Our skin performs many actions for us, and one of its important roles is to protect our bodies from infection. Just like wounds and cuts, burns penetrate the skin, which can expose us to infection. Severe burns can also send the body into shock. Treatment should be given as soon as possible in order to limit damage to the skin.

Burns and scalds both cause damage to the skin through heat and are treated in the same way.

Burns are caused by dry heat, such as iron or fire.
Scalds are caused by something wet, such as hot water or steam.

Severity of burns

We often hear the phrase 1st, 2nd, or 3rd degree burns. This term is used to describe the depth of a burn on the skin. The skin has three layers, and we define burns according to the layer of skin affected:

Superficial burns affect the top layer of skin (dermis).
Partial thickness burns affect the top 2 layers of skin (the dermis and the epidermis).
Full-thickness burns affect all layers of skin, down to the fat layer and nerve endings. These are the most serious types of burns. They can often look black and charred.

Use the acronym SCALD to assess the severity of a burn.

S: Size of the burn (a 1% burn is the size of the child’s palm).

C: Cause

A: Age. Younger children and older people are more at risk.

Location: Which part of the body is affected (face, throat, eyes, chest, and genitals are the most serious)

D: Depth of the burn (a full-thickness burn can often result in no pain due to the nerve endings being burned).

Causes of burns:

Wet heat or steam
Dry heat or flame
Electrical
Chemical
Radiation

Treating Burns and Scalds

Cool the burn with cool water for 20 minutes; this will lessen the swelling and the overall impact of the burn. If you can’t find running water, use a bottle of soft drink or milk until you can get to a tap.
Remove any clothing or jewellery that is near the affected area, but be careful not to tear the skin or create further damage. If this is proving difficult, leave it.
Cover the burn with a layer of cling film. Tear pieces of cling film from the roll and place them all around the burn. If it is a limb, do not wrap it too tightly.
If cling film is not available, use a burn dressing from your first aid kit. A clean plastic bag can be used if this is all you have to keep the affected area clean.
Do not use ice, lotions, or ointments.

Think back to SCALD when deciding whether to seek medical help for a burn:

Size, Cause, Age, Location, Depth

Burns larger than the palm of the child’s hand.
Full-thickness burns that appear black and charred.
A child that has endured smoke inhalation from a house fire. For example, inhaling harmful smoke can inflame your lungs and airway, causing them to swell and block oxygen.
A burn that goes all the way around a limb (the swelling could cause restricted blood flow)
Burns on the face, hands, arms, feet, legs, or genitals

First aid for cuts and grazes

Cuts and grazes are common types of injuries that occur in everyday life. Most can be dealt with by cleaning them carefully and covering them with plaster or dressing.

Note: If a cut continues to bleed or looks like it needs stitching, the child will need to seek medical help. Also, seek medical help if you believe there is dirt or small debris inside the cut that is difficult to clean.

How to treat a cut:

Put on protective gloves if possible (remember to use them once, then change or dispose of them correctly).
Clean the wound under running tap water.
Apply some pressure to the area.
Apply plaster.

The child should be urged to change the plaster regularly and to keep the cut clean. They should also be advised to seek medical advice if the cut looks like it’s not healing well or becomes infected.

Signs of infection include:

Swelling of the affected area
Feeling generally unwell
A high temperature (fever)
Pus is forming in the affected area.
Redness around the affected area

Remember that any used dressings should be brought to the attention of paramedics or taken with the child to the hospital. These can be an indicator of the amount of blood lost.

Used dressings should be disposed of in a yellow medical waste bag or bin. They should not be placed in a standard bin.

First Aid for Cuts, Grazes, Burns and Scalds

Unii's Paediatric First Aid Journey helps you treat everyday injuries.