ABC of child abuse. Burns and scalds.

Hobbs, Chris

doi:10.1136/bmj.298.6683.1302

Cited by 37 publications

(21 citation statements)

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“…In the literature, the presence of splash marks often supports accidental injury, presumably from children in motion attempting to escape from hot water. 9,14 In our series, minor splash marks were observed in only 1 case. Several explanations could account for this.…”

Section: E192mentioning

confidence: 85%

“…Injury inconsistent with the history provided by the caregiver is 1 of the most predictive factors for inflicted injury. [7][8][9] Patterns of burns are useful in the evaluation of injury. Familiarity with the patterns of burns permits appropriate recognition of both accidental and inflicted injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Inflicted immersions tend to be of uniform depth as a result of the inability of the child to move in the water. 9 These sink-related burns were predominantly anterior, resulting from the knee and shin coming directly in contact with the water, whereas calf, thigh, and intertriginous areas were relatively spared. The relative confinement of the sink area, in addition to the likelihood that the children faced the water to play with it, may have contributed to the anterior position of the burns.…”

Section: E192mentioning

confidence: 99%

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Accidental Scald Burns in Sinks

Titus¹,

Baxter²,

Starling³

2003

Pediatrics

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ABSTRACT. Scald burns to the feet and lower extremities in children are described in the literature as often resulting from forced immersions. This report illustrates 3 cases of burns whose distribution and historical factors identify them as accidental. The location of these accidental burns is similar to those found in inflicted injury, but the patterns were indicative of flowing water burns, not forced immersions. Burns in these locations may be confused with abuse. Medical providers need to be aware of information that may enable them to distinguish the 2 causes. Effective caregiver education regarding the importance of lowering the temperature of water heaters and discouraging play in household sinks is critical to prevent additional tap water scald burn injuries. Pediatrics 2003;111:e191-e194. URL: http://www. pediatrics.org/cgi/content/full/111/2/e191; scalds, burns, injuries, pediatric, abuse.

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Section: E192mentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: E192mentioning

confidence: 99%

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Accidental Scald Burns in Sinks

Titus¹,

Baxter²,

Starling³

2003

Pediatrics

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“…No trabalho de Showers & Garrison 16 , a queimadura intencional constitui 12,0% de todos os casos de abuso físico e 10,0% das admissões na unidade de queimados. Segundo Hobbs 17 , a queimadura deliberada é encontrada em 10,0% das crianças submetidas ao abuso físico, em 5,0% dos que se sofrem abuso sexual e em 1 a 16,0% de todas a crianças que recorrem ao hospital com queimaduras.…”

Section: Discussionunclassified

A descriptive study of burn injuries in children and adolescents

Costa

Abrantes²,

Lamounier³

et al. 1999

J Pediatr (Rio J)

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Objective: To investigate the frequency of different kinds of burns, associated factors, major complications and their relations to other variables.Methods: Descriptive study performed at Hospital João XXIII from January to December of 1992 with five hundred and thirtyseven children and adolescents.Results: The age distribution was as follows: 408 patients were children (76%) and 129 were teenagers (24%). Most of the accidents, 398 cases (74%) happened at home, 235 of which (59%) in the kitchen. 80 patients were interned. They had the highest relative frequency of accidents outside home (p<0.05). Of these interned patients, 7 (9.0%) developed septicemia. The flame was the predominant agent within the group of inpatients (p<0.01) and was responsible for the highest extension of burning (p<0.05). Teenagers had the largest body burned surface compared to children (p<0.01). Local treatment with pomade or home made medicine was observed in 290 cases (54%); local wash with water only in 32 (6.0%). Dehydration was the most frequent complication and occurred in 28 (5,0%) patients. The average amount of internment was 30±33 days.Conclusions: Most of burning were consequence of domestic accidents, especially in youngers than 7 years old; hot liquids are the most frequent agents and kitchen the most frequent place. Flame, which determined the largest and deepest lesions, was the first cause of burns in teenagers and the second in children. Dehydration is the most frequent complication in the earlier phases and septicemia in the others. ResumoObjetivo: Investigar a freqüência das queimaduras, os fatores associados, as principais complicações e a relação com diversas variáveis.Métodos: Estudo descritivo, conduzido no Hospital João XXIII (jan-dez/92), cuja amostra constituiu-se de 537 crianças e adolescentes.Resultados: 408 pacientes (76%) eram crianças (<10 anos) e 129 (24%) eram adolescentes (10-19 anos). 398 acidentes (74%) ocorreram dentro de casa, e destes 235 (59%) na cozinha. 80 pacientes (15,0%) foram internados. Constatou-se maior percentual de acidentes de ocorrência extra-domicilar entre os pacientes admitidos (mais graves) em comparação com aqueles do grupo tratado em ambulatório (p<0,05). Entre os pacientes admitidos, ocorreram sete casos de septicemia (9,0%), a chama foi o agente predominante (p<0,01) e causou queimaduras mais extensas (p<0,05). Os adolescentes apresentaram maior extensão de superfície corporal queimada que as crianças (p<0,01). Em 290 casos (54%) os familiares fizeram tratamento local com pomadas ou produtos caseiros e em 32 (6,0%), banho local com água. A desidratação foi a complicação mais freqüente ocorrendo em 28 pacientes (5,0%). A permanência hospitalar média constatada no estudo foi de 30±33 dias.Conclusões: A maioria das queimaduras constitui acidente doméstico, especialmente em menores de 7 anos; os líquidos quentes são os agentes mais comuns e a cozinha, a sede mais freqüente. A chama ocupa o 1 o lugar em freqüência no adolescente e o 2º na criança, determinando lesões mais e...

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“…They result in a positive image or brand mark and the object used may be easily identifiable. [52][53][54][55] CIGARETTE BURNS Cigarette burns are a common diagnostic problem. Staphylococcal bullous impetigo is important in the diVerential diagnosis and often results in confusion.…”

Section: Burns and Scaldsmentioning

confidence: 99%