Among burns in children under 5 years of age, the leading ones are burns with hot liquid (up to 80%).

Naturally, the smaller the affected area, the safer the injury (with the exception of electrical burns).

First aid for children with thermal burns

Thermal burns (hot liquid, flame, steam, hot (hot) object, etc.) are the most common type of burns.

Types of thermal burns by severity:

• first degree, when redness and swelling of the skin are observed. Such burns often occur from sunlight;
• second degree, when along with swelling bubbles (blisters) filled with clear liquid appear;
• third degree, when the blisters burst and the subcutaneous tissues are affected;
• fourth degree, when not only layers of skin, but also muscles and even bones die (char)

In case of a thermal burn you must:

• stop contact with the source of damage (leave the high temperature zone, extinguish the fire, turn off hot water, etc.);
• if the baby is doused with hot liquid, remove his wet hot clothes as quickly as possible;
• if clothes are stuck to the baby’s body, do not tear them off so as not to further injure the skin;
• hold the burned area for several minutes under a weak stream of cold water or immerse it in cold water;
• You can apply ice packs to the affected area or blow cold air on it, then apply a towel soaked in cold water to this area;
• For 1st-2nd degree burns on a small area of ​​the body (smaller than the size of the baby’s palm), parents often do not consult a doctor. The main thing is not to injure the affected areas of the body. If the burn site hurts (particularly sensitive areas of the body are affected: groin, palms, feet...), then a visit to the doctor is required.

In case of deep or extensive burns, call a doctor immediately!

You can apply a dry sterile bandage to the wound made from a special dressing material, the fabric of which does not stick to the wound. If there is no such dressing material, then it is generally better not to apply bandages to the affected areas of the body, where, for example, blisters have broken out, until the doctor arrives.

What not to do on your own:

• tear off clothing stuck to the wound;
• puncture blisters;
• lubricate the wound (if blisters have burst) with oils, creams, ointments, etc.

Contrary to the belief that a serious burn can only be caused by contact with a very hot liquid, we present the following data: a 2-3 degree burn occurs when exposed to water heated to 50 °C on the skin of an adult for 5-10 minutes; the skin of a baby, certainly much more gentle, so draw your own conclusions!

First aid for children with chemical burns

Chemical burns are damage and destruction of the skin and body tissues by various chemicals. In real life, such burns occur much less frequently than thermal burns. Their severity is determined in almost the same way as thermal ones. The only difference is that with chemical burns, blisters are much less common; instead, the affected area is usually covered with a scab - a crust formed after the wounds dry out. Concentrated acids and alkalis pose the greatest danger to humans.

If any chemicals (even from household chemicals) come into contact with the baby's skin:

• Immediately remove any clothing from your baby that may have been exposed to chemicals;
• rinse the active substance from the skin as best as possible with a stream of cold running water for several minutes (up to 20 minutes);
• after washing the burned area of ​​the body, it is necessary (if possible) to neutralize the effect of the chemical;
• In case of an acid burn, wash the damaged area of ​​the body with soapy water;
• further first aid actions are approximately the same as for a thermal burn.

If a dangerous chemical gets into your eyes or is swallowed, then immediately call an ambulance in addition to quickly and abundantly washing your eyes and stomach!

Note that the destructive effect of the chemical on the skin and tissues of the child can continue even after direct contact with it ceases due to its penetration (“absorption”) into the burned area of ​​the body. Therefore, the true depth of a chemical burn is revealed only after a few days.

If the area of ​​skin damage is comparable to the baby’s palm, then immediately call an ambulance! Be sure to give the doctor a sample of the chemical that burned your child.

First aid for children with electrical burns

Electrical burns occur when electrical current passes through the skin and into the tissue.

Electrical burns appear in two places: at the point of contact of the body with the current source and at the point where the current exits the body (for example, on the arm and leg at the same time). These burns may look quite harmless on the surface (small reddened and swollen areas of the skin), but in fact they can be very deep and dangerous.

Strong electric shocks are fraught not only with burns, but also with electric shock (loss of consciousness, respiratory arrest and palpitations).

If your baby holds onto a faulty wire or device:

• the first thing to do is to immediately turn off the current (for example, unscrew the plugs or turn off the toggle switch of the apartment or house circuit breaker);
• if for some reason this is not possible, stand on any insulating material and remove the current source from the baby, also with any non-conducting object (stick, mop, etc.).

After the child is isolated from the power source, it is necessary:

• if he is unconscious and not breathing, immediately perform resuscitation;
• if conscious, calm the baby down, and treat the resulting burns in the same way as with an ordinary severe thermal burn;
• if the burn area is small (2-3 cm2), you can do it on your own by cooling the skin or rinsing it abundantly with cold water and applying a dry bandage from a sterile bandage. However, be sure to consult a doctor.

In case of a strong electric shock, especially if it caused an electric shock, urgently call a doctor or take the child to the hospital and provide the child with first aid, depending on the symptoms (presence of consciousness, breathing and heartbeat).

If a blister forms after a burn, do not pierce it under any circumstances. For the same reason, it is better to refrain from treating burns with urine, although this simple method is widely used in folk medicine.

First aid for children with sunburn

Sunburns are reddened and inflamed areas of the skin and most often appear in areas that were not covered by clothing.

Among other types of burns, sunburns are considered the mildest; the damage affects only the superficial layers of the skin. True, anyone who has experienced this at least once will not want to experience it again. What might it be like for your little one? |Remember that it is better for children under one year of age not to be in the open sun at all, especially from 11:00 to 16:00. Just 15-20 minutes - and the baby may end up with a burn! Even in the shade, especially near bodies of water, a person is exposed to up to 40% of the sun's ultraviolet rays.

If your baby is burned (overheated) in the sun:

• urgently move it to the shade;
• If you have anti-burn spray on hand, spray it on the affected areas. If blisters appear, remember not to poke them!

Traditional medicine can help heal sun-damaged skin areas: kefir, sour cream, milk, egg white. Before using them, be sure to consult your doctor!

Violation of the integrity of soft tissues, both in a child and an adult, is not always associated with the mechanical impact of surrounding objects, falls or other injuries. High temperature, affecting the skin and mucous membranes of the human body, also leads to thermal injury. A burn in a child is a fairly common situation in which damage occurs to the soft tissues of the surface of the body (less often the external parts of the internal organs) due to direct contact with a source of high temperature or receiving thermal radiation from it.

There are a great many possible examples of when a child gets burned. Often these are situations in everyday life or the pranks of teenagers. It is only worth noting that, as statistics show, the causes of severe and extensive burns in children under 2 years of age are the carelessness of parents. The danger of this condition is not only pain, but also the possible development of burn shock, when the area of ​​the burn and its depth are significant.

Incorrectly provided first aid by parents and further self-medication lead to infection and prolonged healing of areas of damage to the skin and mucous membranes as a result of thermal effects, as well as to the formation of disfiguring scars.

The mechanism of a burn is extremely simple. Exposure to temperatures sufficient to cause protein denaturation (irreversible loss of its normal chemical structure) leads to cell death and the release of biologically active substances into the interstitial fluid. This contributes to the development of inflammation and the appearance of symptoms accompanying the burn.

Disturbances in the normal barrier function of the skin lead to excessive release of interstitial fluid, soft tissue swelling, blistering and a dangerous decrease in circulating blood volume, especially pronounced in young children.

The following common situations cause burns:

Signs and symptoms of thermal skin damage

Symptoms of local damage during a thermal burn depend on the degree of soft tissue damage:

• In the first degree, there is redness and swelling of the skin at the site of contact with a source of elevated temperature. The skin feels hotter to the touch than the surrounding areas, is tense and painful.
• A 2nd degree burn in a child appears as red skin with blisters of varying sizes. Pain in the second degree of thermal injury is severe and is often associated with a feeling of fluid tension in the cavity of the blisters.
• The 3rd degree is characterized by necrosis of soft tissues, not extending in depth beyond the thickness of the skin. Around the necrosis, swelling and hyperemia of the skin is formed, which is manifested by pain and other inflammatory signs.
• At grade 4, soft tissue damage is observed, up to charring reaching the muscles and bones.

Quite often, extensive body burns combine areas of thermal damage that vary in depth. It is important to consider that in addition to the severity, the clinical course and prognosis of the general condition require determining the area of ​​the burn.

For this, various methods are used, both according to schemes and using the patient’s palm, taking its size as 1% of the total surface area of ​​the body.

Thermal burns in children carry a number of dangers associated with both the severity of the course and complications, which are especially likely if treated incorrectly:

1. Deterioration of general health, development of shock with a large area of ​​damage to the body, even with 1-2 degree burns.
2. Prolonged pain that worsens with any skin irritation (thermal, tactile, etc.).
3. Development of infection of soft tissues, up to the development of burn sepsis. Such wounds take quite a long time to heal on their own and require additional therapeutic measures to clean the wound surface and accelerate its healing.
4. The need for skin grafting and plastic surgery for extensive skin defects so that the wound can regenerate. This will also reduce possible cosmetic skin defects.
5. Stenosis of the esophagus due to a thermal burn of the tongue and the subsequent need for plastic surgery of this organ through a complex operation.
6. Charring of the limbs in the 4th degree requires significant excision of soft tissue to the level of healthy ones, as well as amputation of the limbs.

It is also important to understand the risk of a 3rd degree burn in a child even after treatment. A cosmetic defect that has formed at the site of damage causes not only aesthetic discomfort, but can also lead to a feeling of skin tightness, pain and the development of keloid scars. Treatment of burns in children at home is permissible only for 1st or 2nd degree and a small burn area (1-2%). In other cases, consulting a doctor is simply necessary. There is no need to use any burn cream for children, since not only local treatment is necessary, but also often infusion therapy to maintain circulating blood volume, as well as reduce the toxic load on the body.

“The principle is just to anoint the burn area and everything will go away on its own” in such situations is an unjustified tactic, even dangerous. The child’s good health in the first hours after thermal injury is not indicative of the further prognosis of treatment. Moreover, this is not a reason for self-medication or experimentation. Seeing a doctor and treating your child under his supervision is mandatory!

The application of various fats, oils, and dairy products, which is often practiced by parents, will only lead to softening of the skin and the formation of cracks (or the opening of blisters on its own), as well as the creation of favorable conditions for the proliferation of pathogenic microflora and subsequent infection.

Treatment and first aid for burns in children.

First aid for burns for children involves very simple measures. Parents need:

• Remove contact with the heat source that caused the thermal injury.
• Cool the burn area thoroughly with running water at room temperature. Do not use chilled water, ice or frozen foods, as prolonged contact with them can lead to frostbite.
• Cover the burn site with a clean, preferably sterile, bandage. Do not forcefully open or remove blisters and areas of necrosis.

If parents have doubts about the extent of soft tissue damage and the area of ​​damage, the emergency dispatcher will always tell you what to do if the child has a burn, as well as whether he or she requires emergency medical care. In severe cases, the ambulance team will quickly deliver the child to a specialized department, where he will be given anti-shock measures and prescribed treatment.

For a child 10 years of age and older, how to treat non-severe thermal injuries can always be found out during a routine visit to a pediatrician at the clinic. Also, the doctor, having assessed the child’s condition, can always hospitalize him for treatment in a hospital setting, which will prevent the development of severe consequences of burn disease or soft tissue infections. An ointment for burns prescribed by a doctor for children should be used according to the instructions supplied with the drug. It must be smeared regularly until the clinical signs of the burn disappear.

The blister resulting from such damage must be treated with an antiseptic that does not contain alcohol (chlorhexidine, betadine, etc.). Opening the blisters on your own is prohibited, as this can lead to infection of the resulting wound. When the blister has opened on its own, the remaining epidermis is carefully removed with sterile scissors.

If a child has a burn on the palm that leads to severe pain when trying to squeeze the hand, the doctor may prescribe additional immobilization of the limb to create rest in order to reduce discomfort.

Extensive skin defects can be covered with modern hydrogel dressings, ointments, and artificial skin. When the wound is completely cleared of necrosis, fibrin and pus, and there are active granulations in it, plastic closure of the defect is performed. For this purpose, artificially grown patient skin, skin grafts, autodermoplasty (own skin taken from another part of the body) can be used. The task of doctors in this case is to form a normal skin surface at the site of thermal damage, which will allow the dermis to perform its protective functions and the cells to regenerate faster. Unfortunately, it is burns in childhood that cause the appearance of various scars that begin to bother a person in adulthood.

First aid for a child with burns at home updated: March 24, 2017 by: admin

– a type of injury that occurs when tissue is damaged by physical and chemical factors (thermal energy, electricity, ionizing radiation, chemicals, etc.). The clinical picture of burns in children depends on the influencing factor, localization, depth, extent of tissue damage and includes local (pain, hyperemia, swelling, blistering) and general manifestations (shock). The main tasks of diagnosing burns in children are to determine the nature of the burn injury, the depth and area of ​​damage, for which infrared thermography and measurement techniques are used. Treatment of burns in children requires anti-shock therapy, cleaning the burn surface, and applying bandages.

General information

Burns in children - thermal, chemical, electrical, radiation damage to the skin, mucous membranes and underlying tissues. Among the total number of people with burn injury, children make up 20–30%; Moreover, almost half of them are children under 3 years old. The mortality rate due to burns among children reaches 2-4%, in addition, about 35% of children remain disabled annually. The high prevalence of burns in the pediatric population, the tendency to develop burn disease and severe post-burn disorders make the prevention and treatment of burn injury in children a priority in pediatric surgery and traumatology.

The peculiarities of children's anatomy and physiology are such that the skin of children is thinner and more delicate than that of adults, has a developed circulatory and lymphatic network and, therefore, has greater thermal conductivity. This feature contributes to the fact that exposure to a chemical or physical agent, which in an adult causes only superficial skin damage, leads to a deep burn in a child. The helplessness of children during injury causes longer exposure to the damaging factor, which also contributes to the depth of tissue damage. In addition, imperfection of compensatory and regulatory mechanisms in children can lead to the development of burn disease even with damage to 5-10%, and in infancy or with a deep burn - only 3-5% of the body surface. Thus, any burns in children are more severe than in adults, since in childhood disorders of blood circulation, metabolism, and the functioning of vital organs and systems occur more quickly.

Causes and classification of burns in children

Depending on the damaging agent, burns in children are divided into thermal, chemical, electrical and radiation. The occurrence of thermal burns in children in most cases is caused by skin contact with boiling water, steam, open fire, melted fat, or hot metal objects. Young children are most often scalded by hot liquids (water, milk, tea, soup). Often, burns in children occur as a result of parental negligence, when they immerse the child in a bath that is too hot or leave them to warm themselves with heating pads for a long time. At school age, various pyrotechnic fun, lighting fires, “experiments” with flammable mixtures, etc. pose a particular danger to children. Such pranks with fire, as a rule, end in failure, since they often lead to extensive thermal burns. Thermal burns in children usually affect the integumentary tissue, but burns of the eyes, respiratory tract and digestive tract can also occur.

Chemical burns are less common and usually occur when household chemicals are not stored correctly and within the reach of children. Young children may accidentally spill acid or alkali on themselves, spill powdery substances, spray hazardous chemicals, or drink caustic liquids by mistake. When aggressive chemicals are ingested, a burn to the esophagus in children is combined with a burn to the oral cavity and respiratory tract.

The causes of electrical burns in young children are malfunction of electrical appliances, their improper storage and operation, the presence in the house of electrical outlets accessible to the child, and exposed exposed wires. Older children usually get electrical burns when playing near high-voltage lines, riding on the roofs of electric trains, or hiding in transformer boxes.

Radiation burns in children are most often associated with skin exposure to direct sunlight for a long period of time. In general, thermal burns in children account for about 65-80% of cases, electrical burns - 11%, and other types - 10-15%.

Within the framework of this topic, the features of thermal burns in children will be considered.

Symptoms of thermal burns in children

Depending on the depth of tissue damage, thermal burns in children can be of four degrees.

First degree burn(epidermal burn) is characterized by superficial damage to the skin due to short-term or low-intensity exposure. Children experience local pain, hyperemia, swelling and a burning sensation. At the site of the burn, slight peeling of the epidermis may be observed; superficial burns in children heal in 3-5 days on their own, completely without a trace or with the formation of slight pigmentation.

Second degree burn(superficial dermal burn) occurs with complete necrosis of the epidermis, under which clear liquid accumulates, forming blisters. Swelling, pain and redness of the skin are more pronounced. After 2–3 days, the contents of the bubbles become thick and jelly-like. Healing and restoration of the skin lasts about 2 weeks. With second degree burns in children, the risk of infection of the burn wound increases.

Third degree burn(deep dermal burn) can be of two types: IIIa degree - with preservation of the basal layer of the skin and IIIb degree - with necrosis of the entire thickness of the skin and partially the subcutaneous layer. Third degree burns in children occur with the formation of dry or wet necrosis. Dry necrosis is a dense scab of brown or black color, insensitive to touch. Wet necrosis has the appearance of a yellowish-gray scab with a sharp swelling of the tissue in the burn area. After 7-14 days, the scab begins to be rejected, and the complete healing process is delayed for 1-2 months. Epithelization of the skin occurs due to the preserved germ layer. IIIb degree burns in children heal with the formation of rough, inelastic scars.

IV degree burn(subfascial burn) is characterized by damage and exposure of tissues lying deeper than the aponeurosis (muscles, tendons, blood vessels, nerves, bones and cartilage). Visually, with fourth-degree burns, a dark brown or black scab is visible, through the cracks of which the affected deep tissues are visible. With such lesions, the burn process in children (wound cleansing, formation of granulations) proceeds slowly, local, primarily purulent, complications often develop - abscesses, phlegmons, arthritis. IV degree burns are accompanied by a rapid increase in secondary changes in tissues, progressive thrombosis, damage to internal organs and can result in the death of the child.

Burns of I, II and IIIa degrees in children are regarded as superficial, burns of IIIb and IV degrees - as deep. In pediatrics, as a rule, there is a combination of burns of various degrees.

Burn disease in children

In addition to local phenomena, burns in children often develop severe systemic reactions, which are characterized as burn disease. During a burn disease, there are 4 periods - burn shock, acute burn toxemia, burn septicopyemia and recovery.

Burn shock lasts 1-3 days. In the first hours after receiving a burn, children are excited, react sharply to pain, and scream (erectile phase of shock). Chills, increased blood pressure, increased breathing, and tachycardia are noted. In severe shock, body temperature may drop. 2–6 hours after the burn, children enter the torpid phase of shock: the child is adynamic, inhibited, makes no complaints and practically does not react to the environment. The torpid phase is characterized by arterial hypotension, rapid thready pulse, severe pallor of the skin, severe thirst, oliguria or anuria, and in severe cases, vomiting “coffee grounds” due to gastrointestinal bleeding. First degree burn shock develops in children with superficial damage to 15-20% of the body area; II degree – for burns of 20-60% of the body surface; III degree - more than 60% of the body area. Rapidly progressing burn shock leads to the death of the child on the first day.

With further development, the period of burn shock is replaced by a phase of burn toxemia, the manifestations of which are caused by the entry of decay products from damaged tissues into the general bloodstream. At this time, children who have received burns may experience fever, delirium, convulsions, tachycardia, arrhythmia; in some cases, coma. Against the background of toxemia, toxic myocarditis, hepatitis, acute erosive-ulcerative gastritis, secondary anemia, nephritis, and sometimes acute renal failure can develop. The duration of the period of burn toxemia is up to 10 days, after which, with deep or extensive burns in children, the septicotoxemia phase begins.

Burn septicotoxemia is characterized by the addition of a secondary infection and suppuration of the burn wound. The general condition of children with burns remains serious; complications are possible in the form of otitis media, ulcerative stomatitis, lymphadenitis, pneumonia, bacteremia, burn sepsis and burn exhaustion. During the recovery phase, the processes of restoration of all vital functions and scarring of the burn surface predominate.

Diagnosis of burns in children

Diagnosis of burns in children is made on the basis of anamnesis and visual examination. To determine the area of ​​the burn in young children, Lund-Browder tables are used, taking into account the change in the area of ​​​​various parts of the body with age. For children over 15 years of age, the rule of nine is used, and for limited burns, the rule of the palm is used.

Children with burns need to have their hemoglobin and blood hematocrit examined, a general urine test, and a biochemical blood test (electrolytes, total protein, albumin, urea, creatinine, etc.). In case of suppuration of a burn wound, the wound discharge is collected and bacteriologically inoculated for microflora.

It is mandatory (especially in case of electrical trauma in children) to be performed and repeated in the dynamics of the ECG. In the case of a chemical burn of the esophagus in children, esophagoscopy (EGD) is necessary. If the respiratory tract is affected, bronchoscopy and lung radiography are required.

Treatment of burns in children

First aid for burns in children involves stopping the action of the thermal agent, freeing the affected area of ​​skin from clothing and cooling it (by washing with water, an ice pack). To prevent shock at the prehospital stage, the child can be given analgesics.

In a medical institution, primary treatment of the burn surface, removal of foreign bodies and scraps of epidermis are carried out. Anti-shock measures for burns in children include adequate pain relief and sedation, infusion therapy, antibiotic therapy, and oxygen therapy. Children who have not received appropriate preventive vaccinations are given emergency immunization against tetanus.

Local treatment of burns in children is carried out by closed, open, mixed or surgical methods. With the closed method, the burn wound is covered with an aseptic bandage. For dressings, antiseptics (chlorhexidine, furatsilin), film-forming aerosols, ointments (ofloxacin + lidocaine, chloramphenicol + methyluracil, etc.), enzyme preparations (chymotrypsin, streptokinase) are used. The open method of treating burns in children involves refusing to apply bandages and managing the patient under conditions of strict asepsis. It is possible to switch from a closed method to an open one to speed up the recovery process, or from an open to a closed one if an infection develops.

During the rehabilitation period, children with burns are prescribed exercise therapy, physiotherapy (Ural irradiation, laser therapy, magnetic laser therapy, ultrasound),

Prevention of burns in children, first of all, requires increased responsibility on the part of adults. A child should not be allowed to come into contact with fire, hot liquids, chemicals, electricity, etc. To do this, in a house where there are small children, safety measures must be provided (storing household chemicals in an inaccessible place, special plugs in sockets, hidden electrical wiring, etc.). d.). Constant supervision of children and a strict ban on touching dangerous objects are required.

Little children are inquisitive and restless, they explore the world around them, want to see and touch everything. The task of adults is to protect the baby as much as possible, to remove everything that could cause him injury. One of the most common childhood injuries is burns from boiling water. The complications and consequences of thermal damage to the skin and other tissues depend on how quickly parents react and what measures they take.

Content:

Classification of boiling water burns

Boiling water burns are thermal damage to the skin, in which, depending on the impact, the skin or deeper layers are damaged. Children most often receive such injuries at home. In first place are burns with hot liquid, in second place with boiling oil. As a rule, the lesions are quite large in area. Burns from 1st to 4th degree are diagnosed.

1st degree. Only the outer layer is exposed to thermal effects. The skin turns red, feels painful, and swells. Such burns go away quickly enough and almost always do not require hospitalization.

2nd degree. The skin and part of the underlying layer are affected. Blisters with thin walls filled with liquid appear. It is treated for 1-2 weeks, with proper therapy there are no traces left. For extensive lesions or injuries in children under 1 year of age, doctors advise treatment in a hospital.

3A and 3B degrees. The deep layers of the skin down to the fatty tissue suffer. Blisters may form, but with thick walls, filled with bloody contents. When the blisters are opened, a deep wound is left. With such injuries, the outer layer of the epidermis is destroyed, and after healing scars remain, so most often for grade 3 (especially grade 3B) skin grafting is recommended.

4th degree. In case of injuries from boiling water, such burns are rare and are formed during prolonged exposure to hot liquid. The deep layers of the skin, the muscles located underneath them, and the nerve endings suffer. For such lesions, surgical cleaning and removal of necrotic tissue is performed.

If a child is burned by boiling water, an immediate response from an adult is required. The faster first aid is provided, the less pronounced the injuries will be.

First aid for burns with boiling water

The severity of the child’s injuries will depend on the speed of reaction of adults and the timeliness of measures taken. Therefore, help for burns with boiling water, as doctors put it, should be literally “emergency”:

1. It is necessary to remove wet clothes from the child as quickly as possible to stop contact of the hot surface with the skin.
2. Burned areas should be cooled to reduce the temperature and avoid injury to the deeper layers of the skin. The skin is cooled under running water for at least 7-10 minutes. Then a cloth soaked in cold water and wrung out is applied to the affected area. It is better not to use ice or frozen foods in these cases, since inflammation (for example, of the lungs or brain) may accompany the burns.
3. It is important to calmly examine the child to assess the extent of the damage. Subsequent actions depend on this.
4. To relieve pain, the affected area is treated with a spray or gel with lidocaine, and after drying, Baneocin powder is applied (namely a powder, not an ointment!). Apply a sterile, loose bandage.

Video: What to do if a child is burned by boiling water

How to assess the degree of damage from boiling water

Doctors estimate the area of ​​the burn surface in several ways, the most common of which are the “rule of nines” and the “rule of the palm.”

Rule of nines

According to this technique, the human body is divided into zones, and each of them is equal to the number 9. Thus, the numbers will be as follows:

• damage to one upper limb – 9% of the body surface;
• one lower limb – 18%;
• head and neck – 9% each;
• back and buttocks or chest and abdomen – 18%.

Please note that this ratio is approximate. In children, due to age characteristics, the ratio of body parts will be different.

Palm rule

The meaning of this technique is that the human palm is 1% of the surface area of ​​the body. When determining the affected area of ​​a child’s skin, the size of his palm is taken into account, not that of an adult.

Important: The help of a specialist is necessary if a child’s burn with boiling water is 15% or more of the body area for burns of 1-2 degrees and 7% of the body for burns of 3 degrees. If even small areas with 4th degree burns are diagnosed, you should immediately consult a doctor.

What not to do when providing first aid

Contrary to popular belief, it is strictly forbidden to lubricate burned skin with animal fat, oil or rich baby creams. This reduces heat transfer from the injured surface. It is also not recommended to use kefir or sour cream: the acid they contain, if it comes into contact with an open wound, will cause pain to the child. In addition, the products are corrosive and slow down the healing process.

You should not pierce, let alone rip off blisters, as this is a natural protection against infection of the wound, apply cotton wool and cotton swabs, which leave lint, and also cover the wound with a band-aid.

Immediately after an injury, as well as during the healing process, doctors do not advise treating wounds with alcohol-containing solutions, as this can cause an additional burn, already a chemical one.

Treatment of burns

For 1st degree burns and small area damage for 2nd degree burns, treatment is usually carried out at home. For extensive 2nd degree burns and even minor 3rd-4th degree burns, you should call an ambulance or take the child to a traumatologist yourself. It is also obligatory for the child to be examined by a specialist if he is under 3 years old for injuries of any degree.

Treatment includes mandatory treatment of the affected surface with antiseptics. A solution of furatsilin, miramistin, chlorhexidine is used. For processing, a gauze swab is used; you can apply an antiseptic by spraying. For the first 3 days, treatment is carried out every day, then, according to the doctor’s recommendations, you can disinfect the wound after 1-2 days until complete healing.

After treatment, a sterile bandage is applied to the affected surface, which should not be too tight and not too dense, so that the wound has the opportunity to “breathe”, the blood supply is not disrupted and a greenhouse effect does not occur, from which it will take much longer to heal.

Important: During the healing process, do not tear off the dried gauze bandage from the wound. As a rule, only a doctor does this and only after soaking with a disinfectant solution. At the last stages of tissue regeneration, it is recommended to leave the dried bandage; during the process of complete healing, it will fall off along with the dead tissue.

In the absence of blisters, ointments or sprays (panthenol, dexpanthenol, olazol, radevit and others) are used to speed up tissue regeneration and relieve pain. If there were blisters that have already burst, open wounds have formed in their place, use antibacterial ointments (levomekol), baneocin powder.

For 4th degree boiling water burns, necrotic lesions are removed surgically. Antibacterial and anti-shock therapy is carried out, removing tissue decay products from the body through the intravenous administration of special solutions. To restore tissue after 3-4 degree burns, drugs with a regenerating effect (Actovegin) are prescribed to prevent the formation of scars (Contractubex) or the proliferation of connective tissue, the formation of so-called colloidal scars (Lidase).

For burns from boiling water, antibiotics are rarely prescribed to children, only if there is a danger of infection of the affected surface.

Consequences of burns from boiling water

The consequences of 1-2 degree burns are minimal, treatment is possible even at home. There are no scars or scars left. 3rd degree burns carry the risk of forming unsightly colloidal scars, which subsequently require contacting a plastic surgeon. For 3B and 4th degree burns, the damaged tissue is completely removed, so skin grafting is often required.

Often, with 3rd and 4th degree burns, painful shock and so-called burn disease develop, which require urgent hospitalization.

Often, after skin damage by boiling water, wound infection is observed, which leads to abscesses and sepsis, lymphadenitis, the development of phlegmon, impaired sensitivity and motor functions of the affected areas.

Prevention

Preventing a child from getting burns of varying degrees depends entirely on how adults were able to create safe conditions for the child to stay indoors. The following rules must be observed:

1. Do not allow your child to play in the kitchen, where there is an increased risk of such injuries.
2. Do not carry hot liquids (tea, soup) over the child. If the baby accidentally pushes, all this will spill out on him.
3. Do not leave hot foods and drinks in places where a child can reach. Children are very curious, they need to check everything, so a bowl of soup or a bright mug of tea will definitely attract them. By pulling, the baby will spill hot liquid on himself.
4. The same applies to teapots and pots with hot contents. During cooking, they should be placed on distant burners, and after cooking, immediately put out of the reach of children.
5. Do not leave your baby alone in the bathroom when bathing, as young children often open hot water taps, which can lead to thermal injuries.

If possible, a special thermostatic device should be installed on the hot water tap, which sets a certain temperature. The water in the tap will not heat above the set temperature.

Video: How to act if skin is damaged by boiling water

Burns in children are damage to the skin as a result of exposure to chemical, thermal, electrical, and radiation factors. The skin of a one-year-old baby is thinner and more delicate than that of an adult, and has high thermal conductivity. Injuries are more difficult for children to endure. Help includes removing the damaging factor, cooling the wound, and antiseptic treatment. The limbs (arms, legs, fingers) of infants are more often burned.

Classification:

• thermal – damage to the skin as a result of the harmful effects of boiling water, steam, fire;
• chemical – damage to the skin due to contact with chemicals (usually household chemicals);
• radiation - occur during prolonged stay on the street during solar activity hours;
• electrical - appear as a result of improper operation of electrical equipment.

How to treat at home

The severity of treatment for a burn injury depends on the timeliness of first aid. It is urgent to eliminate the damaging factor - a source of electric current, hot steam or liquid, a chemical, ultraviolet rays. If possible, remove the affected area from clothing. The extent of the injury should be assessed - first and second degree injuries can be treated at home.

Wash a 1-2 degree burn in a child with running cool water for at least 15-20 minutes.

Do not use ice or warm water for cooling.

After cooling, apply a bandage to the damaged area with anti-burn ointment (Panthenol, Bepanten, Olazol). If the wound suppurates, treat with antiseptic, regenerating ointments as prescribed by a doctor (Levomekol, Levosil). If there is an elevated temperature, Ibufen and paracetamol are prescribed.

Traditional methods will help treat a child’s burn, reduce pain, and speed up healing.

For minor damage, you can use regular baby cream if the skin peels and peels.

Do not use traditional methods for 2-3 hours after exposure to the damaging factor. The given remedies are relevant for thermal and sunburns of the first or second degree.

In what cases is specialized help required?

• third, fourth degree burns;
• damage to internal organs (esophagus, tongue, ingestion of toxic liquid);
• damage to the face, genitals, eyes, mucous membranes, regardless of degree or area;
• the area of ​​the damaged area is more than two children's palms;
• increase in temperature;
• formation of blisters (the blister may swell or burst in the absence of medication, which promotes infection).

It can occur when 5 percent of a child’s body is affected, in an infant – from 3 percent. It leads to fever, coma, loss of consciousness, and acute renal failure. If a child is injured, consultation with a doctor is necessary in any case.

Features of treating burns in infants

It is important to urgently call an ambulance and continue treatment in the hospital. There is a possibility of getting burn shock. Purchase the medications listed below at a pharmacy and use only on the recommendation of a doctor.

Apply the medications until the wound is completely healed. First degree lesions heal in 5-7 days, second degree – up to 14 days.

At least 4% of burns are fatal, and 35% of children may be disabled for many years or for life. Take care of your children - seek medical help promptly.

To avoid injury, parents should be attentive to young children. At home, children should not have access to chemical liquids, fire, hot objects, or electrical appliances. In order for children to get burned, it is necessary to supervise them, prohibit them from touching dangerous objects, and limit their time in the sun.