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Burns

What are burns?
Burns are a type of injury caused by heat. The heat can be thermal, electrical, chemical, or electromagnetic energy. Most burn accidents occur at home. About 75 percent of all burn injuries in children are preventable.
Fire and burns are some of the leading causes of accidental injury- related deaths among children ages 14 and under.
The leading cause of residential fire related death and injury among children ages 5 and younger is child play, when children are left unattended. Most fires started by child play are set with matches or lighters

What are the different types of burns?
A burn injury usually results from an energy transfer to the body. There are many types of burns caused by thermal, radiation, chemical, or electrical contact:

Thermal burns
Burns due to external heat sources which raise the temperature of the skin and tissues and cause tissue cell death or charring. Hot metals, scalding liquids, steam, and flames, when coming in contact with the skin, can cause thermal burns.

Radiation burns 
Burns caused by prolonged exposure to ultraviolet rays of the sun, or to other sources of radiation such as X-ray.

Chemical burns
Burns caused by strong acids, alkalies, detergents, or solvents coming into contact with the skin and/or eyes.

Electrical burns
 Burns from electrical current, either alternating current (AC) or direct current (DC).

What are the classifications of burns?
Burns are classified as first-, second-, or third-degree, depending on how deep and severe they penetrate the skin's surface.

First-degree(superficial)burns 
First-degree burns affect only the epidermis, or outer layer of skin. The burn site is red, painful, dry, and with no blisters. Mild sunburn is an example. Long-term tissue damage is rare and usually consists of an increase or decrease in the skin color.

Second-degree(partialthickness)burns 
Second-degree burns involve the epidermis and part of the dermis layer of skin. The burn site appears red, blistered, and may be swollen and painful.

Third-degree(fullthickness)burns 
Third-degree burns destroy the epidermis and dermis and may go into the subcutaneous tissue. The burn site may appear white or charred

Fourth degree burns 
Fourth degree burns also damage the underlying bones, muscles, and tendons. There is no sensation in the area since the nerve endings are destroyed.

What is a first-degree burn?
A burn is damage to tissues of the body caused by contact with things such as heat, radiation, or chemicals. A first-degree burn affects only the outer layer of skin (epidermis). 

What causes a first-degree burn?
The causes of a first-degree burn can include:
• Mild sunburn
• Very hot water
• Hot object, like a pot or pan

What are the symptoms of a first-degree burn?
Symptoms can occur a bit differently in each child. Symptoms can include skin that is:
• Red
• Dry
• Peeling
• Painful for 48 to 72 hours and then feels better
The symptoms of a first-degree burn can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is a first-degree burn treated?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
A first-degree burn usually heals on its own within a week. 
Treatment may include:
• A wet cloth soaked with cold water (cold compress) held to the skin, to ease pain
• Antibacterial cream, to help prevent infection
• Other creams, to lessen pain and swelling
• Over-the-counter medicine such as acetaminophen or ibuprofen for pain and swelling
• Any other treatment advised by your child’s healthcare provider
First-degree burns are usually not bandaged.

What are possible complications of a first-degree burn?
Long-term tissue damage is rare and may be an increase or decrease in the skin color. In some cases, the area may become infected.

Can a first-degree burn be prevented?
The following are some of ways to prevent burns in children:
• Keep your child out of the sun. Use sunscreen when your child is old enough, usually at 6 months.
• Make sure hot water is set below 120° F (48.8° C).
• Put covers on electrical outlets.
• Make sure pot and pan handles are turned toward the back of the stove.
• Be careful with hot drinks.
• Keep hot appliances in safe places. This includes toasters, irons, and hair-styling tools.

When should I meet my child's healthcare provider?
Call your child's healthcare provider if:
• Your child has a fever
• There is fluid leaking from the burn area
• There is increased swelling or redness of the burn area

What is a second-degree burn?
A burn is damage to tissues of the body caused by contact with things such as heat, radiation, or chemicals. A second-degree burn affects the outer layer of skin (epidermis) and part of the inner layer of skin (dermis).

What causes a second-degree burn?
In most cases, second-degree burns are caused by:
• Very hot water
• Flames
• Skin that briefly comes in contact with a hot object
• Sunburn
• Chemicals
• Electricity

What are the symptoms of a second-degree burn?
Symptoms can occur a bit differently in each child. Symptoms can include skin that is:
• Blistered
• Deep red
• Swollen
• Wet and shiny
• Painful to the touch
• White or discolored in an irregular pattern in the burn area

How is a second-degree burn treated?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
A second-degree burn usually heals in 2 to 3 weeks, as long as the wound is kept clean and protected. Deep second-degree burns may take longer to heal.
Treatment may include:
• A wet cloth soaked with cold water (cold compress) held to the skin, to ease pain
• Antibacterial cream, to help prevent infection
• Other creams, to lessen pain and swelling
• Non-stick dressing or bandage that’s changed every day
• Over-the-counter medicine such as acetaminophen or ibuprofen for pain and swelling
• Keeping the area elevated (for example, an arm or leg) to lessen pain and swellingv 
• Giving a tetanus vaccine
Do not break blisters. Let your child's healthcare provider manage blisters as needed.

What are possible complications of a second-degree burn?
Possible complications can include:
• Infection of the burned area
• The skin in the burned area will be more sensitive to sunlight while healing
• The skin in the burned area may stay darker or lighter than other skin

Can a second-degree burn be prevented?
The following are some of ways to prevent burns in children:
• Make sure your hot water heater is set below 120° F (48.8° C).
• Be careful with hot drinks.
• Make sure pot and pan handles are turned toward the back of the stove.
• Be careful using car seats, strollers, and seatbelts that are left in hot cars. The material and metal may get very hot.
• Keep your children away from fireplaces and grills.
• Keep your child out of the sun. Use sunscreen when your child is old enough, usually at 6 months.
• Keep cleaning products and other chemicals in a safe place. If they are under a sink, use a lock on the cabinet door.
• Put covers on electrical outlets.
• Keep hot appliances in safe places. This includes toasters, irons, and hair-styling tools.

How is a second-degree burn managed?
Your child may need to see his or her provider often to check and treat the burn. As the burn heals, the area will be itchy. Apply cream as instructed by your child's healthcare provider. Make sure your child's nails are cut short. Protect the area from sunlight. Your child should stay out of the sun and use sunscreen.

When should I call my child's healthcare provider?
Call your child's healthcare provider if:
• Your child has a fever
• There is fluid leaking from the burn area
• There is increased swelling or redness of the burn area

What is a third-degree burn?
A burn is damage to tissues of the body caused by contact with things such as heat, radiation, or chemicals. A third-degree burn damages affects the outer layer of skin (epidermis) and the inner layer of skin (dermis). A child with a third-degree burn needs immediate medical care.

What causes a third-degree burn?
In most cases, third-degree burns are caused by:
• Very hot liquids
• Contact with a hot object
• Fire
• Electricity
• Chemicals

What are the symptoms of a third-degree burn?
Symptoms can occur a bit differently in each child. Symptoms can include skin that is:
• Dry and leathery
• Changes color to black, white, brown, or yellow
• Swollen
• Is not painful, because the nerve endings have been destroyed
The symptoms of a third-degree burn can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is a third-degree burn treated?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. A child will usually be treated in a hospital unit that specializes in burns.
Treatment for a third-degree burn will depend on the severity of the burn. Burn severity is determined by:
• The amount of body surface that is affected
• Where the burn is located
• The depth of the burn
Treatment for a third-degree burn may include:
• Immediate care in an emergency department, possibly in a hospital burn unit
• Breathing and blood circulation support
• Intravenous (IV), given into a vein, fluids containing electrolytes
• Intravenous (IV) or oral antibiotics for infections
• Cleaning and removal of dead tissue (debridement) from the burn area
• Antibacterial cream, and other creams
• Special bandages or dressings
• Nutritional supplements and a high-protein diet
• Pain medicines
• Anti-itch medicines
• Tetanus vaccine
A large third-degree burn heals slowly. After the burn heals, surgery may be needed. This is done to improve the ability to move, and to remove and repair scarred skin.
In some cases, skin grafting may be needed to close or cover the burn. A skin graft is a piece of healthy skin from one part of the body that is removed and put on an area that needs skin. The burn area that’s covered is called the graft site. The area where a piece of skin is taken is called the donor site. After a skin graft, the donor site looks like a scrape. After a skin graft:
• A dressing is left on the graft site for a few days before it is changed. The site needs to be still and protected to begin to heal.
• The donor site usually heals in about 2 weeks.

What are possible complications of a third-degree burn?
Possible complications can include:
• Infections that may affect any part of the body, such as the lungs
• Scarring
• Being unable to move a joint due to scarred tissue (joint contracture)
• Emotional problems
• Organ failure and death

Can a third-degree burn be prevented?
The following are some of ways to prevent burns in children:
• Make sure your hot water heater is set below 120° F (48.8° C).
• Be careful with hot drinks.
• Make sure pot and pan handles are turned toward the back of the stove.
• Be careful using car seats, strollers, and seatbelts that are left in hot cars. They material and metal may get very hot.
• Keep your children away from fireplaces and grills.
• Keep your child out of the sun. Use sunscreen when your child is old enough, usually at 6 months.
• Keep cleaning products and other chemicals in a safe place. If they are under a sink, use a lock on the cabinet door.
• Use outlet covers.
• Keep hot appliances in safe places. This includes toasters, irons, and hair-styling tools.

How is a third-degree burn managed?
Your child will receive treatment for a long period of time after a third-degree burn. Preventing and treating complications such as scars and contractures are part of ongoing care. Care may include:
• Physical and occupational therapy
• Rehabilitation
• Cosmetic or plastic surgery
• Orthopedic surgery
• Counseling

When should I meet my child's healthcare provider?
Call your child's healthcare provider if your child has:
• Signs of infection such as increasing redness, warmth, swelling, pain, or odor
• A fever above 101.5° F (38.6° C) rectally or by mouth
• Pain that gets worse
• Uncontrollable itching
• A contracture



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