Influence of agents and mechanisms of injury on anatomical burn locations in children <5 years old with a scald

• Published in: Archives of disease in childhood Vol. 106; no. 11; pp. 1111 - 1117
• Main Authors: Javaid, Assim Ali, Johnson, Emma, Hollén, Linda, Kemp, Alison Mary
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01-11-2021; BMJ Publishing Group LTD
• Subjects: Age; Anatomy & physiology; Baths; Burns; Child Abuse; Child Safety; Children; Childrens health; Emergency medical care; Emergency medical services; Epidemiology; Ethnicity; Gender; Health Promotion; Injuries; Kitchen utensils; Original research; Pediatrics; Referral; Scald; Social Services; Water; United Kingdom > UK; England; Wales; child abuse; epidemiology
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2020-320710

ObjectiveTo demonstrate how the mechanism and agent of injury can influence the anatomical location of a scald.DesignProspective multicentre cross-sectional study.Setting20 hospital sites across England and Wales including emergency departments, minor injury units and regional burns units.PatientsChildren aged 5 years and younger who attended hospital with a scald.Main outcome measuresPrimary outcome: a descriptive analysis of the mechanism, agent and anatomical location of accidental scalds. Secondary outcome: a comparison of these factors between children with and without child protection (CP) referral.ResultsOf 1041 cases of accidental scalds, the most common narrative leading to this injury was a cup or mug of hot beverage being pulled down and scalding the head or trunk (132/1041; 32.9% of cases). Accidental scalds in baths/showers were rare (1.4% of cases). Accidental immersion injuries were mainly distributed on hands and feet (76.7%). There were differences in the presentation between children with accidental scalds and the 103 who were referred for CP assessment; children with scalds caused by hot water in baths/showers were more likely to get referred for CP assessment (p<0.0001), as were those with symmetrically distributed (p<0.0001) and unwitnessed (p=0.007) scalds.ConclusionsAn understanding of the distributions of scalds and its relationship to different mechanisms of injury and causative agents will help clinicians assess scalds in young children, particularly those new to the emergency department who may be unfamiliar with expected scald patterns or with the importance of using appropriate terminology when describing scalds.