Scalds as a result of vapour inhalation therapy in children

Objective: To determine the numbers of paediatric scald injuries associated with the practice of inhaling warmed vapour or warm-humidification of rooms for treatment of upper respiratory tract infection (URTI). Methods: Cases comprised a 6-year consecutive series of scalds in children 0-14 years attending the Royal Children's Hospital (RCH) in Brisbane, Australia. All scalds were sustained either directly from a container of hot water, or by room humidification. Results: During 2001-2006, 27 children were treated for scald injury associated with breathing humidified air. Aged from 7 months to 14 years, 44% were under 3 years old and the modal age was 1 year. Injuries included steam burns to the hands from commercial vapour-producing devices in children younger than three, and spills from containers of hot water which resulted in larger scalds to multiple body sites in children aged 5-14. No child received an airway scald from hot vapour. Two children required grafts and four had a prolonged hospital stay. Total body surface area (TBSA) scalded, ranged from 1% to 15% and the majority of burns were deep dermal partial thickness. Conclusions: The common practice of warm-humidification of inspired air as home treatment of URTI's carries an under-recognised risk of serious scalding. An alternative means of providing humidified air is to sit with your child in a closed bathroom whilst running the shower for a short time. If warm humidification is to be used, increased awareness of the risk by both parents and health professionals may reduce the incidence of this serious burn