Heat and horror

Continuing our series on children and home accidents, Kumudini Hettiarachchi looks at burn injuries, Pix by M.A. Pushpa Kumara

The sights are heart-rending. A beautiful toddler, just one year and three months old, covered in plaster – even the face showing severe marks lies on one bed, while a nine-year-old boy lies on another, with a sheet thrown over his raw and peeling body and the head fully covered with a stretching bandage, with openings only for his eyes and long eye-lashes, nose, mouth and ears.

Burnt or scalded – this has been their plight and tragically in their own homes. The kitchen is a veritable “burn hazard”, MediScene understands.

If the child is younger than four years old, burns or scalds, another category of “home accidents” may occur inside. If the child is older, he will be inquisitive and handle things or experiment more outside the house resulting in such injuries.

Giving instances where a smaller child can get burnt or scalded, Consultant Paediatrician Dr. Kalyani Guruge of the Lady Ridgeway Hospital for Children says some mothers may carry a child and at the same time carry boiling water or very hot food.

“The child can pull the jug or pan that the mother is carrying while on the other hand the mother can stumble spilling the hot stuff accidentally on the child,” she points out.

Another thoughtless action on the part of an adult can be keeping a steaming mug of tea, a dish of hot curry or kanjee on a table with or without a table-cloth.

A toddler will pass by and tug at the cloth, making the hot liquid spill on the child and even pull the mug or the dish with the same result, she says.

It will be the same if an electric kettle or a heater (as in the case of the toddler now in the Burns Treatment Unit of the LRH under the care of Plastic Surgeon Dr. Romesh Gunasekera) is plugged within easy reach of a child. “Here the child will pull the cord and spill the ‘dangerous’ contents,” says Dr. Guruge.

Be careful before giving the child a warm water bath. “Firstly don’t take the hot water from the kitchen to the bathroom but fill the basin with cold water first, then take it to the kitchen and gently pour in the hot water, she says.

“Check the temperature of the water with the elbow before lowering the child into the basin, for many are the children who are brought to the LRH after suffering burns on their buttocks. When carrying hot water to and fro, there may be an accident or the child seeing the basin may climb in if the carer is not alert while making preparations for the child’s bath. Parents also must be wary if their home has hot-water taps.”

The long handles of saucepans that jut out from the cooker, just asking to be grabbed can also be very tempting. A tug and the hot curry will be on the hapless victim, she points out adding that heated irons and in more affluent homes hair-straightening irons can also cause burns.

Beware of oil lamps, especially unsafe bottle lamps, warns Consultant Paediatrician Dr. Deepal Perera of the LRH, explaining that in some homes the cans or bottles having kerosene and petrol get mixed up causing a deadly combination.

The many don’ts

In the unfortunate event of a child getting burnt or scalded, hold that part of the body under running water for about 20-30 minutes, say the Burns Treatment Unit staff.

Even if it is the eye, wash it with clean water.
Don’t apply ice, toothpaste, honey, butter, kukul thel or any substance on the burn or scald. Don’t puncture blisters that may have formed, they urge. If the child is in pain, a pain-killer like paracetamol should be given and the child brought to a hospital immediately.

If the child is unconscious make sure the airway is clear and the child is breathing.

The boy in the Burns Unit had attempted to light a Petromax lamp after pouring what he assumed was kerosene.

It was only when it blew up all over his face and body that the family realized that the kerosene had been put into a bottle which had held petrol earlier.

The gas stove may also pose a danger, as there could be a gas leak or the knob may have been turned on and someone strikes a match, says Dr. Perera.

“Be careful about storing acids and alkalines in your home,” he stresses, citing the example of someone engaged in the rubber industry keeping sulphuric acid which a child may have access to.

The heated silencer of a motorcycle can cause serious burns too, he says, mostly in older children who like to touch things. They may also play around with boxes of matches and exposed electric wires. Crackers are another source of burns, says Dr. Perera, adding that older children tend to experiment by taking out the powder which very easily could blow up in their faces.

Prevention being the best form of cure in the first place, both doctors advise parents to think long and hard. Here are some suggestions from them:

  • Barricade the kitchen if you have a small child in the home, by erecting a short gate which the child cannot climb over.
  • Never carry a child and hot stuff at the same time.
  • Keep boxes of matches out of reach of children.
  • Seal plug points or use dummy plugs, as children may poke their tiny fingers into the socket holes.
  • Don’t keep hot stuff on tables close to the edge or on a table-cloth.
  • Use cordless kettles and keep the kettle out of the child’s reach.
  • Be mindful for gas leaks before lighting a gas-cooker. Always make sure that a window is open in the area.
  • When making the bath water ready – pour hot water into a basin which already has cold water and check the temperature with the elbow before putting the child in.
  • Older children should be told about the dangers of playing with fire.

Beware of ash burns

Ash burns are another type the staff at the Burns Treatment Unit deal with. In paddy-growing areas, dahaiya (paddy husk) which may have been set on fire could still be having intense heat and smouldering days after.

Children without realizing this may play on it, sustaining serious burn injuries. In the unit is a little child who had played on a garbage heap set fire by the parents earlier. All outward signs indicated the rubbish was burnt and there was no heat. The child had walked on it, burnt the feet and then fallen, burning the hands as well.

“Most of them are brought with charred toes,” the staff added.

Steam inhalation: Be there

If a child has to inhale steam, don’t let him/her do so on their own, MediScene understands. Always keep the pan with boiling water under a rattan chair, so that the child will not accidentally trip over it.

Then put your face close to that of the child, cover with a cloth and hold your faces down towards the seat of the chair to allow the steam to come through the rattan, said the staff at the unit.

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