First Aid for Scalding: How to Treat Hot Water Burn Injury
Author:
CPR Select
Last updated:
11/3/2024
Many burns are caused by dry heat, chemical, and electrical burns. But a burn caused by steam or hot water — is called a scald. Hot water burns happens in various settings, such as the kitchen, bathroom, or workplace. They range rom partial thickness burns, causing redness and blisters, to full thickness burns, penetrating deeper layers of the skin. Knowing how to administer first aid for hot water burns is essential for everyone. In this article, we will discuss the steps you should take to provide immediate care for hot water burns.
How to treat a burn from boiling water?
Effective first aid for hot water burns include immediate cooling with lukewarm water and covering the affected area with a clean, dry cloth. Seeking prompt medical attention is essential to properly evaluate and treat burns, reducing the risk of complications and promoting optimal healing. Here are the steps for first aid for hot water burns:
Prioritize safety by turning off the source of heat.
Cool the burn with cool (not cold) running water for 10-20 minutes.
Carefully remove jewelry and tight clothing around the burn.
Gently pat the burn dry with a clean, sterile cloth or gauze.
Apply a sterile, non-stick bandage or gauze to cover the burn.
Use over-the-counter pain relievers for pain and inflammation.
Seek immediate medical attention for severe hot water burns.
1. Prioritize Safety
Ensuring safety is paramount when assisting someone with a boiling water burn. Before rushing to help, first check for any immediate hazards to yourself and the victim. Quickly turn off any sources of hot water, and if possible, move the person away from the source to prevent further injury. Hot items, including metal surfaces or clothing soaked in boiling water, should be removed carefully to avoid aggravating the burn.
Why is this step so important?
If you don’t ensure safety, both you and the person burned risk further harm. Acting safely first helps prevent worsening the situation. Burns can cause shock, which impairs judgment, so take a moment to assess the scene.
2. Cool the Burn
After ensuring safety, start cooling the burn immediately. Run cool (not cold) water over the affected area for about 10-20 minutes. This cooling helps lower skin temperature, stopping the burn from penetrating deeper layers and minimizing tissue damage. However, avoid ice or very cold water, as extreme temperatures can worsen skin damage.
Why avoid ice or very cold water?
Cold exposure constricts blood vessels, potentially slowing blood flow and healing, and it may even cause frostbite on the damaged skin.
3. Remove Jewelry and Tight Clothing
If the burn is on a limb or area with jewelry or tight clothing, remove these items gently and quickly. Burns cause swelling as fluids accumulate around the injury to aid healing. Constriction from rings or tight fabric can restrict circulation and worsen damage if left in place.
If removing the items causes pain or risks further skin injury, it’s best to wait until medical help is available to avoid tearing the skin.
4. Keep the Burn Clean
After cooling, pat the burn dry gently with a clean cloth or sterile gauze. Avoid rubbing, as this can irritate and damage the delicate burned skin. Keeping the area clean helps reduce infection risk, which is critical for burns, as damaged skin has a higher susceptibility to bacteria and other contaminants.
Why is infection prevention essential?
Burns compromise the skin barrier, making infection a common complication. Infection can slow healing, increase pain, and in severe cases, lead to systemic complications.
5. Apply a Sterile Dressing
Once dry, cover the burn with a sterile, non-stick bandage or gauze. Avoid adhesive dressings directly on the burn, as removing them could tear healing skin. Changing the dressing regularly keeps the burn clean and helps you monitor it for signs of infection (redness, swelling, or pus).
Change it daily or whenever it becomes wet or dirty to prevent bacterial buildup. Observe for any signs of infection that may require medical attention.
Use Pain Relief
If the person is in pain, give them over-the-counter pain relievers like ibuprofen or acetaminophen. These helps ease the pain and reduce any swelling. Just make sure to follow the dosage instructions on the label. Providing pain relief makes the burn victim more comfortable while they heal. Additionally, topical antibiotic ointments or creams are applied to prevent infection in open blisters or wounds.
Seek Medical Attention
While most minor hot water burns are treated at home, it's crucial to recognize when medical attention is necessary. Seek immediate medical help if:
The boiling water burn covers a large area or is deep.
The boiling water burn affects sensitive areas like the face, hands, feet, or genitals.
The boiling water burn causes blisters or the skin appears charred or white.
The person is experiencing severe pain or signs of shock, such as rapid breathing, weakness, or confusion.
According to studies, hot water scalds are associated with large TBSAs, long stays in the ICU, and worse outcomes compared to the other scald types
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Scalds are slow-healing burns caused by moist heat. Scalds arerisky because it destroys affected tissues and cells in the body. In more severe cases, burn victims go into shock, which is be life-threatening.
Boiling water burns are accidental, and they’re often caused by minor accidents when you are in a hurry or under pressure, such as spilling a hot drink on your skin. Steam from the oven causes scalding as well. Tap water burns are more likely if your hot water heater is set above 120°F.
Scald burns are widespread in the restaurant industry. This is because the water temperature in a restaurant kitchen must be kept high to prevent bacterial overgrowth and properly clean cookware.
What’s the Difference Between Burns and Scalds?
Burns and scalds are both forms of thermal injury. Treatment for both is generally similar, but scalds are typically confined to the outer layers of skin, while burns causes extensive damage to deep tissue.
Human skin withstand up to 44°C temperatures for a prolonged period of time, up to 6 hours, before suffering irreversible damage. With immersion scalds, the contact between the hot liquid and the skin is considerably longer than with spill scalds, thus increasing the severity of the injury.
First-degree burn or superficial burn is associated with scalds. It usually causes immediate pain. But if the hot water stays on the skin or covers a large body area, it causes lasting damage. Severe burns leads to death.
What Causes Hot Water Burns?
Hot water burns results from various sources, including:
Boiling Water: Spills or splashes from boiling water while cooking or preparing hot beverages are common causes of burns.
Steam: Steam from cooking pots, kettles, or other appliances scalds the skin if it comes into contact.
Hot Tap Water: Water heaters set at high temperatures leads to scald injuries, particularly in children or the elderly.
Hot Bath or Shower Water: Testing the water temperature before entering a bath or shower is essential to avoid scalds.
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Hot water burns are classified into three degrees of severity:
First Degree Burns: These are the mildest and affect only the top layer of skin. They appear as red, painful areas and develops minor swelling.
Second Degree Burns: These burns extend deeper into the skin and causes blisters, intense pain, and swelling. They often require more time to heal.
Third Degree Burns: The most severe, third-degree burns damage all layers of the skin and affect underlying tissues. They appear charred or white and are often less painful due to nerve damage.
What Are the Symptoms of Scalding or Hot Water Burn?
Scald burns are excruciating, but the amount of pain is not always related to how serious the burn is. Even a severe burn are relatively painless. Hot water burn causes the following symptoms:
Blisters
Red or peeling skin
White or charred skin
Swelling
How do you treat a hot water burn at home?
If you have a minor burn caused by boiling water, consider using home remedies to alleviate pain and promote healing. However, it's essential to remember that these remedies are for minor burns only. For more severe burns, it's crucial to seek immediate medical attention. Here are some home remedies for hot water burns:
Cool Water: As an immediate response, run cool (not cold) water over the burn for about 10-20 minutes. This helps to cool the skin and reduce the severity of the hot water burn.
Aloe Vera: Applying pure aloe vera gel or a commercial aloe vera product help soothe the scald and promote healing. Aloe vera has anti-inflammatory and skin-repairing properties.
Cold Compress: Apply a cold, damp cloth or a cold compress (a clean cloth soaked in cold water) to the burn for short periods to alleviate pain and reduce swelling.
Frequently Asked Questions
Here are the most common questions asked about scalding or hot water burns
How long does it take for a hot water burn to heal?
Healing time depends on burn severity. Minor burns may heal within a few days to a week, while deeper burns might take several weeks and require medical care.
What are the home remedies for treating hot water burns?
Basic remedies include cooling the burn with water, using non-stick bandages, and applying over-the-counter ointments. Avoid ice to prevent further skin damage.
Can you use ointments on a boiling water burn?
Yes, antibiotic ointments can prevent infection, especially on open blisters, but avoid products with strong chemicals.
What ointment to put on a burn from boiling water?
For minor burns caused by boiling water, consider applying an over-the-counter topical antibiotic ointment such as Neosporin or a burn-specific ointment like Silvadene (silver sulfadiazine cream). These ointments helps prevent infection and keep the burn moist as it heals.
Why Do Burns Have Water Inside?
Burns develop blisters filled with fluid, often referred to as "water" as a protective response by the body. This fluid is primarily composed of serum, a clear portion of blood, and serves to cushion and protect the underlying tissue from further damage. Blisters form as a result of the body's inflammatory response to the burn injury.
What is Staphylococcal scalded skin syndrome?
Staphylococcal scalded skin syndrome (SSSS) is a skin condition primarily affecting infants and young children, caused by certain strains of Staphylococcus bacteria. It leads to widespread redness, blistering, and peeling of the skin, resembling a scald injury. Prompt medical attention is crucial, with treatment typically involving antibiotics to target the underlying infection, along with supportive care measures. Prevention includes practicing good hygiene and avoiding close contact with individuals with skin infections. SSSS leads to serious complications if left untreated, emphasizing the importance of seeking medical care promptly.
What Does a Water Burn Look Like?
A water burn, or scald injury, typically appears as red, irritated skin, often resembling a sunburn. In more severe cases, blisters develops, containing clear fluid. The severity of the burn depends on factors such as the temperature and duration of exposure to the hot water.
How Long Does a Scald Take to Heal?
The healing time for a scald injury depends on the severity of the burn and individual factors such as age, overall health, and the effectiveness of treatment. Minor scalds heals within a few days to a week with proper wound care, while more severe burns takes several weeks to heal completely and requires medical attention.
When to seek medical attention?
If you or someone else has suffered a scalding hot water burn, it is important to seek medical attention as soon as possible. If the burn covers more than 10% of the body, or if it is on the face, hands, feet, groin, buttocks, or a major joint, seek medical attention immediately, especially if the burn is deep, accompanied by other symptoms such as fever or chills, or if the person has a weakened immune system.
Can certain home remedies worsen scald burns?
Yes, certain home remedies worsens scald burns. According to the American Burn Association, applying butter, oils, or toothpaste to burns is discouraged because these substances traps the heat and cause further tissue damage. Ice or very cold water harms the skin by causing frostbite or additional damage to already injured tissues. The Mayo Clinic advises against using these substances and instead recommends running cool (not cold) water over the burn for 10-15 minutes.
Are specific materials better for covering burns?
Yes, specific materials are recommended for covering burns. The American Academy of Dermatology recommends using non-stick dressings, such as Telfa pads, to prevent the dressing from adhering to the burn wound, reducing pain and the risk of further injury during dressing changes. Sterile gauze provides a barrier against infection, and hydrogel dressings help keep the wound moist, which promotes faster healing and reduces pain.
Can medications interfere with burn healing?
Yes, some medications interfere with burn healing. Corticosteroids, for example, delays wound healing by suppressing inflammation and immune responses. Immunosuppressants used for conditions like autoimmune diseases hinders the body’s ability to fight infection and repair tissue. Certain antibiotics, such as those in the sulfa class, causes skin reactions that complicate burn healing . Healthcare providers often review patients' medications to avoid those that interferes with recovery.
What to put on a burn?
For a minor burn, apply a burn cream to soothe the area and help prevent infection. Burn creams often contain ingredients like aloe vera or antibiotic agents, which can aid healing and reduce pain.
How to treat a burn blister?
When treating a burn blister, avoid bursting it, as this can increase infection risk. Gently apply burn cream around the blister and cover with a non-stick, sterile dressing.
Is there a higher risk of infection with scald burns compared to other burns?
No, there is no definitive evidence that scald burns inherently have a higher risk of infection compared to other types of burns. The risk of infection primarily depends on the severity, depth, and extent of the burn, as well as the quality of wound care provided. All types of burns, including scald burns, has significant risk of infection if not properly treated and monitored.
However, scald burns do pose a high risk of infection due to the moist environment they create, which is conducive to bacterial growth. According to a study published in the Journal of Burn Care & Research, the risk of infection is prominent in burn patients, with an infection rate of around 30% in severe cases. The compromised skin barrier from burns makes it easier for bacteria to enter the body, necessitating diligent wound care and monitoring.
Do different water sources affect burn severity differently?
Yes, the severity of burns is affected by the temperature of the water and the duration of exposure. Boiling water (100°C or 212°F) causes third-degree burns within seconds of contact. In contrast, hot tap water causes serious burns if the temperature is set too high, typically above 48°C (120°F). According to the National Institute of Standards and Technology, hot water at 60°C (140°F) causes third-degree burns in just five seconds, whereas water at 49°C (120°F) takes about five minutes to cause similar burns . Immediate cooling of the burn with lukewarm water for about 20 minutes is recommended to mitigate the damage.
How to Prevent Hot Water Burns?
Preventing hot water burns is crucial for your safety and the safety of those around you, especially in households with children and the elderly. Here are several steps you take to prevent hot water burns:
Adjust Your Water Heater Temperature: Set your water heater's thermostat to a safe and comfortable temperature, typically around 120°F (49°C). This lower temperature helps reduce the risk of scalding burns.
Install Anti-Scald Devices: Consider installing anti-scald devices or thermostatic mixing valves on your faucets and showerheads. These devices help regulate water temperature and prevent sudden hot water spikes.
Test Water Temperature: Before stepping into a bath or shower, test the water temperature with your hand or a bath thermometer. Adjust the water until it reaches a comfortable and safe temperature.
Supervise Children: Always supervise young children when they are in or near the bathtub, sink, or any source of hot water. Young children are particularly vulnerable to hot water burns.
Teach Water Safety: Educate your children about the dangers of hot water and the importance of not playing with faucets or turning them to extremes. Make sure they know how to test water temperature safely.
Use Caution When Cooking: Be careful when cooking with hot liquids. Use oven mitts and pot holders to handle hot pots and pans, and keep handles turned away from the stove's edge to prevent accidental spills.
Secure Appliance Cords: Ensure that cords from appliances like kettles and coffee makers are not hanging over the edge of the counter, where they are pulled down by accident.
Install Safety Latches: Install safety latches on the doors of ovens and stoves to prevent young children from accessing them.
Use Microwave Safely: When heating liquids or food in the microwave, use microwave-safe containers and follow the recommended heating times and instructions to avoid spills and burns.
Be Mindful of Hot Beverages: Take care when handling hot beverages like coffee and tea. Make sure they are placed out of reach of children and away from the edges of tables and countertops.
Educate Family Members: Ensure that all family members are aware of hot water safety practices and know what to do in case of a burn.
Regularly Check Plumbing: Inspect your plumbing system for leaks or malfunctioning faucets and repair or replace them promptly to prevent unexpected hot water bursts.
By taking these precautions and practicing hot water safety, you reduce the risk of hot water burns in your home. Remember that prevention is key to ensuring the safety and well-being of yourself and your loved ones. It's essential to enroll in First Aid Certification classes to be ready in case of an emergency.
How Does Life Saving Skill Training Prepare You to Handle Hot Water Burns?
Life-saving skill training, encompassing first aid and CPR courses, prepares you to handle hot water burns with confidence and effectiveness. Participants are equipped with the knowledge to swiftly recognize the signs and severity of burns caused by hot water, enabling them to promptly initiate the appropriate response. Through CPR and First Aid Training, you will learn to prioritize safety and master proper techniques for dressing the burn. Crucially, life-saving skill training instills the ability to discern when professional medical attention is necessary for severe burns, empowering individuals to take decisive action and potentially save lives.
Sources:
American Burn Association. "Burn Care FAQ."
American Red Cross. "First Aid Steps for Burns."
Mayo Clinic. "Burns: First Aid."
American Academy of Dermatology. "How to Treat Burns."
National Institutes of Health. "Steroids and Wound Healing."
Journal of Burn Care & Research. "Infection Rates in Burn Patients."
National Institute of Standards and Technology. "Burns and Scalds: Preventing Tap Water Scalds."
Schulz A, Grigutsch D, Alischahi A, Perbix W, Daniels M, Fuchs PC, Schiefer JL. Comparison of the characteristics of hot tap water scalds and other scalds. Burns. 2020 May;46(3):702-710. doi: 10.1016/j.burns.2019.10.001. Epub 2019 Oct 31. PMID: 31679795.
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