BURNS

Burns happen with some frequency in children and knowing how to manage them effectively is needed for all parents and caregivers.



If a child’s clothing catches fire, it’s crucial to act swiftly to extinguish the flames and prevent burns. The first step is to instruct the child to stop immediately, drop to the ground, roll on the ground and cover their face with their hands. This classic “Stop, Drop, and Roll” method helps smother the fire by cutting off its oxygen supply. If the child is unable to do this, quickly covering them with a heavy blanket or coat can also help extinguish the flames by depriving them of oxygen. Stop the child from running, as running can fan the flames and make the situation worse.

Once the flames are out, call 911 without delay, even if the fire appears extinguished. After quickly ensuring the scene is safe, cool any burns by running cool (but not cold) water over the affected areas for about 10 minutes. Avoid using ice, as it can cause further damage to the skin. Loosely cover the burns with a sterile cloth or bandage to protect them from infection. Throughout this process, stay calm and provide reassurance to the child while waiting for professional help to arrive.

Burn treatment:

Once the source of the burn is removed and the child is safe, the first step in treating any burn is to assess its severity. Burns can range from a minor first degree burn, which involves only redness and slight irritation of the skin to more severe burns such as second or third degree burns. Each degree of burn requires its own management:

Third-Degree (full thickness) Burn treatment:

1. Stop the Burning Process: Remove the child from the source of the burn immediately. If the child’s clothing is on fire, put it out with a "stop, drop and roll" maneuver or smother it with a blanket or coat. Pour cool water on the burned clothing to cool the clothing and prevent further burns. Remove any hot materials from the site to avoid further injury.
2. Assess severity: Third-degree burns involve all layers of the skin (epidermis, dermis and hypo-dermis) and sometimes the tissues beneath. These burns can appear white, black, or charred and might not be painful initially due to nerve damage.
3. Third degree burns are a medical emergency: Call 911 or go directly to Arkansas Children’s Hospital ER. ACH has an excellent burn center specifically for children.
4. Cover the Burn: While waiting for help to arrive, cover the burn with a sterile, non-stick dressing or a clean cloth. Avoid breaking any blisters or applying topical ointments.
5. Do not immerse in water: Unlike milder burns, third-degree burns should not be immersed in water. Water is used to put out the fire and to get the burned clothing cooler. Then, priority should be given to preventing shock and covering the burn with dry, sterile coverings.
6. Monitor for Shock: Keep the child warm and monitor them for signs of shock, which can include faintness, rapid breathing, or paleness. IV fluids are needed to treat shock.
7. Avoid providing any food or drink to a burn victim in case surgical intervention is required once medical help has arrived. It is dangerous to anesthetize anyone who has recently eaten or had something to drink. 

Second-Degree Burn treatment:

1. Stop the Burning Process: Remove the child from the source of the burn immediately. Put the fire out and remove any hot materials from the site to avoid further injury.
2. Assess severity: Second-degree burns affect both the outer layer of skin (epidermis) and the underlying layer (dermis). Symptoms include severe pain, redness, swelling, and blistering.
3. Cool the Burn: Immediately rinse the affected area under cool (not cold) running water for about 10 minutes. This helps reduce pain and swelling and prevents the burn from worsening. Avoid using ice or ice-cold water, as they can cause further tissue damage.
4. Protect the Burn: Gently pat the area dry with a clean cloth and cover it with a sterile, non-stick dressing or cloth. Avoid applying butter, oils, or ointments, which can trap heat and make the injury worsen or cause infection.
5. Manage Pain: Offer pain relief with over-the-counter medications like Acetaminophen (Tylenol) or Ibuprofen. See our acetaminophen or ibuprofen dosing guide .
6. Seek Medical Attention: Always seek medical evaluation for second-degree burns, particularly if the burn is large or located on sensitive areas such as the face, hands, feet, joints, or genitals.
7. For more minor burns that break the skin, call our office for a same day appointment at 501-224-5437. For more severe burns, go directly to the emergency room at Arkansas Children’s Hospital. 

First-Degree Burn treatment:

1. Stop the Burning Process: Remove the child from the source of the burn immediately. Put the fire out and remove any hot materials from the site to avoid further injury.
2. Assess severity: First-degree burns are the mildest type of burns, affecting only the outer layer of skin (epidermis). They often result in redness, swelling, and pain but typically don’t cause blisters or longterm damage.
3. Cool the Burn: Immediately run cool (not cold) water over the burn for about 10 minutes. This helps to soothe the pain and reduce swelling. If running water isn’t available, you can use a cool, wet compress. Avoid Ice: Do not apply ice directly to the burn as it can cause further tissue damage.
4. Protect the Burn: Gently pat the area dry with a clean cloth and cover it with a sterile, non-adhesive bandage or cloth to protect it.
5. Pain Relief: Mild burns do hurt. Offer over-the-counter pain relievers like Acetaminophen (Tylenol) or Ibuprofen to help manage pain and inflammation. Check the dose of these medications on our Dosing Guide page.
6. Moisturize: Once the burn has cooled, you may apply a soothing lotion or Aloe Vera gel to keep the area moisturized and to relieve discomfort. Avoid using butter or oils.
7. Avoid Popping Blisters: If any blisters do develop (indicating a second degree burn), don’t try to pop them, as this increases the risk of infection.
8. Monitor the Burn: Keep an eye on the burn as it heals. If you notice signs of infection, such as increased redness, swelling, or pus, seek medical attention. First-degree burns usually heal within a week or so and are less likely to require professional medical treatment unless accompanied by concerns such as an infection or extensive skin coverage. Always seek medical advice if you are unsure about the severity of the burn or how to treat it. If the burn results in blisters or the skin is broken, you must ensure that the child’s tetanus vaccination is up to date; if it has been more than five years since the last booster. In that case another tetanus shot will be needed to guard against tetanus. After the initial treatment is done, always be attentive to any changes in the wound that might indicate infection or worsening conditions, like surrounding redness of the skin and pus coming from the wound. If this happens, seek medical attention.