Kitchens, candles - even frostbite - can send kids to the Burn Unit
More than 100 burn patients admitted each year, 700 more treated in ambulatory setting
This time of year, in addition to the most common causes of serious burns such as hot liquids, fireplaces and candles, there’s another risk that potentially could send a youngster to the Children’s Mercy Burn Unit: frostbite.
To a burn surgeon like Pablo Aguayo, MD, Associate Director-Trauma, Critical Care and Burns, the injury caused by severe frostbite is similar to that of a burn caused by scalding, flame or steam.
“The pathophysiology of frostbite is the same as a burn,” Dr. Aguayo said. “There is a classification system for frostbite just as there is for burns; it depends on the depth of the injury, determined by how cold the skin gets and the length of exposure, exactly the same as we do with regular burns where it depends on how long you we in contact with the hot liquid or object, and how hot it was.”
Dr. Aguayo explained that frostbite forms microscopic ice crystals that slowly kill cells by puncturing them and causing them to dehydrate. And just like burns, frostbite causes blisters; however, blisters caused by frostbite are much deeper on areas like the soles of the feet and therefore less obvious at first. If the frostbite injury is serious enough, skin grafting may be required.
“Frostbite injuries usually occur on the hands and feet, although after prolonged exposure it can happen on the nose and ears,” Dr. Aguayo said. “One of the big contributors is when clothes get wet from snow while sledding or other outdoor activity. Parents should check hands and feet to make sure they stay warm and dry.”
While frostbite cases are rare at the Children's Mercy Burn Unit — the region’s only burn unit devoted exclusively to pediatrics — parents should be aware of the risk.
The Burn Unit admits more than 100 patients each year and treats more than 700 patients in the ambulatory setting. Scalds from hot water, other liquids and steam are the most common burn injuries at Children's Mercy.
“People generally are knowledgeable about fire safety, but for whatever reason in their normal environment they can become somewhat careless and maybe complacent. We hear it all the time from people who say, 'I just turned away for a second and this happened.’”
Hot water will burn skin at temperatures much lower than the boiling point of 212 degrees Fahrenheit (two seconds of exposure to hot water at 148 F can cause burns serious enough to require surgery; the average specialty or retail coffee is served between 160-180 F.) Hot water heaters should be set no higher than 120 F.
“Throughout the year, especially in the winter when kids are inside and hanging out in the kitchen, the most common burn injuries are due to scalds,” Dr. Aguayo said.
One study found that 90 percent of two-year-olds can open a microwave oven door and remove hot contents. Ramen noodles—quick, easy and prepared at scalding temperatures—are frequently the culprit, sticking to the skin and potentially burning even deeper than liquids. The best solution is to establish a “no kid zone” in the kitchen around microwaves, stoves and ovens.
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“Winter is also the time we see hand, finger, palm and sometimes even forehead burns when kids come in contact with the glass plates covering fireplaces,” Dr. Aguayo said. “When little ones are learning to walk they hold on to surrounding objects, and those glass plates happen to be one of them. Even if it’s just a pilot light, that cover glass can get very hot.”
Candles are another hazard for children and in general: on average there are 29 home fires caused by candles reported daily, and of those, four will be large enough to burn down entire houses.
Most burns are preventable, but in the routine of daily life precautions can be neglected.
“People generally are knowledgeable about fire safety, but for whatever reason in their normal environment they can become somewhat careless and maybe complacent,” Dr. Aguayo said. “Everyone knows not to boil water around kids, but what parents need to be aware of is that accidents can occur quickly. We hear it all the time from people who say, 'I just turned away for a second and this happened.’ The key is to be cognizant of your surroundings and the potential dangers.”