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Scalds: Seconds Count

Boiling water

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Painful Realities

Every year thousands of people sustain scald injuries. These can be caused by contact with hot water in the bathtub, shower, or sink. Scalding may also come from a person’s direct exposure to steam and other hot and moist sources such as hot, wet towels for treatment, therapy, or grooming. Most prevalent are scalding burns experienced when water for bathing is simply too hot.

Burns from tap water scalds are likely to occur when a person slips or falls into the bathtub or shower, when the person providing support to the consumer fails to recognize that water is too hot, and when water temperature fluctuates due to water being used elsewhere in the home.

Classification of Burns

Burns are categorized by the severity of damage to the skin and extent of treatment needed for healing. The table below describes the different characteristics of first, second, and third degree burns.

  Burn Degree Characteristics

 First

  • Minor damage to the skin
  • Skin is dry without blisters
  • Color is pink to red
  • Painful
  • Generally heals in 3-5 days with no scarring
 Second
  • Damages, but does not destroy, top two layers of skin
  • Skin is moist, wet, and 'weeping'
  • Blisters are present
  • Significant swelling (edema)
  • Color is bright pink to cherry red
  • Very painful
  • Generally heals in 10-21 days
  Third
  • Destroys all layers of the skin
  • May involve fat, muscle, and bone
  • Charred veins may be present
  • Color may be very bright red or dry and leathery, charred, waxy, white, tan, or brown
  • Person is unable to feel touch in areas of injury
  • Requires skin grafting for healing

Hot Water Burn Factors

Burns from excessively hot water typically involve one or more of the following factors:

  • Temperature of the water: According to the American Burn Association, water temperature of 100° F is the safest temperature for bathing.
  • Length of time skin is exposed to hot water: While some temperatures will cause a severe burn immediately, lower water temperatures can cause a severe burn if the skin is exposed for a sufficient length of time.
  • Integrity of the skin: The skin of very young children and very old adults are more susceptible to burn injuries. People who have healing wounds, rashes, and other skin conditions are also more susceptible to sustaining injuries when burned.
  • Staff supervision: Adequate supervision of persons who lack the ability to remove themselves from hot water or the ability to recognize its danger is critical to avoid scalding incidents.

Speed of Scalding

Just how fast can a person be scalded when water is too hot? The table below illustrates how long it takes for a person to sustain a very serious, third degree burn.

Water Temperature (fahrenheit degrees) Time Elapsed for a Third Degree Burn
  155   1 second
  148   2 seconds
  140   5 seconds
  133   15 seconds
  127   1 minute
  124   3 minutes
  120   5 minutes

Steps You Can Take to Prevent Scalds

What precautions can you take to prevent scalding incidents? The following steps service providers can take will make an enormous difference in the safety of those in their care.

  • Provide adequate supervision of consumers who cannot remove themselves from hot water on their own, or consumers who lack danger awareness regarding hot water. Do not leave these consumers unattended from the time the bath or shower is being prepared until the consumers complete their bath or shower and leave the bathroom.
  • Include safe use of hot tap water in ongoing training of consumers and service providers.
  • Turn the faucet to the COLD position when not in use if the bathtub has a single faucet handle.
  • Make sure the HOT water position on faucets is clearly marked.
  • Check with your licensing agency regarding regulations for temperature settings for water heaters and follow their guidelines.
  • Install grab bars and non-slip flooring or mats in bathtubs or showers if a consumer is unsteady or weak. Provide a shower chair or other support device as needed.
  • Avoiding flushing toilets, running water, or using the dishwasher or clothes washer while anyone is showering to avoid sudden fluctuations in water temperature.
  • Install anti-scald devices on hot water heaters. Anti-scald devices, anti-scald aerators, and scald guards are heat-sensitive devices that stop or interrupt the flow of water when the temperature reaches a pre-determined temperature to prevent hot water from coming out of the tap before scalding occurs.
  • Use cold water vaporizers and humidifiers.
  • Use warm, wet towels or compresses with great care to ensure they are not too hot.
  • Day Program service providers should also take precautions regarding water temperature and anti-scalding devices in restrooms and work areas where consumers may be exposed to hot water hazards.

Summary

Nationwide, tap water scalds result in more inpatient care, typically cover a larger area of the person’s body, and end in more fatalities than other types of scald injuries. With careful planning and consistent attention, service providers can reduce consumer risk for these traumatic and painful injuries.

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Last updated on Mon, 06/14/2010 - 17:18