The hospital burn unit is a popular place on the day after Thanksgiving. I found that out the hard way three years ago, when my 18-month-old daughter touched a radiator pipe while toddling around our friends' Virginia farmhouse. Instead of feasting on leftover stuffing, I held my child as she screamed despite the morphine, while doctors cut blistered skin from her tiny hands. Instead of getting a jump on my Christmas shopping, I learned how to debride second-degree burns and bandage little fingers with Silvadene, gauze, and custom-made splints, designed to keep scar tissue from contracting my daughter's hands into useless claws. The burn unit at Children's National Medical Center was full of little girls and boys who should have been home playing with visiting cousins rather than discovering that burns are the most painful and difficult injuries to treat.
Our story had a happy ending. With weeks of twice-daily debriding and bandaging sessions at Mommy and Papa's kitchen-table burn clinic, my daughter's hands healed, miraculously smooth and pink. But other children we saw at the outpatient burn clinic weren't so lucky. I saw hands that would never play the piano, a mouth that would never smile straight, a scalp that would never grow hair. All the parents had stories of accidents as innocuous as ours: a cup of tea knocked from a side table, a tumble into a space heater. "Heaters and soup," one veteran nurse told me at the hospital. "That's all it is. Heaters and soup."
It turns out that small children are uniquely vulnerable to scalds and contact burns. Researchers are just now discovering the terrible toll caused by these injuries. Children 2 years old and younger account for half of the 10,000 hospitalizations for pediatric burn injuries each year, according to a study published this week in the Journal of Burn Care and Rehabilitation. "It's really remarkable," says Gary Smith, a coauthor of the study and director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. Most of the injuries were to hands and wrists, and most came from contact with hot liquids or from touching hot objects. Not only do small children not realize the danger posed by hot objects; their skin is much thinner than that of adults. They burn more quickly, and the burns tend to be deeper and more severe.
Toddlers and preschoolers suffer a disproportionate share of burns that aren't severe enough to demand a hospital stay. Children under age 4 are five times as likely to suffer scalding burns as the population at large and 3.5 times as likely to suffer cooking-related burns, according to new research by the National Fire Protection Association. "I had no idea that the heightened risk for very small children for scalds and thermal burns is as high as it is," says John Hill, assistant vice president for the NFPA, which studied the issue at the behest of the U.S. Fire Administration, the federal agency that deals with fire safety. By contrast, small children are twice as likely as adults to suffer a burn from fire, the "playing with matches" type of fire that's the focus of so many prevention efforts.
Traditional fire safety education has focused on preventing fires. The number of children injured by playing with fire has declined substantially since 1994, when the Consumer Product Safety Commission required that cigarette lighters be child-resistant. "We know people know about smoke alarms," says Chrissy Ciaflone, program manager for Safe Kids USA, a nonprofit that works to reduce childhood injuries. Now, fire safety experts hope that public education efforts will turn to scalds and burns that can be just as devastating as injuries caused by flame.
Fire safety experts say parents can reduce the risk to their children with moves like these:
— Establish a 3-foot "no go" zone around the stove and microwave, even taping a line on the kitchen floor for a while in order to get the message across.
— Store cookies and other goodies away from the stove, so no one will be tempted to reach across a hot burner.