Pediatric Burn Care

Symptoms

• Red, dry skin (first-degree/superficial burn): The outer skin layer only, red and painful with no blisters, similar to a mild sunburn; it usually heals within about a week.
• Blisters (second-degree/partial-thickness burn): Fluid-filled blisters, wet or shiny skin, swelling, and significant pain that reach into the deeper skin layer; these need closer medical evaluation, especially in young children.
• White, leathery, or charred skin (third-degree/full-thickness burn): The skin looks white, brown, black, or leathery and may be numb because nerve endings are destroyed; this is always a medical emergency.
• Swelling around the burn: Inflammation at and around the burn site, which can worsen over the first day or two.
• Pain out of proportion or, conversely, numbness: A very painful burn is common, but a burn that is painless can signal deeper, more serious damage.
• Signs of smoke or heat inhalation: Coughing, hoarse voice, singed nose or facial hair, soot around the mouth, or trouble breathing after a fire, which point to possible airway injury.
• Signs of infection: Increasing pain, spreading redness, warmth, pus or drainage, or fever developing a day or more after the burn.
• Chemical or electrical exposure: Burns from household chemicals or electrical outlets and cords can cause deeper injury than the skin surface suggests.

When It's an Emergency

Call 911 immediately if your child was in a house fire, was exposed to smoke, or has any trouble breathing, coughing, hoarseness, or soot around the nose or mouth. These signs can mean the airway is injured, which is life-threatening even when the skin looks fine.

Come straight to Bellaire ER — open 24/7 — for any burn that blisters and is larger than the size of the child's palm, and for any burn on the face, eyes, ears, hands, feet, genitals, or over a major joint. Burns in these areas can affect function and scarring and need in-person evaluation.

All deep burns (white, brown, leathery, or charred skin), all electrical burns, and all chemical burns are emergencies, even if they look small. Electrical and chemical injuries are often deeper than they appear on the surface. For infants under one year, a burn that would be minor in an older child should still be seen promptly.

Also come to the ER if a burn shows signs of infection a day or more later: spreading redness, increasing pain, warmth, pus, or fever. Bellaire ER at 5302 Bellaire Blvd is open 24/7; if you are unsure how serious a burn is, it is always safer to have it evaluated.

When It's Not an Emergency

Many small burns in children can be managed at home. A first-degree burn (red, dry, no blisters) or a small blister burn smaller than the child's palm on an arm or leg can usually be cared for by cooling the area under cool, not ice-cold, running water for about 10 to 20 minutes, then covering it loosely with a clean, non-stick dressing and giving age-appropriate pain relief.

Do not use ice, butter, toothpaste, or ointments on a fresh burn, and do not pop blisters. A telemedicine visit or online urgent care is a reasonable first step for a small, uncomplicated burn when you want guidance on wound care or are unsure whether it needs to be seen in person.

Your pediatrician or an urgent care clinic can also check a healing burn or update a tetanus shot. If a burn that seemed minor is not improving in a few days, becomes more painful, or shows signs of infection, have it re-evaluated in person rather than waiting.

What Happens at Bellaire ER

At Bellaire ER, a board-certified emergency physician evaluates your child right away, estimating the depth and the percentage of body surface the burn covers and checking for airway involvement after any fire or smoke exposure. Keeping your child comfortable is a priority, so pain is treated early.

The burn is gently cleaned and, when needed, blisters and loose tissue are managed and the wound is dressed with appropriate non-stick coverings. For chemical burns the area is thoroughly irrigated, and electrical injuries are assessed for deeper damage. On-site lab work, X-ray, and other diagnostics are available in the same visit if the physician needs them.

Most children with minor and moderate burns are diagnosed, treated, and sent home in a single visit with clear wound-care instructions, pain management, and guidance on watching for infection. When a burn is severe or extensive, our team stabilizes your child and coordinates transfer to a specialized burn or pediatric center. A tetanus update is given if it is due.

Prevention

Most childhood burns happen at home and are preventable. Set your water heater to no higher than 120 degrees Fahrenheit, and always test bath water before placing a child in it, since hot tap water and spilled hot drinks are leading causes of scald burns in young children.

Cook on the back burners of the stove and turn pot handles inward, keep hot liquids and appliance cords out of a child's reach, and never hold a child while carrying hot food or drinks. Keep lighters, matches, and chemicals locked away and use childproof covers on electrical outlets.

Install and test smoke alarms on every level of the home, keep children away from fireplaces, grills, and space heaters, and use sunscreen to prevent sunburn. Having a working fire-escape plan adds another layer of protection.