I4

BURNS AND CHILD ABUSE

Presenters: Kenneth Feldman 

Abstract Category: Medical

Instruction Level: Intermediate

Presentation: Click Here, Click Here

Description:      

The patterns and evaluation of inflicted and unintentional burn injuries will be reviewed.

Abstract:

Children sustain burns from a variety of sources. injuries from hot objects, either soilds or smoldering objects, and from hot fluids are the most common inflicted burns. The usual accidental contact burn involves an exposed body part. A single glancing burn is observed. Inflicted contact burns are often directly inprinted, multiple and involve unusual body surfaces. Burns from hot fluids can result from flowing contact or immersion in basins of heated fluids. The former injuries result in variable depth burns, with the pattern influenced by splashing and gravitational flow. Immersions result in clear body counter-line burns of fairly uniform depth. The time/temperature relationships for hot water are well described. Above 130 degrees F the burn time rapidly becomes shorter and children, due to their thinner, skin, begin to burn more rapidly than adults. The pain threshold of 112 degrees F is lower than the threshold to sustain burns, so pain should preceed burning. Other fluids are usually more viscous and have a higher heat contact than water causing deeper burns and limited flow patterns. The time/temperature relationships for contact injuries are more complex. Rates depend on the object's heat contact, the heat flow within the object, its surface  heat emissivity and any coupling medium between the object and body.

Children may be victims of inflicted burns in house fires. These often occur in the settings of domestic violence or suicide. Rarer sources of inflicted burns or burn-like injuries include steam or hot air, caustics, sun, microwave ovens and cold.