Getting Your Child Ready for Home after a Burn Injury
There's no place like home
There’s no place like home when you and your family can begin to readjust to normal activity and lifestyles. You will probably experience a variety of feelings and emotions that are all normal. You may feel scared, nervous or uneasy about leaving the hospital and you may be concerned about how friends and family will react to your child’s appearance. Your mixed feelings are normal and it can help to have someone to talk with. Remember there are plenty of support persons who were involved in your child’s care that are available after discharge. Feel free to contact the main number to the hospital (668-7000) if you have questions that our staff may be able to answer or if you need resources. Our physical therapists, nursing staff, chaplains, social workers and child life specialists can be reached during regular work hours. Many times your emotions can affect the physical recovery of your child. We want you to feel free to contact us with any concerns you have once you get home. Remember, we are here to help!
Home Wound Care
Your child may go home with some areas that are still healing. These may be covered with xeroform/aquacel or still require dressing changes.
If your child’s burns are covered with xeroform/aquacel and it is adhered, there is very little care needed. As the new skin grows, the xeroform/aquacel will begin to lift up around the edges. These edges can be trimmed as they lift. Care should be taken to keep the xeroform/aquacel dry. If the xeroform/aquacel begins to look moist, ooze or develop an odor, call your child’s doctor.
Your child may go home with open areas that still require dressing changes. You will be instructed on how to do this before you leave the hospital. It is not necessary to maintain a sterile environment for home dressing changes, but the area you use should be as clean as possible. It is helpful to set out and open the new dressings before removing the old ones.
- Wash your hands before you start.
- Remove the old dressings and throw away.
- Clean the area gently, as instructed.
- Apply any cream that has been ordered, being careful to place it only on the open area.
- Cover with clean bandages, secure with netting if this has been used to hold bandages in place.
- Wash your hands when you are done.
If it appears that the dressing changes are painful for your child, discuss pain medication with your doctor.
Specific instructions for your child:
Healing skin can be dry. The glands in the skin that make oils are damaged by the burn. Until the glands work again, you can put lotion on your child’s dry skin. Cocoa butter is often recommended. Do not use things on the skin that have alcohol or lanolin or perfumes in them. Alcohol dries the skin. Lanolin can cause blisters in newly healed skin. Perfumes can irritate healing skin. You will need to read the labels on different lotions to see if they have alcohol, perfumes or lanolin and then avoid that lotion. For example, Lubriderm has lanolin and should be avoided.
Healing skin can be itchy. Try not to let your child scratch the skin. To avoid scratching, you can:
- use lotion such as cocoa butter.
- give medicine by mouth, as prescribed by your child’s doctor. Benadryl is often suggested and is an “over the counter” medicine.
Use lukewarm water when giving your child a bath. Be sure your hot water tank temperature is set below 120 F so that very hot water cannot be turned on accidentally. It is important to keep burned skin areas clean, but be gentle when bathing.
The new skin over the burn area is more sensitive than the skin over the rest of the body. To protect your child’s skin:
- put on comfortable clothes.
- try to avoid bumps and bruises.
- avoid going out in the sun as much as possible. Wear clothes, hats, and sun screen (with a sun protection factor [SPF] of at least 15) on your child when in the sun, even for a short time - your child’s healing skin can get sunburned easily.
- do not stay out in cold weather. Healing burn areas are also sensitive to cold.
If your child has difficultly adjusting
It is extremely difficult to cope with stressful situations that last for a long time. Children have less ability to cope with stress because of their limited life experiences. Some common crisis reactions in children are listed below.
- Agitated behavior – crying, thumb sucking
- Disturbed bodily functions – eating, sleeping, elimination
- Separation anxiety – clinging, refusing to sleep alone, wanting to be held constantly
- Sleep disturbances, nightmares
- Regression in toileting, dressing, self-feeding
- Decreased self-confidence
- Makes depreciating comments about self
- Aggression, both verbal and physical
- Repeated episodes of sadness
- Compulsive re-enactment of traumatic events in play
- Concentration difficulties
- Behavior changes – the quiet become frantic, the energetic become lethargic
- Physical ailment – headaches, stomach aches, dizziness
- Increased dependence
- Resentment of unfairness of situation, blaming
- Difficulty with peers
- Unrealistic expectations of self and others
- Frustration, producing rebellion
- Avoidance and denial to avoid addressing issue
- Reluctance to trust or open self to others
- Feelings of hopelessness, meaningless of life
- Lowered impulse control, easily frustrated
- Drug/alcohol abuse
Any unusual, persistent behavior should be evaluated by a qualified mental health professional. If you would like to discuss your child’s behavior and explore possible solutions to help your child, please call us! It is often very beneficial to get another opinion when you are concerned or unsure about what to do next. If one or more of these behaviors persist over a long period of time, and to a marked degree, professional help may be needed to perform an assessment.
Coping with changes
Your child will be very happy to once again be with his own toys, friends, school, and family. However, your child’s burn care and emotional recovery will continue when you leave the hospital. Along with the excitement, you and your child may also feel uneasy about what will happen next.
Your entire family has experienced a crisis as a result of the burn incident, hospitalization, and the disruption of home life. Children are affected not only by how a crisis impacts on their own lives, but also by their parents reactions to the situation. Below are some important strategies for helping children cope with the stress of his/her injury, the hospitalization, medical treatment, and now, returning home.
- Try to set up a daily routine that includes some of the day-to-day activities that you did before your child’s injury.
- Take one day at a time! Make simple goals every day; be proud of your daily achievements.
- Take care of yourself! Ask for help. Simplify your life. Prioritize your obligations and values. Eat well and get enough rest. You have experienced a lot and you are going home tired!
- Remember that the way your child comes through this will largely be determined by the way you handle it. He/she can be stronger as a result of this experience.
- Understand your child’s level of development. Be on the lookout for symptoms. Don’t punish your child for symptomatic behavior.
- Expect regression, changes, problems, and anger.
- TALK with your child – a lot. Don’t assume that, because he/she hasn’t mentioned it, it isn’t on your child’s mind. Tell the truth. Tell him/her how you feel, but be careful not to overwhelm your child if you are having difficulty coping.
- Encourage your child to talk. LISTEN! Listen for cues in his/her talk with others, play, etc. Encourage verbal expressions of anger or sadness.
- Reassure your child. Tell your child what to expect in the future and keep your child focused on his/her goals.
- Encourage your child to express opinions, suggestions, and solutions.
- Reassure your child of the normalcy of his/her feelings. Expose him/her to other children your child’s age with the same problems.
- Encourage your child’s development of competence and independence.
- Inform the school. Talk with your child’s teachers.
- Let others help you (grandparents, relatives, friends, neighbors, church groups). Seek professional help, if necessary.
- Reassure your child of your love and support.
Each year there are two camps available to burn survivors in Virginia. The Mid-Atlantic Burn Camp is located in Harrisonburg and is offered to children ages eight to eighteen. The Central Virginia Burn Camp in Charlottesville is offered to children ages seven to seventeen. Both camps are often free of charge to the campers due to fund raising efforts throughout the year.
Each camp offers unique programs that help campers deal effectively with burn-specific issues. The staff are burn survivors, burn therapists, nurses, and other dedicated volunteers experienced and trained to supervise the activities and programs. The programs promote teamwork, self-confidence, and self-esteem. But above all, the camps are designed to be FUN!
If you are interested in more information about the camps, please call us.
When to call your child's doctor
- If your child is not eating or drinking well.
- If there is uncontrollable behavior at home or school.
- If there are signs of infection (healing burn areas change appearance and become red, warm swollen, extremely tender and have foul drainage or odor).
- If there is uncontrollable itching.
- If the scar cracks open or splits.
- If contracture occurs.
- If your child’s temperature is greater that 101.5F rectally or by mouth.
- If it appears that dressing changes are painful for your child, discuss pain medication with your doctor.
Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.