A child can receive a burn from hot liquids or objects, fire, electricity, or chemicals. Prolonged exposure to the sun can also cause sunburn. It is common to grade burn injuries according to how deep the burn goes in the skin.
First-degree burns: Only the top layer of the skin is damaged. The skin is red, warm, and tender. The surface of the skin is dry and without blisters. This type of burn injury will heal after a few days without leaving a permanent scar on the skin. Most sun burns are first-degree burns.
Second-degree burns: The skin has been damaged to a deeper level. The skin will be extremely painful, red or pale, and will have swollen and blistered areas. Healing will often take 14 days or more, and there is a small risk of scarring.
Third-degree burns: All layers of the skin have been destroyed. The skin may be white, brown, or blackened and charred. It feels dry, like parchment or leather. There usually is little or no pain at first because the nerves, which make it possible to sense pain, have also been damaged. With this type of burn injury, there will always be permanent scarring, and a skin graft will be needed.
All burn injuries, regardless of the degree, in which the damage corresponds to more than 10 percent of the child's body surface, must be regarded as potentially serious. Burn injuries to the face, genitals, hands, and feet are the most serious. When burn injuries occur in children, it is important to estimate the extent of the burn or the total amount of the skin area that has been damaged. The palm of a child's hand corresponds to approximately 1 percent of her entire body surface. Use the child's palm size to estimate the extent of the burn.
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Cool the burned area immediately. This is even more important than getting to a doctor quickly. For first- and second-degree burns, use water at a temperature that is cool but not ice-cold. Use whatever is available: a bathtub, shower, hose, fountain, lake, or seawater. Do not put ice or snow directly on a burn, as this can cause frostbite; wrap the ice or snow in a towel and hold that on the burn. Do not rub the burn because this can cause blisters to form. Continue to cool the area for at least 10 minutes; this will relieve the child's pain and prevent the burn injury from penetrating deeper into the skin. Use special burn bandages if you have them. These bandages consist of a water-based gel that has a cooling effect, reducing the pain and keeping the wound clean and moist.
Call 911 or your doctor immediately if: