Childhood burns can happen when least expected: An inquisitive toddler crawling around the kitchen pulls on a coffee pot's dangling electrical cord, causing the scalding liquid to burn his tiny arm.
The Trauma and Burn Program at Washington University School of Medicine and St. Louis Children's Hospital — the only dedicated pediatric burn center in a 250-mile radius of St. Louis — admits approximately 165 burn patients a year and treats another 200 on an outpatient basis.
The American Burn Association reports that every year 1.1 million people have burn injuries that require medical attention and 50,000 of these people require hospitalization. In Missouri, burn injuries are the second most common cause of childhood traumatic deaths after motor vehicle accidents.
"Burns are the leading cause of accidental death in the home for children 14 and under," says Washington University pediatric surgeon, Robert P. Foglia, M.D. "Contrary to what many people believe, fire is not the leading cause of burn trauma in children, the majority of burn cases are caused by hot liquids."
And for small children, kitchens and bathrooms are the most dangerous places in the home. Dangling electrical cords connected to slow cookers, coffee makers and curling irons entice children who have just begun crawling and walking to grab and pull on cords, which can lead to painful burns.
Another problem source is the temperature of hot water heaters — which should never be higher than 130 degrees.
"Parents should never leave children alone in the bathtub, both to ensure that the child doesn't drown and to make sure the bath water doesn't become too hot or that the child does not turn the faucet," Foglia explains.
Thirty percent of children admitted to Washington University's Burn and Wound Treatment Center suffer from burns severe enough to require skin grafting. Fortunately, the remaining 70 percent can be treated with other treatments, such as daily whirlpooling, removal of damaged tissue from the wound and allowing the injury to heal as new skin forms.
Dressing changes and whirlpool therapy are an integral part of burn care.
"Previously, these could often be quite painful procedures for children," Fogila says. "Over the past decade, our use of procedural sedation has greatly changed the care of these children."
"You can do any treatment with a child once, but if it is a painful experience, the child will be terrified the next time," says Robin Moushey, a clinical nurse specialist in the Burn and Trauma Program. "Treating patients in the most pain-free manner possible is critical for both the child and the parents, who often are emotionally on edge because of the injury their child has suffered."
The Washington University trauma team continues to look for better ways to treat burn patients.
"The bottom line is that so many of these accidents are preventable," Foglia says. "Education and parenting classes devoted to increasing awareness of these dangers are key to prevention."
Ways to prevent household burns:
* Hot water heaters should not be set higher than 130 degrees.
* An adult should always check the bath water temperature — and never leave a child alone in the bathtub.
* Do not leave hot electrical devices unattended and keep electrical cords out of a child's reach.
* In the kitchen, keep hot liquids, including coffee and oatmeal, out of the reach of children.
* On camping trips, make sure the camp fire is completely extinguished and cold at bedtime. Young children can wake up in the middle of the night, be disoriented and may step or fall into the old camp fire.
* Pay close attention to children around barbeque grills in the summer.
* Remember to child proof your home, particularly the kitchen and bathroom, for potential burn problems.
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