Burn injuries are basically injuries to the skin or any other body surface, which can be caused by extremes of temperature (commonly hot substances such as liquids, fires, and hot solid substances such as flat irons). These injuries can also be caused by electricity, chemicals such as contact with acids or even radiation.
Globally, WHO estimates that fires alone are responsible for more than 265,000 deaths annually, and 95% of these deaths occur in low and middle income countries in which it is found that about one in five people dies after a burn injury. Also important to know is that even the people that survive these burn injuries commonly sustain varying degrees of permanent disability both physically and psychologically.
Today in Rwanda, during our clinical practice, we are noticing a dramatic surge in the number of burn injured patients. Unfortunately, most of these affected are young children. Unlike adults, these children are prone to serious complications after sustaining burn injuries, and have a higher risk of losing life even with a relatively small burn injury.
Most of the children brought to our plastic surgery units have been burned by hot liquids especially water, porridge, cooking oil. Some have incidents with direct contact with fires such as falls in cooking sites, fire explosions with cooking gas, and a smaller number by contact with hot solids especially flat irons. Another common cause of fatal burn injuries, especially to toddlers and much younger infants, are candlelight fires that ignite the beddings.
There are also incidences when children get burned by electricity when they hold live electric wires, attempt biting electric wires or insertion of metallic substances into electric sockets.
Also, though not so common, it should be known that chemicals can also be a serious cause of burns in these children, hence, chemical substances such as acids or others should be kept out of reach of these children as much as possible, given the explorative behaviour if these children.
It is important to know that treatment of moderate to large burn injuries, especially in children, can be difficult, even in presence of all the medical resources in developed burn care centers. This calls for more vigilance at prevention of these injuries, especially in these days when children are staying at home all day long.
Burn injury associated deaths and the lifelong disabilities are preventable. Most and almost all these causes of burn injuries in children are preventable with simple and seemingly obvious measures yet easily overlooked, hence the daily cases of burn injuries.
Some of the measures to prevent the commonest burns include; children should be kept away from the kitchen or any fire sources, hot liquids kept away until it is deemed cool enough, in-house games monitored, avoid holding or carrying a child while carrying or drinking any hot liquids. Don’t place hot beverages on low tables where children can easily reach them. If you have a toddler or small child at home, avoid using a dining tablecloth as these can be pulled on by children while playing and cause burns if hot substances were placed on the table. Use of candleholders that are heavy and large enough to hold candles, never leave candles unattended, and these should be avoided near beddings. Keep away all matchboxes, flammable substances, and flat irons should never be left unattended until they are cool enough. Electric wires, sockets should all be insulated, and still kept away from children’s reach.
Once the child has contact with hot substance (been burned), the immediate first aid is to place the burned body surface under cold running water for about 15-20 minutes (NEVER use cold water from a refrigerator or ice as this worsens the injury), avoid placing any of the commonly used traditional remedies onto the burned area. Keep the child warm with warm clothes and seek immediate proper medical care.
Stay home, stay safe!
Dr. Ian Shyaka
Resident, Plastic Surgery. Rwanda Military Hospital.
iangashugi@gmail.com