Burn injuries is a main cause of injury amongst children and adolescents in Singapore. As the national tertiary referral centre for major child burn injuries in Singapore, KK Women’s and Children’s Hospital (KKH) manages approximately 400 cases of child burns every year. The hospital found that half of the children who presented at the hospital with burn injuries did not receive first aid before being attended to by medical professionals.

Performing burns first aid immediately can prevent complications

In the event of a burn, first aid performed on the child immediately can prevent potential complications such as shock from the excessive loss of body fluids, wound infections, deepening of burns, and lung complications in the case of smoke inhalation.

Community healthcare professionals play a significant role in educating caregivers on how to provide burns first aid to children (Table 1) and safety tips to prevent burns in the home (Table 2).


​Table 1. Burns first aid that caregivers can administer to a child
WHAT TO DO IMMEDIATELY:​
​Minor burns
  • First degree burns: Superficial burns involving redness of the skin without blistering
  • Second degree burns: Burns with blistering that cover a body surface area that is less than 10 times the size of the child’s palm, or less than 10 per cent of the child’s total body surface area (TBSA)
​What to do:
  1. Immerse the affected part in cool water or place it under gently running cool water for 20 minutes, to cool the burn and prevent further thermal injury to the skin.
  2. Cleanse the wound with antiseptic solution such as chlorhexidine, or sterile or cool boiled water.
  3. Cover the wound with a non-adhesive dressing such as non-woven gauze, tulle gras or foam dressing.
  4. Provide pain relief such as children’s paracetamol in appropriate dosage.
​Major burns
  • Blistering burns which cover an area larger than 10 times the size of the child’s hand (>10% TBSA) or are in vital areas such as the child’s face, genitalia or hands
​What to do:
  1. Remove the child’s hot or wet clothes.
  2. Immerse the affected part in cool water or place it under gently running cool water for 20 minutes, to cool the burn and prevent further thermal injury to the skin.
  3. Cover the burn with a clean towel or wrap the child in a clean sheet and blanket to keep warm.
  4. Where necessary, use kitchen transparent cling wrap or transparent medical dressing to cover the affected part, to prevent the child from losing excessive body fluid from burnt skin areas.
  5. Seek medical attention immediately, such as calling an ambulance. This is especially important if the burn area is extensive or if the child experiences breathing difficulty resulting from flame / fire / smoke inhalation burns.
​WHAT NOT TO DO:
  • Do not cover the wound with materials that are potentially adhesive such as tissue, kitchen paper towels or toilet paper.
  • Do not stop treatment when blisters form around or on the wound. Running water does not cause the burn to worsen and is not the cause of the blisters.
  • Do not remove the skin flaps if a blister breaks.
  • Do not apply ointments, oil-based creams, and other alternative remedies such as powder, toothpaste, jelly, oil, soy sauce or vinegar to the wound. These may introduce bacteria or further worsen the wound.


Safety and vigilance at home is key

Burns are preventable and making simple choices can create a safe home environment for children to explore, learn and have fun.


​Table 2. Safety tips to prevent burns in the home
  • ​Place hot drinks well out of reach of children.
  • Place hot and shiny appliances (e.g. pots and irons) well away from toddlers’ sight and reach.
  • Avoid using tablecloths as toddlers may pull on overhanging fabric and cause hot food to spill on them.
  • Choose kitchen appliances with child safety locks.
  • Keep children out of the kitchen using safety gates and play pens.
  • Keep electrical sockets covered when not in use. Discard faulty electrical devices.
  • Ensure that one caregiver is available to supervise toddlers at all times. Teamwork amongst adults can also help prevent burns in children.


​Resources for parents and caregivers:


KKH introduces microcurrent stimulation therapy to speed healing for burn wounds

KKH has introduced wireless microcurrent stimulation therapy (WMCS) to enhance burn healing in children. This pain-free treatment delivers electrical current to the wound surface to encourage recovery and suppress inflammatory reactions. It is offered as a treatment option for all patients with burn injuries.

A world-first WMCS trial, conducted among 80 children with superficial partial thickness burns at KKH from July 2016 to September 2021, found that the treatment sped up burn healing from an average of 8.42 days with conventional dressings to 5.76 days using WMCS. Burn deepening rates also significantly fell from 20.8 per cent using conventional dressings to 5.9 per cent using WMCS, with minimal side effects.

​
 ​Dr James Mok, Consultant, Department of Plastic, Reconstructive and Aesthetic Surgery, KKH

Dr James Mok’s clinical interests are in paediatric plastic surgery and burns, cleft and craniofacial surgery, breast reconstruction and cosmetic surgery.

Awarded the prestigious Singapore Stanford Biodesign Fellowship in 2015, which trains the next generation of medical technology innovators in Asia, Dr Mok has been implementing innovative treatments at KKH to enhance patient outcomes. In 2017, he was also awarded the National Outstanding Clinician Scientist Resident Award for his outstanding performance and contribution to clinical training and research to improve patient care.

Dr Mok graduated with distinction from Barts and the London, Queen Mary University of London, United Kingdom, and returned to Singapore to complete his plastic surgery training with SingHealth.