Scalds: A serious home hazard for young children

Allie Johnson

Common household items like a pot of boiling water, a cup of hot coffee or a container of microwave soup all can cause scald burns - a serious hazard in the home.

"People don't realize that scald burns are just as bad as flame burns," says Patsy Porter, president and CEO of the Burn Foundation, a nonprofit that provides burn prevention education and support for burn survivors.

Scald burns are a common occurrence, and they happen when very hot liquid or steam makes contact with the skin and causes a burn. Scald burns represent more than 33 percent of all burns and are most common in children under age 5, according to a 2012 report by the American Burn Association ABA).

Scalds often are caused by items found in a typical house - piping hot milk, bath water or even the steam from a bag of microwave popcorn - and 75 percent of these types of burns happen at home.

Scalds: A serious hazard for children

The severity of a scald burn can depend on several things: how hot the substance is, how large an area of the skin it touches and how long it stays in contact with the skin, experts say.

For example, liquid at 140 degrees Fahrenheit - which is not as hot as the 160- to180-degree temperature at which tea and coffee often are served - can cause a serious burn in five seconds, according to the ABA. Bath water at 120 degrees Fahrenheit could take five minutes of continuous exposure to cause a very severe burn.

Children and the elderly are at higher risk for scald burns because they have thinner skin, says Susan Cannon, nurse manager of the burn unit at St. Christopher's Hospital for Children, in Philadelphia.

Treatment for scald burns could include medication and hospitalization and typically would be covered by health insurance.

A patient with a less serious injury might have the burn treated with a sterile dressing and then be sent home, Cannon says. But, she says, the average scald burn on a toddler, with at least 10 percent of the body affected, could require three to five days of hospitalization. Treatment could include IV fluids and, in some cases, a skin graft. And a patient with a severe scald burn could spend months in the hospital.

However, the average scald burn case that requires hospitalization in a pediatric burn unit costs $22,700, according to Safe Kids USA.

7 tips on preventing scalds in the home

Experts say vigilance is essential to prevent scald burns. Here are tips for keeping your family safe from these injuries:

  1. Check the setting on your hot water heater. Experts recommend you set the temperature on your hot water heater at a maximum of 120 degrees Fahrenheit. If you rent your home and don't control the setting yourself, talk to your landlord, Porter recommends. Tap water causes one out of four scald burns, according to Safe Kids USA.
  1. Don't heat a baby bottle of milk in the microwave. "It gets too hot and might explode while you're feeding the baby and burn their chest," Porter says.
  1. Parents, drink your own hot liquids out of covered travel mugs. It's easy for kids to pull a mug off a table or counter and get burned. "If you have a kid, use a lid," Porter says.
  1. Don't put hot beverages in the cup holder on a stroller. "Every stroller in America has a place for a cup of hot coffee," Porter says, noting that she often sees parents with a Starbucks in the cup holder. "It doesn't take much for you to bump into something and that coffee gets spilled on the child."
  1. Keep children away from hot pots and pans. If you have children at home, remember to use the back burners on your stove and turn handles toward the back. Parents should consider taping off a three-foot space around the stove and teaching kids to stay out of it, Porter says.
  1. Be careful with microwaveable foods. Microwave soups are a common cause of scald burns in kids, Cannon says. They get extremely hot and can accidentally get dumped on the child - and the grease on microwave noodles can make the burn worse, Porter says. Even the steam from a bag of microwave popcorn can cause a scald burn, she says.
  1. Check bath water temperature. Very hot bath water is a common cause of scald burns in newborn babies and the elderly, experts say. In some cases, the elderly might lose sensitivity to temperature extremes, especially if they're diabetic, and might not know the water is burning them, Porter says. Caregivers can use their own elbow or a thermometer to check the water temperature, Porter says.

If a scald burn does occur, caretakers sometimes make mistakes that can make things worse - such as putting ice, toothpaste or butter on the burn. "Never put any product on a burn," Cannon says. Another mistake, she says, is waiting too long to seek care, or assuming lack of pain is a good sign. "The deeper the burn, the less it hurts," Cannon says, noting that third-degree burns can damage nerve endings.

How to treat a scald

Here are three steps you should take if a scald burn occurs, according to Cannon:

  1. Run lukewarm or cool - but not cold - water on the burn to cool the skin. Do not put any other substance on the burn.
  1. Wrap the affected area in clean white cotton material, such as a sheet, if you can.
  1. Seek care right away, even if you need to go to an emergency room.

"Some people think, ‘This isn't that bad - I'll call the pediatrician in the morning,'" Cannon says. But if you fail to get treatment right away, infection could set in, making the burn harder to treat.

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