First Aid for Scalding: How to Treat Hot Water Burn Injury

Many burns are often 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.

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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:

1. Prioritize safety by turning off the source of heat.
2. Cool the burn with cool (not cold) running water for 10-20 minutes.
3. Carefully remove jewelry and tight clothing around the burn.
4. Gently pat the burn dry with a clean, sterile cloth or gauze.
5. Apply a sterile, non-stick bandage or gauze to cover the burn.
6. Use over-the-counter pain relievers for pain and inflammation.
7. Seek immediate medical attention for severe hot water burns.

Prioritize Safety

Ensuring safety is paramount when assisting someone with a boiling water burn. Before jumping in to help, it's essential to make sure both you and the person who's burned are safe. Quickly turn off any sources of hot water and remove anything that could cause more harm. This includes anything hot or sharp.

Cool the Burn

Once safety is ensured, it's time to cool down the burn. This step is critical to prevent the boiling water burn from getting worse. Run cool (not cold) water over the burn for about 10-20 minutes. This helps lower the skin temperature and stops the burn from progressing deeper. Do not use ice or very cold water, as extreme temperatures causes further damage to the skin.

Remove Jewelry and Tight Clothing

If the hot water burn is on an area of the body where jewelry or tight clothing is present, carefully remove these items. Burns causes swelling, and leaving jewelry or tight clothing in place exacerbate the injury.

Keep the Burn Clean

After cooling the burn, it's time to dry it off gently. Use a clean cloth or gauze to pat the area dry. Avoid rubbing the hot water burn, as this makes it hurt more. Keeping the burn clean is important to prevent infections and help it heal properly.

Apply a Sterile Dressing

Once the boiling water burn is clean and dry, apply a sterile, non-stick bandage or gauze to cover the burn. Avoid using adhesive bandages directly on the burn, as they can stick to the wound and cause discomfort during removal. Regularly change the dressing and monitor the burn for signs of infection or worsening symptoms. If the burn is severe or shows signs of infection, seek medical attention promptly.

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 may be applied to prevent infection in open blisters or wounds.

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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.

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 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

What is a Scald?

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.

Degrees of Hot Water Burns

Hot water burns are classified into three degrees of severity:

1. 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.
2. Second-Degree Burns: These burns extend deeper into the skin and causes blisters, intense pain, and swelling. They often require more time to heal.
3. 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

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How do you treat a hot water burn at home?

If you have a minor burn caused by boiling water, consider using some 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 minor 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.

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Frequently Asked Questions

Here are the most common questions asked about scalding or hot water burns

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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.

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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.

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 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 can lead to serious complications if left untreated, emphasizing the importance of seeking medical care promptly.

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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 may develop, containing clear fluid. The severity of the burn depends on factors such as the temperature and duration of exposure to the hot water.

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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 may heal within a few days to a week with proper wound care, while more severe burns may take several weeks to heal completely and may require 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.

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