Burns are one of the most painful injuries a child can suffer. Knowing how to recognize the degree of a burn, and the proper treatment, can make a huge difference in how well the burn will heal.

Burns are divided into four different levels.

1st degree burns are minor and heal quickly. Symptoms are redness, tenderness, and soreness (like most sunburns).

2nd degree burns are serious injuries. First aid and medical treatment should be given as soon as possible. Symptoms are blistering (like a severe sunburn), pain, and swelling.

3rd degree burns (also called full-thickness burns) are severe injuries. Medical treatment is needed right away. Symptoms are white, brown, or charred tissue often surrounded by blistered areas. There may be little or no pain at first.

4th degree burns are severe injuries that involve skin, muscle, and bone. These often occur with electrical burns and may be more severe than they appear. They may cause serious complications and should be treated by a doctor right away.

Call your pediatrician if your child suffers anything more than a minor burn. ALL electrical burns and any burn on the hand, foot, face, genitals, or over a joint worse than 1st degree should receive medical attention right away.

There are many different causes of serious burns in children, including sunburn, hot-water scalds, and those due to fire, electrical contact, or chemicals. All of these can cause permanent injury and scarring to the skin.

Chemicals that cause burns also may be absorbed through the skin and cause other symptoms. Call the Poison Help Line (1–800–222–1222) or your pediatrician after washing off all the chemicals.

Treatment

Your immediate treatment of a burn should include the following.

- As quickly as possible, soak the burn in cool water. Don’t hesitate to run cool water over the burn long enough to cool the area and relieve the pain immediately after the injury. Do not use ice on a burn. It may delay healing. Also, do not rub a burn; it can increase blistering.

- Cool any smoldering clothing immediately by soaking with water, then remove any clothing from the burned area unless it is stuck firmly to the skin. In that case, cut away as much clothing as possible.

- If the injured area is not oozing, cover the burn with a sterile gauze pad or a clean, dry cloth.

- If the burn is oozing, cover it lightly with sterile gauze if available and immediately seek medical attention. If sterile gauze is not available, cover burns with a clean sheet or towel.

- Do not put butter, grease, or powder on a burn. All of these so-called home remedies actually can make the injury worse.

When treating a burn at home, watch for any increase in redness or swelling or the development of a bad odor or discharge. These can be signs of infection, which will require medical attention.

Prevention

Most burns that are not fatal are not related to fires. Most often, these are scalds from hot liquids—for example, when a child turns over a cooking pot upon himself, or turns the knobs on a bathtub faucet so that hot water flows on him. Children also sometimes suffer burns by touching a hot iron, a coil on an electric stove, a curling iron, hot barbecue charcoal, or fireworks.

- Install smoke detectors in hallways outside bedrooms, the kitchen, living room, and near the furnace, with at least one on every floor of the house. Test them every month to be sure they work. It is best to use alarms that have long-life batteries, but if these are not available, change batteries at least annually on a specific date that you’ll remember (such as January 1 of each year).

- Practice home fire drills. Make sure every family member and others who care for your children in your home know how to leave any area of the home safely in case of a fire..

- Have several working fire extinguishers readily available. Place fire extinguishers around the home where the risk of fire is greatest, such as in the kitchen, furnace room, and near the fireplace.

- Teach your children to crawl to the exits if there’s smoke in the room. (They will avoid inhaling the smoke by staying below it.)

- Purchase a safety ladder if your home has a second story, and teach your children how to use it. If you live in a high-rise building, teach your children the locations of all exits and make sure they understand never to use the elevator in a fire. (It can become trapped between floors or open on a floor where the fire is burning.) Agree on a family meeting point outside the house or apartment so you can make certain everyone has gotten out of the burning area.

- Teach your children to stop, drop, and roll on the ground if their clothing catches fire.

- Avoid smoking indoors.

- Do not leave food cooking on the stove unattended.

- Lock up flammable liquids in the home. It is best to store them outside the home, out of children’s reach, and away from heat or ignition sources.

- Lower the temperature of your water heater to below 120 degrees Fahrenheit (48.9 degrees Celsius) to prevent hot water scalds and burns.

- Don’t plug appliances or other electrical equipment into extension cords if they place too much “amperage” or load on the cord, thus creating a potentially unsafe situation.

- Keep matches and lighters away from children, locked and out of reach.

- Avoid all fireworks, even those meant for consumer use.