Feb 8, 2017

Interviewer: What should do if your child gets burned? That's next on The Scope.

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Interviewer: I think it could be one of the scariest things a parent could witness or see or think about their child getting burned, whether it's fire or a hot liquid. But if it does happen, what should you do? There's actually a set of steps you should follow. Annette Matherly is with the University of Utah Burn Center. Let's talk about if a child gets burned, what you should do.

Annette: Well, first of all, it would depend on if there was flame involved. If there's flame involved, then the first thing anyone should do is go back to kindergarten, go back to stop, drop, and roll. Get on the ground. Roll around. Put that fire out and extinguish it. But we forget to do that because it's . . . I don't know about you but it's been a while since I went to kindergarten, so it's not muscle memory. And so, I want to run because I'm on fire and that just makes the fire worse. So remember to go back all the way to kindergarten and stop, drop, and roll.

Interviewer: All right. So you extinguish the fire, now you've got the burn injury. How do you help your child with that? What do you do? What's the first thing you do?

Annette: That comes down to the four C's which is super easy to remember: cool it, clean it, cover it, and then if you need to call for help.

Interviewer: Okay. Cool it, clean it, cover it, call for help. Let's circle back around, that cool it, what's that mean?

Annette: So cool it means that you want to take the heat out of the tissues because now your tissues have been burned. And so they have this additional heat. So, when you take the heat out of the tissues as quickly as you can, it decreases that depth of injury which is absolutely what you want. You want to make sure that you can prevent that injury from going deeper.

Interviewer: So further depth, like when you take your steak off the barbecue and it continues to cook for 10 minutes afterwards.

Annette: Absolutely.

Interviewer: Except for your skin, you don't want that.

Annette: No, that's a bad thing.

Interviewer: Yes. So what are we talking about cooling? Are we talking about pouring cold water on it or a washcloth, what?

Annette: We want to use cool, not cold water or ice, so cool water and you want to cool it for at least five minutes. And it doesn't matter what it is. If it's your grandma's Gatorade or if it's a nearby pond that you're going to jump in, as long as you're taking that heat out of the tissues as soon as possible with whatever is the closest liquid that you have. Obviously, you don't want that liquid to be hot, because that would not be helpful but too.

Interviewer: Or too cold either because that can cause additional problems, so cool. All right. So top that burning from happening. Number two is clean, that's infection, right?

Annette: Right, right. We want to make sure that if there's any debris in that area of injury that we get that debris off as soon as possible.

Interviewer: And what does that look like cleaning it?

Annette: So we, you know, in the burn center, we just use a washcloth to clean it. But if you're just pouring some kind of water over an area that has been burning, you might use your hand to get rid of maybe any gravel or soil that you've rolled around in if you performed stop, drop, and roll particularly.

Interviewer: Sure, okay. So cool it, clean it, and then cover it.

Annette: Right. What's really important about a burn injury and the reason why burns are so painful is that when you take off that top layer of skin, you expose those nerve endings to air, and those nerve endings are really painful. So by covering it, not only are you diminishing the chance of infection which we talked about a little earlier, but you're also covering those exposed nerve endings so that you feel better. And the other thing by covering it, because a burn is very psychological, so when you look at your hand that's now being burn injured and now you're missing some skin, that's really scary. So when you cover it, it helps you not feel so anxious.

Interviewer: Yeah, it helps calm your child down quite a bit. I didn't even think of that aspect of it. All right. And then finally, you call for help, but how do I know? Because there are different degrees of burns, right? There's first, second, third. Is there a rule or does it get a little complicated?

Annette: Definitely. You could spend the next 24 hours with me talking non-stop which wouldn't be impossible. But this is kind of tricky but the thing that we think about the most is, is it a danger to my airway? Is it going to prevent me from breathing and will I have any circulation issues that could be attributed to wherever this burn injury is.

Interviewer: Okay. And if it's burned through the skin, is it a good idea to go see somebody? Because we're talking that first-degree burn doesn't actually penetrate the skin, second-degree does.

Annette: Absolutely. But, you know, even if a burn doesn't penetrate the skin, so just like a superficial injury, the very young and the very old are still at risk because they don't want to drink very much. And even when you have a sunburn, you want to resuscitate yourself with some-degree of fluid.

But a second-degree injury which is where that top layer of skin has gone, now that coat of armor of your skin has an opening in it, and so there's an opportunity for infection to set in. And a second-degree burn doesn't heal for about 10 to 12 days. So you've got that open area which is an opportunity again for infection and then it, again, is very painful. So to use the correct topicals and to get that seen is really important.

Interviewer: Yeah, so not a bad idea at that point, second and third-degree burns, go get it seen. Plus also, it can hamper your mobility for the rest of your life, in a lot of cases burns can, which surprised me to find out.

Annette: Right. If you have an injury, even if it's just to the palmar surface of your hand, so maybe over a couple of joints, if you think about your position of comfort, you're going to keep your hand as comfortable as possible, which doesn't mean moving it to most people. But then that can lead to mobility issues long-term.

Interviewer: Yeah. So, another good reason to maybe get it seen and seen by professionals that handle burn stuff.

Annette: Yes, yes.

Interviewer: All right. Any final thoughts on that? I think you've given us some good steps. You cool it, you clean it. Well first, you put the fire out, you cool it, you clean it, you cover it, and then you call for help.

Annette: You know, the other thing is, what if you're forever away from a burn center. It's not just convenience. So to go to your local provider is fine. But we can use telemedicine or digital images, and those can be sent to a professional that does take care of burns full-time. And then they can talk to your primary care provider in regards to whether this is something that you may need to be seen eventually at a burn center for, or whether this is something that could be managed via distance in collaboration, in partnership with the burn center.

Interviewer: Any final thoughts for a parent when it comes to burns in their children?

Annette: So I think in closure, to remember the best burn is the one that never happened, to remember you're a mentor to your children, to practice burn and fire safety yourself, to remember the simple things around your home can cause lifelong injury and detriment to especially a small child, but to a teenager also. And then to remember that burn prevention is a team sport, to pull in all your family and to educate them to the consequences and the severity of burn injury.

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