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Hi Dr. Cason,

My 18-month old burned his fingertip on some hot glue the childcare workers were using for an arts and crafts project. (I have already written a very heated letter to the proper administrators informing them of my horror at hot glue being used with toddlers.) Anyway, his fingertip is white and swollen. I administered Neosporin (the kind with pain relief,) and covered it with a band aid. He seems to be OK, is there something else I should be doing? I don’t remember my first aid training for burns.

Thanks so much! – GM

Hi GM-

It sounds like from the description it might be a first degree burn or second degree burn. With glue there is a possibility of the burn being worse because the hot glue probably stuck to the skin before it was wiped off. If it blistered then it is a second degree burn. If that is the case then I’d take him to the doctor because second degree burns can progress to full thickness burns if they get infected!!

Here’s a little primer on burns. I got the following info from MedlinePlus Medical Encyclopedia. It’s a detailed review and I agree with their presentation. Remember first that there are three different kinds of burns and those are:

• First-degree burns affect only the outer layer of the skin. They cause pain, redness, and swelling.
• Second-degree (partial thickness) burns affect both the outer and underlying layer of skin. They cause pain, redness, swelling, and blistering.
• Third-degree (full thickness) burns extend into deeper tissues. They cause white or blackened, charred skin that may be numb.

Before giving first aid, evaluate how extensively burned the person is and try to determine the depth of the most serious part of the burn. Then treat the entire burn accordingly. If in doubt, treat it as a severe burn.

By giving immediate first aid before professional medical help arrives, you can help lessen the severity of the burn. Prompt medical attention to serious burns can help prevent scarring, disability, and deformity. Burns on the face, hands, feet, and genitals can be particularly serious.

TREATMENT FOR MINOR BURNS

1. If the skin is unbroken, run cool water over the area of the burn or soak it in a cool water bath (not ice water). Keep the area submerged for at least 5 minutes. A clean, cold, wet towel will also help reduce pain.
2. Calm and reassure the person.
3. After flushing or soaking, cover the burn with a dry, sterile bandage or clean dressing.
4. Protect the burn from pressure and friction.
5. Over-the-counter ibuprofen or acetaminophen can help relieve pain and swelling. DO NOT give children under 12 aspirin. Once the skin has cooled, moisturizing lotion also can help.
6. Minor burns will usually heal without further treatment. However, if a second-degree burn covers an area more than 2 to 3 inches in diameter, or if it is located on the hands, feet, face, groin, buttocks, or a major joint, treat the burn as a major burn.
7. Make sure the person is up-to-date on tetanus immunization.

I hope this helps. For a more extensive discussion on burns please go to the complete article.

If you are at all unclear then take your child to their doctor or at least call for a phone consult. I hope he feels better!

Tags: Dermatology, Health, Pediatric Advice

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