TEACHERS FACT SHEET:
What is a burn?
Our skin is the body’s biggest organ and has many functions including moderating our temperature, retaining and
maintaining fluid levels in the body, protects us from bacteria and infections and is responsible for gathering sensory
information.
The skin consists of two distinct layers – the Epidermis (provides protections from injury, holds in fluids and protects
the nerves from too much stimulation), and the Dermis (contains the capillaries, hair follicles, nerves cells and sweat
glands).
Underneath the dermis lies the padding layers of Subcutaneous Fat which separates the skin from deeper muscular
and bony structures. These layers provide important cushioning from trauma.
Burns are an injury to any layer of the skin and are caused by extreme heat or cold, contact with electricity,
chemicals, friction or radiation. Burn severity is measured according to the depth of skin damage:
·
Superficial thickness (First degree) burn: affects the outer layer or epidermis. Common symptoms include
localized redness and pain
·
Partial thickness (Second degree) burn: affects the second layer of skin or the dermis. Symptoms include
blisters, clear fluid emitting from the site and localized pain or with a whitish appearance for a deeper burn and
deeper damage. This burn may have limited associated pain due to damage to the blood vessels and nerve endings.
·
Full thickness (Third degree) burn: often leaves a hard leather-like eschar, purple fluid and no or little pain due
to the depth of damage. Skin may appear whitish or black depending on the type of burn.
Cross-section of skin showing representation of the degrees of burns
Superficial thickness
Partial thickness
Full-thickness
BurnSafe Fact Sheet - General
Incidence
The statistical information for incidence of preventable burn injury is quite frightening, especially when you consider
that the majority of burn related injuries are accidental and preventable. Burn Injury is one of the top three causes
of accidental death in children under the age of 5 and, on average 9-10 children, under the age of 16 are admitted or
treated in the Women’s and Children’s Hospital due to a burn related injury each day. Disturbingly, we saw an
increase of 27% in South Australia and 67% in the Northern Territory of burn related injuries during the 2005/06
period. (Australian & New Zealand Burns Association, 200?)
Causes
The most common cause for children under the age of three to four presenting with a burn injury to a hospital is due
to scalding. These types of burns account for approximately 60% of all children treated. Scalds are often due to
children inadvertently tipping hot liquids on themselves following their inquisitive natures and focused intent or
scalding through contact with hot tap water, especially in the bath or shower. It takes less than 1 second for a child
to be seriously scalded by boiling water from a kettle or cup of coffee.
Of the older age group, burns through contact with hot objects and naked flames are often caused by
experimentation with fire and chemicals and participation in risk taking behaviours; for example playing with
matches, lighters and flammable liquids or through simply not paying attention to what’s around them - running and
stumbling into combustion heaters, knocking over a cup of noodles for example.
Burn Classification (see fact sheet ‘Burn Classification’ for more details):
- Scalds
- Chemical and Acid
- Hot and Cold Surface
- Radiation (sunburn)
- Friction
- Fire and Flame
- Electrical
Implications of Burn Injury
The implications of a young person experiencing a severe burn injury can have a major impact beyond the individual
to their friends, parents and siblings.
Immediate hospitalisation for a severe burn injury can be anywhere between 1 week and 3-4 months with further
recovery time needed at home before they are ready to return to school. The average length of stay in hospital for a
child with a burn injury is 9.6 days. Ongoing weekly treatment for dressings will also increase time off school. A deep
burn can cause the skin to scar, which, if over a large area can require ongoing operations to release contractures
(skin contracting) or to cosmetically enhance the skin’s appearance.
A burn in a young person will also affect parents and family members. Support for the ongoing treatments eg travel
and time away from normal routines can be draining on the family and may impact on parents’ working lives and
ability to continue with normal routines.
Scarring, especially if visible on the hands, face, neck or arms of a young person can greatly affect a young person’s
self image, resulting in low confidence and low self-esteem. This has the potential become a barrier to participation
in school based and social activities. The skin, which has been damaged even to a partial thickness burn injury, loses
its ability to stretch, sweat, control its temperature and safely absorb sunlight this is due to the destruction of the
sweat glands, hair follicles, nerve endings and melanin which are all located in the epidermis and dermis, the two
outer layers of skin. This can greatly restrict mobility and subsequent participation in some social and physical
activities. It also means that, as the young person grows and develops, the damaged skin will not grow and stretch
BurnSafe Fact Sheet - General
with the body causing contractures. Ongoing surgery is required to release the skin and graft new skin into the area
(see Teachers’ Fact Sheet; Latest Research).
Burn 1st Aid Management
Burn injuries continue to burn the skin for up to twenty minutes after the cause of the burn has been removed. It is
therefore vital that the burn area is cooled as quickly as possible to prevent further damage. Cool running water
within the first hour of injury will stop the burning process and cool the burn. Ice butter, tomatoes, toothpaste or
toothpaste are all commonly suggested home remedies but should never be used as they can cause deeper tissue
damage.
·
Safety for the 1st Aider is paramount – ensure the area is free from danger
Things such as hot oil or water spilled on the floor or gases which may be leaking. Remember if you are also injured
you are less able to care for the patient. In case of clothing being on fire, remember STOP, COVER, DROP & ROLL
·
Cool the burn under cool running water for 20 minutes
The longer a burn is left untreated, the deeper and more serious it becomes. It is therefore vital that cooling the burn
area is the first step in burn 1st aid management. Ideally this should be done under cool running water however if
running water is not available, two dampened cloths can be used and alternated as heat will be transferred from the
burn area to the cloth quite quickly. If the burn surface area is large ie front or back torso of a child, or full arms, the
body may lose heat due to the skin losing its ability to regulate normal body temperature. Children can become cold
very quickly if the burn is large. At any sign of shivering or shock the patient should lay down and be loosely covered
to keep warm.
·
Remove any clothing & jewelry from area which isn’t stuck to the skin
Clothing and jewelry can hinder the healing process in two ways. Burns will continue to burn the skin until the area
cools. Clothing and jewelry can retain heat and can also restrict the body if swelling occurs. Clothing which is stuck to
the skin must not be removed as this can cause further damage and expose the wound, leading to infection and heat
loss.
·
Cover area with clean lint free cloth or if a large burn area, cover loosely with cling wrap
Many burn complications arise as secondary conditions to the burn itself. These are commonly related to shock,
toxicity to the area or local infection of the wound and surrounding tissue. To reduce the likelihood of infection and
to assist the body in retaining body warmth it is advised to cover the burn injury loosely with a plastic cling wrap or
clean, lint free cloth. It is important to wrap the area loosely to allow for some swelling of tissue.
·
Seek Medical Advice
If the burn area is deep, is larger than a 20 cent piece or on the face, hands, feet or in the groin area or skin folds or if
there is potential damage to the lungs or throat. Creams, ointments, ice and sauces can cause further damage to the
skin so should NOT be used before seeking medical advice.
BurnSafe Fact Sheet - General
Teacher’s role in Reducing the Incidence of Burn Injury
Teachers can play an active role in reducing the incidence of burns and accidents in and around the home through
exposing children to hazard identification, problem solving activities and strategies for dealing with unsafe situations.
Building in ways for children to share information with parents and caregivers into the classroom program on safety
will encourage messages to be passed on. Examples of this could include sending home children’s workbooks,
inviting parents and caregivers into the classroom to listen to children’s project presentations, presenting an
assembly item eg safety role play or version of the ‘Cool Drop’ song and inviting parents along to watch, setting a
homework task on completing a home safety checklist (see additional resources Yr 3-5, Kidsafe Home Safety
Checklist) or identification of hazards in and around the home. Children and their parents could be invited to: develop a home safety action plan for changing hazards and habits to reduce the possibility of burns and other
accidents,
- practice making 000 calls using their full name, address and identifying prominent landmarks
- complete a risk management grid for inside and around their home (see additional resources yr 6/7, Risk
Management Grid)
Impact of Severe Burns
Many burns sufferers are affected by their burns for life. A deep second degree or third degree burn can cause the
skin to scar, which, if over a large area can require ongoing operations to release contractures (skin contracting) or
to cosmetically enhance the skin’s appearance. Scarring is especially of concern if over a joint and the scaring
prevents normal function. According to statistics from the Women’s and Children’s Hospital Burns Unit, Children
with major burns can expect a hospital stay for up to 3-4 months which is likely to have a serious impact on the
family’s working life and finances and on the child’s schooling and education. Due to the length of time off school,
children who return from a lengthy hospital stay may struggle fitting back into the classroom; coping with the work
they’ve missed, fitting back in with friends as well as dealing with the emotional, physical and social impacts of a
burn injury which can have a serious and lengthy effect on the child’s self-esteem. This length of hospital stay and
rehabilitation phase also greatly affects the working life of the child’s parents further causing family stress.
Why an education program?
The national Australia & New Zealand Burn Association (ANZBA) figures show that 63% of children and 65% of adult
burn related injuries occur in the home environment. Research also indicates that the majority of burn injuries are
accidents and are therefore preventable. The Julian Burton Burns Trust aims to reduce the incidence and severity of
burn injuries through community education and support. Through a schools program, an Aboriginal remote
communities program and community awareness activities the Burns Trust aims to reduce the incidence of burn
injury by affecting behavioural and social change in Australian communities.
BurnSafe Fact Sheet - General