Addressing Bath Scalds in

the Under Fives

 What is a Scald?
A scald is a burn injury caused by hot liquids
 Water
 Tea/coffee
 Cooking oil
 Hot food/soup
 Vapour/steam
 The type of scald
which has the
highest incidence of
death or severe
injury is caused by
hot bath water
Who Is At Risk?
 Very young

 Elderly

 Due to slower reactions and thinner skin

 Sustain scalds more quickly at lower

temperatures and often with a greater depth of
burn
Why Young Children?
 Learn by experimenting
 Unaware of what will hurt them
 Dependent on others to keep them safe
 Economic factors – children from lower
socio economic groups are 50% more
likely to experience burns and scalds
than higher socio economic groups
 How?
Accident Mechanism 0-4 5-10 11-17
Fell into water 37% 56% 40%
Climbed into hot bath usually 29%
unsupervised
Put into hot bath by parent or 7%
sibling
Baby/young child turned on hot 7%
tap themselves
Sibling turned on hot tap 7% 40%
Other 13% 44% 20%
Based on data from DTI burns and scalds accidents in the home.
Government Consumer Safety Research 1999
Antrim Area Hospital A&E
Attendances due to Scald Injuries

Age 2004/05 2005/06

0 10 10
1 12 21
2 13 9
3 7 10
4 5 5
Total 47 55
Degree of Scald
Depends on:

 Temperature and volume of hot water

 Length of time body is exposed to it

 Can only take seconds for a severe

scald to occur
First Degree Burn
 A 1st Degree Burn – superficial
sunburn where there is no blistering

 A 2nd Degree Burn – a burn with

blisters and with proper treatment may
go on to heal without a skin graft
Severity Can Be Expressed As:
 A 3rd Degree Burn – entire thickness
of the skin destroyed. Wound surgically
removed and area covered with a skin
graft
Impact
Severe scalds can cause:
 Long term disability
 Disfigurement
 Distress and pain
 Psychological trauma
 Emotional difficulties
 Prolonged hospital treatment
What Temperature? How Long?
Temperature oC Exposure Time
44 6 hours
49 9 minutes
51 2-6 minutes
52 2 minutes
55 20-30 seconds
60 5-6 seconds
66 2 seconds
70 1 second

Adult exposure time for partial thickness burns. Information source DTI
Research Document Burns and Scalds in the Home 1999
Preventing Bath Water Scalds
 Bath water scalds lend themselves
to prevention because the risk of a
tap water scald injury is virtually
eliminated when hot water is
supplied at a safe temperature
What is a Thermostatic Mixing Valve
(TMV)?

 Mixes hot water from

boiler/water heater with
cold water – delivered
through hot tap at a preset
temperature
 The mechanism
automatically compensates
for any variations in the
pressure or temperature of
the water supply to maintain
a safe temperature
 Accident Prevention Is
Everyone’s Business

Health Promotion RoSPA

Coleraine Borough
Surestart Strategic
Ballysally
Partnership

NI Housing NNHAZ
Executive
Health
Visiting
Steering Group Identified:

Who do we target, why and how?

How can we deliver the scheme?

How do we evaluate the scheme?

 What We Did
 Identified what needed to be done and which
organisation/group were best placed to
deliver it
 Health Visiting/ Health Promotion –
co-ordinated/purchased TMVs
 Surestart –
identified families/made contact
 Coleraine Strategic Partnership –
informed residents of scheme
 What We Did
 NNHAZ –
funded awareness raising session
 RoSPA –
delivered awareness raising session to local
community/families
 Health Visitors –
advised and referred families to scheme
 NIHE –
fitted and will maintain TMVs
 How Are We Progressing

 To date 15 Thermostatic Mixing

Valves have been fitted
What Have We Learned
 Partnership working
 Community support
 Continued promotion
 Monitor and review
 Awareness raising sessions
 Evaluation
 New ways of working
Prevention is better than
treatment