Objective To demonstrate how the mechanism and agent of injury can influence the anatomical location of a scald.
Design Prospective multicentre cross-sectional study.
Setting 20 hospital sites across England and Wales including emergency departments, minor injury units and regional burns units.
Patients Children aged 5 years and younger who attended hospital with a scald.
Main outcome measures Primary outcome: a descriptive analysis of the mechanism, agent and anatomical location of accidental scalds. Secondary outcome: a comparison of these factors between children with and without child protection (CP) referral.
Results Of 1041 cases of accidental scalds, the most common narrative leading to this injury was a cup or mug of hot beverage being pulled down and scalding the head or trunk (132/1041; 32.9% of cases). Accidental scalds in baths/showers were rare (1.4% of cases). Accidental immersion injuries were mainly distributed on hands and feet (76.7%). There were differences in the presentation between children with accidental scalds and the 103 who were referred for CP assessment; children with scalds caused by hot water in baths/showers were more likely to get referred for CP assessment (p<0.0001), as were those with symmetrically distributed (p<0.0001) and unwitnessed (p=0.007) scalds.
Conclusions An understanding of the distributions of scalds and its relationship to different mechanisms of injury and causative agents will help clinicians assess scalds in young children, particularly those new to the emergency department who may be unfamiliar with expected scald patterns or with the importance of using appropriate terminology when describing scalds.
- child abuse
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Contributors AAJ (lead author): writing article and data analysis. EJ: writing abstract, literature review, article review and reference organisation. LH: data analysis and article review. AMK: supervision of article and study design.
Funding This study was supported by the Scar Free Foundation and Health and Care Research Wales.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical approval was granted through Cardiff University with waived consent; MREC No. 13/WA/0003, 15/WA/0259 and 15CAG0203.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available. For data access enquiries, please contact Professor Alison Kemp.
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