A 6 year old girl is brought to clinic by her mother who says the child suffered a serious burn from hot tea two hours prior. Mom had just brewed a fresh cup and had placed it on the kitchen table where the child was sitting. A younger sibling accidentally bumped into the table tipping the cup over and spilling the hot contents into the patient’s lap. Mom says the child now has burns on her inner thigh and genital area. She immediately placed the child in a bath of cool water and ran out to the local drugstore where she bought a “burn spray”. She then applied the burn spray on the child’s wounds which made the pain worse so she brought her in for evaluation.
On exam, the child looks uncomfortable but is cooperative. There is redness with a few blisters on her left inner thigh and pelvic region. The wounds are covered with a clear, greasy substance. The child’s vital signs are normal.
Kids are all too often the victims of kitchen accidents involving hot beverages or hot food. Keep this in mind if there are children around when you are cooking. These types of burns can easily be avoided.
Burns are often classified as first-degree, second-degree, and third-degree. First-degree burns are red and painful but usually heal within a few days. Second-degree burns are also red and painful but often have blisters. They may take a few weeks to heal. Third-degree burns are more serious and involve all layers of the skin. They may look either white or black and may cause little pain because the nerves in the skin have also been damaged. These burns often require specialized care and may take a very long time to heal.
Many minor burns can be managed at home, but there are some that require a doctor’s attention, namely:
1) Any burn that involves a large area of the body (more than 2-3 inches in diameter)
2) Any burn that is located on your face, hands, feet, or genitals
3) Chemical burns
4) Burns involving infants or the elderly
5) Any burn in someone who hasn’t received a tetanus booster in the last 5 years
To treat a burn, first you want to cool the area immediately with cold water or a cool compress. Do not use ice which can cause more damage to the skin and do not apply butter or mud which increase the risk for infection. After cooling down the area, apply an over-the-counter antibiotic ointment, like Bacitracin or Neosporin (or a generic equivalent), with a nonstick dressing. You can take an over-the-counter pain reliever like ibuprofen or acetaminophen to ease the pain. Change the dressing daily and reapply antibiotic ointment until the pain is gone. Do not purposefully break any blisters that may form which can increase the risk of infection. If you notice signs of infection (increased redness, increased pain, or pus) seek medical attention right away.
The patient’s wounds were treated with antibiotic ointment and a large dressing to cover the areas involved. She was given ibuprofen for pain. Given the size and location of the burn, an appointment was made for her to be seen in a local burn clinic the next day. The patient is reportedly doing well.
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