Annals of the M.B.C. - vol. 1° - n° 1 - September 1987

THE PREVENTION OF BURNS IN CHILDREN (VIDEOTAPE)

Ferrara M.M., Masellis M., Amico M., Caputo G., Sferrazza G.

Divisione di Chirurgia Plastica e Terapia delle Ustioni - Ospedale Civico, Palermo

SUMMARY. A 15 - minute videotape is presented showing a series of situations - some acted, others illustrated with coloured drawings - in which children risk burn injury. The episodes have been reconstructed in order to attract the attention of the spectator and they show either scenes of family life or children playing together. Every episode ends with a very realistic reconstruction of the way the accident happens, with shots of the burned children which in it eir frank realism will certainly leave a marked impression on the viewer.
The commentary has been made deliberately (asy to follow and it stresses how often a child's imaginative ideas may lead to dramatic situations. The videotape is an attempt by those who pioduced it to propose, by means of the Mediterranean Bums Club, a common message on bum prevention in children, to all colleagues in the Mediterranean area.

As part of a campaign for the prevention of burns in children, we thought it would be useful to produce an educational and informative videotape intended not only for children of all ages bul. also for parents, teachers and all those responsible for the health and safety of the younger generation.
The videotape shows a series of typical situations, some acted, others using coloured drawings, in which children risk being involved in burn accidents. All the situations correspond to moments i.i ordinary family life or to games played by children. Every episode ends with a very realistic constructiori of how and why the accident happened, with. brief shots of the burned child which in their frank realism Aill certainly leave an indelible impression in the minds of all those who view the tape.
The commentary is very straightforward and points out how often it is the child's imagination that produces dramatic and unpredictable situations.
The home - traditionally an oasis of peace and safety - is statistically the site of 36% of all accidents. An ordinary domestic electric or gas fire can become a mortal trap for the unwary child (Fig. 1, 2).
And a harmless pan of milk or water set to boll in the wrong place can be the cause of grave burns. Exploring and experimenting are for the child ways of learning about the world he lives in: there are therefore numerous objects about the houise which may be extremely dangerous if not used with proper care and precaution (Fig. 3, 4, 5).

For example, ovens not provided with heat-resistant windows can cause serious in mpacitating burns to children's hands (Fig. 6, 7, 8). Or a redhot iron left unguarded (Fig. 9, 10).

Or an electric plug in a power point can attract a child's attention and stimulate his curiosity (Fig. 11, 12, 13).

Any act of carelessness by an odult can expose a child to grave danger, for example leaving toxic or harmful products within a child's reach, products such as Niagara - composed of sodium hydroxide - widely used in Italy for clearing obstructious in bathroom and kitchen wastepipes. This product comes in small white lumps which look very similar to various sweet granular substances such as sodium citrate and it represents a great temptation for the child, who may put it in his mouth and swallow it, causing serious 3rd degree chemical burns to the lips, mouth and the upper parts of the digestive system (Fig. 14, 15, 16).
An open brazier fire - still used in many country areas in winter for families to gather around - constitutes an extremely dangerous risk for a child if left for a moment unattended (Fig. 17, 18, 19).

However burn accidents are not only limited to the home and the city environment. In the hot months of the year children are very often left to play outside and to explore the very risky world about them.
Adults in general are not particularly worried because they know the children are playing safely near home with other children their own age. But constant attention must be paid to certain "risk situations-, of which there are innumerable examples: a pot full of homemade tomato sauce left on the boil, prepared according to a common tradition in Italy in order to have a good supply for the winter, constitutes for the child a tremendous attraction and at the same time a terrible danger (Fig. 20, 21, 22).

Another risk situation to be kept particularly in mind is that in which there is the riA of direct contact with flame, as for example when in ite country stubble is being burnt off, or during popular festivities when unwanted household objects are piled up and burnt. The flames - which have an evident cathartic and propitiatory function - exert wii.h their heat and light a natural fascination on the child that may lead to even fatal results (Fig. 23, 24, 25).

However, apart from keeping children under constant control, adults should also show that they use fire correctly and responsibly - for or course children imitate their elders. A barbecue fire may need reviving and this is sometimes done by spraying the burning charcoal with surgical spirit, an extr,-mely dangerous act - and not only for children (Fig. 26, 27, 28).

But watchfulness alone is not enough - for effective prevention of burn accidents ther,- must be proper education. It is natural for children, at a certain age, to want to play alone or in the ec,mpany of other children, to invent situations and to organize collective games. Through their play, through their relationships with their companions, children learn, experiment and increase their knowledge. 11 is a natural and necessary part of any child's develepment to simulate journeys and adventures, and to transform space and the world around him. Thus children may happily play cowboys and Indians, but they should be made to realize that, like many other things, the execution of an enemy is just make-belief, and that the lighting of a fire can have terrible con~,equences (Fig. 29, 30, 31).

The last part of the video shows some simple precautions to be adopted in order to prevent burn accidents - as for example avoiding the use of synthetic materials in clothing fi)r children, especially when there are heat sources in the home, and avoiding placing pots and pans on the Duter hot plates of gas or electric cookers.
It is recommended to use heat-resistant glass in ovens and to instal an automatic cut-off switch in domestic wiring systems whict interrupts the current in the event of a short circuit.
It is also recommended that the thermostat control on water-heaters should be set at no more than 45'C. Adults are reminded that they must constantly be responsible for their actions and nover leave unattended and within the reach of children any toxic substances, matches or any kind of incendiary objects or liquids. Drama is always just around the comer.
The 15-minute videotape was produced by the Mediterranean burns Club and there are versions in French, English, Arabic, Spanish, Italian, Greek and Turkish, which are at the disposal - free of charge - of all Members of the club wishing to receive it. Our purpose has been to stimulate in cvery country a concrete campaign for the prevention of burns in children.

RÉSUMÉ. Un video-clip de 15' reproduit une série de situations en partie mises en scène, en partie à l'aide-de dessins, où un enfant peut risquer un accident du à des agents thermiques. Les épisodes sont construits de façon à attirer immédiatement l'attention du spectateur à qui on propose soit des moments de la vie de famille soit des phases de jeux de ces enfants avec leurs compagnons.
Chaque épisode se conclut par la réconstructior très réaliste du mécanisme de l'accident, avec des gros plans sur des images d'enfants brûlés, qui, étant tellement frappantes, se fixeront dan~ la mémoire de celui qui les voit.
Le commentaire a été étudié pour être extrèmeinent accessible, et met en relief comment la fantaisie de l'enfant peut créer, bien souvent, des situations dramatiques imprévisibles.
Le film veut etre une tentative, de la part de ses réalisateurs, de proposer, par l'intermédiaire du Centre Méditerranéen des Brûlures, un discours unitaire des collègues du bassin Méditcrranéen sur la prévention des brûlures chez les enfants.