Cool, call and cover” is the message. Cool under running water for 20 minutes, call for help (111, 999), cover the cooled burn with cling film or clean, non-fluffy cloth.

We want to advise parents, childcare staff and others about the dangers of hot drinks but there have been national media campaigns, small scale, local endeavours but with short-term, if any, impact.

Why is this the case?

It is probably a mixture of factors including the fact that we often have hot drinks in a social setting so we don’t pay so much attention to our children, supervise them less and give less consideration to where we place our mugs. There is our lack of awareness about how even a cuppa at a temperature that we are happy to drink can still scald a young child. Those mugs with lids are expensive to those on a limited budget and, in reality, can you imagine serving up tea at home in one of those to all your friends?

Those of us in the Children’s Burns Research Centre are looking at ways to raise awareness and reduce scald and burn injuries.

We have just completed the Keeping Children Safe at Home (KCS) programme of work and submitted a 900+page report to the National Institute for Health Research (NIHR)! This was a huge programme of 16 separate studies that we undertook over a five-year period in four study centres based in Nottingham, Bristol, Norwich and Newcastle (universities and trusts), led by Denise Kendrick of the University of Nottingham. The University of Leicester and the Child Accident Prevention Trust were also involved.

For one of the later studies within this programme, we used a structured process of combining evidence with practical service delivery and we developed an Injury Prevention Briefing (IPB) to reduce fire-related injuries – a guidance document for children’s centre staff to use with families.

Why fire-related injuries? They have the steepest of all child injuries in the UK and there is evidence about effective interventions, such as working smoke detectors. We tested it out in children’s centres and, as part of this study, we asked children’s centre staff about parent responsiveness to the advice and discussions, barriers and facilitators to implementation and for suggestions for improvements to the IPB.

Consequent to that, we have developed a second IPB that’s used research results from other studies within the KCS programme (case-control studies, decision modelling, cost effectiveness and literature reviews) and advice from four workshops with practitioners in Nottingham, Newcastle, Norwich and Bristol. It includes key messages and research findings together with information snippets, links with child development checklists, quizzes, handouts and sources of further information and resources for falls, burns/scalds and poisoning injuries. It is aimed at a range of practitioners who can use it in their work supporting families with young children in a variety of different contexts. It is freely available as an interactive pdf.

• The blog was written to mark the Department of Health’s Week of Action last November, which focused on health professionals working with the families of children and young people aged 0-19.

Also in support of the Week of Action, a blog by Sheila Merrill, RoSPA’s public health adviser, is available to read on the blog site of Viv Bennett, the Department of Health’s director of nursing.

One Comment to “Preventing burn injuries to children”

  1. When I had my first child at the age of 21, we were advised by health visitors to fill the bath with cold water first and then put in the hot as this would ensure that the water would not be too hot. it is always better to put a baby into water too cold and comfort her and warm her up than burn her and not be able to comfort her.

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