Children suffering devastating, yet preventable, burns

“Flame burns are devastating injuries with substantial lifelong physical and psychosocial consequences for the affected survivors and their families,” says Dr Gary Dos Passos, head of burns unit at the Red Cross War Memorial Children’s Hospital (RCWMCH) and EXCO member of the Burn Society of South Africa.

Over 1000 children are treated at the RCWMCH, the tertiary referral centre for Paediatric Burns in the Western Cape, every year for a variety of burns injuries, including hot water or liquid burns, contact burns and flame burns.

Increasing trend in flame burns

Between 01 January 2020 and 31 March 2021, 16 patients with flame burns of 25% or greater over their total body surface area were admitted to the world-class burns unit at the facility.

Five of these injuries were directly due to unsupervised children playing with either matches or lighters. Two of these injuries resulted when children were near open flames that had accelerants (petrol, lighter fluid, paraffin etc) thrown onto them in attempts to revive a failing fire. One child was severely burnt when a paraffin heater was knocked over while playing.

Burn prevention is a crucial component of burn management. While accidental fires are inevitable, many injuries can be prevented with vigilance, proper adult supervision and safer practices.

“Burn injuries increase dramatically during the Winter months and caregivers need to be extra careful to ensure the safety of their children,” says Dr Dos Passos.

Keep matches and lighters far out of children’s reach. Young children are curious by nature and lack the judgement required to keep themselves out of dangerous situations. Four out of the five children playing with matches/lighters were aged five or younger. The fifth child was just seven-years old.

The practice of throwing accelerants onto flames is widespread and extremely dangerous. The resultant flash can set nearby structures and bystanders alight. The flame can travel up the fluid stream and set the accelerant container alight, essentially converting it into a giant ‘Molotov Cocktail’. This practice needs to be discouraged, and children need to be kept at a safe distance should someone insist on using accelerants in this way.

Play is normal and healthy for children. Caregivers need to apply proper adult supervision and be mindful of the dangers posed by paraffin and gas devices. Please ensure that children do not play near such devices.

The other eight children were burnt in uncontrolled fires, mostly in informal dwellings. Several siblings and parents were lost in these fires.

“While two of the 16 children are sadly no longer with us, the other 14 will bear lifelong reminders of their ordeal. Don’t let the same fate affect your loved ones, and stay safe,” Dr Dos Passos implores.

As the winter months approach, the use of candles, paraffin stoves and open fires increase, placing children at even greater risk.

Applying the following safety tips can help prevent burn injuries before they happen:

• Invest in a cordless kettle. View your kettle as a weapon.
• Put all hot drinks, hot cooking oil and hot porridge out of reach of children.
• Do not carry urns or pots of boiling water around while there are toddlers on the floor or children running about.
• Turn pot handles away from the front of the stove.
• Put candles in a deep glass bottle with sand in the bottom so it will be put out if it falls over.
• Repair all faulty electrical plugs and leads.
• Report stolen cover plates on power poles or substations with broken fences or locks.
• Do not leave children unsupervised near matches, candles, lighters or fireworks or when they are in or near the kitchen.
• Lock paraffin and other flammables, including "safe" gels away.
• Do not cover braai fires with sand. The heat stays in the sand for hours and will burn unsuspected feet walking over the sand. Pour water over fires and coals.
• Do not cook eggs in a microwave. The shell can explode and cause severe face and eye injuries.
• Noodles cooked in microwave ovens become extremely hot, along with the container, and can cause severe burns.
• Pour cold water in the bath first and then add hot water. Set your geyser to low temperatures (about 55 degrees). Always test the bath water with your elbow before bathing children.
• Avoid using tablecloths or anything a child can pull on and cause hot food or liquid to spill.
• Never hold a child while cooking.
• Test and stir all food before serving children to make sure it is cool enough to eat.
• Should anyone sustain a burn injury involving flames, the victim should stop, drop and roll to put out the flames.
• Do not touch electrical injury victims before removed from the current – use a stick or non-conductor to avoid rescuer injury or death.
• The heat from a fire, hot water or electrical burn will continue to burn the tissue long after the offending contact is removed. It is essential to stop the burning by keeping the burnt body part under cold running tap water for 20 minutes. Do not use ice or ice water; it can cause frostbite because the skin is already damaged.
• Do not apply butter or any oil-based product to a burn injury, the oil can trap the heat and make the burn deeper over time.

For burns prevention and safety tips, please visit https://www.childsafe.org.za/burns.html