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Too Hot for Tots!

"It only takes a second to change a life forever."
Program

Between 2004-2013, there were 1,680 visits to the  Emergency Department of BC Children’s hospital for children under the age of 5 who had suffered a burn injury. During that same period, 5,498 hospital visits were required for follow up burn care and scar management.

The program is a partnership between the BC Professional Fire Fighters' Burn Fund and BC Children's Hospital.  

Each year, BC Children’s Hospital cares for as many as 170 children who have suffered a burn. Over 500 hospital visits are required following the initial injury, for burn treatment and reconstructive surgery. 

Burn treatment is painful and prolonged, often resulting in long-term consequences for the child, such as disfigurement, physical disability, and emotional dysfunction. Sadly, the majority of these injuries could have been prevented through awareness and education. 

Most of these injuries happen in the home - the kitchen, bathroom or family room where safety measures can be taken. Scalds from hot liquids such as tea and coffee, hot tap water and hot surfaces are the most common causes of burns for young children – not fire, as many parents believe.

Young children are curious and move quickly. Burns and scalds happen when young children reach for hot liquid on the table, play in the bathtub unsupervised or crawl up to the fireplace to touch the glass because they are attracted by the flame.


“A child’s skin is four times thinner than an adult’s”
 says Dr Cindy Verchere, Director of the BC Children’s Burn Unit. “When a hot liquid like tea is spilled on a child’s skin, the heat moves very quickly into the deeper layers of the skin causing significant damage in a matter of seconds”.

Frances MacDougall, a clinical nurse who worked for many years on the Burn Unit at BC Children's Hospital, developed the Too Hot for Tots! Program after hearing many caregivers say they were not aware of the burn hazards in the home or how seriously their child could be injured. “After viewing the Too Hot for Tots! video and reading the “take home” brochure, parents will be armed with the 3 B’s of Burn Prevention,” Says Frances, “Parents need to be aware of the burn hazards in their home; be close, within arm's reach when their child is near or around a burn hazard, and burn proof the family home. Using these three strategies in combination will reduce the likelihood of a devastating burn injury.”

 

Workshop

The prevention of childhood burn injuries is complex and can’t be solved by simply giving caregivers more information. During this 2.5 hour workshop, Frances MacDougall will provide educators with a better understanding of how these injuries happen and will suggest strategies for delivering this information in a way that makes the message stick!  Email us to schedule your workshop today!


Mailing list

If you would you like to be added to our Too Hot for Tots! contact list please send your name, complete mailing address, email, phone, title and organization to Too Hot for Tots! Contact List

Too Hot for Tots logo 

Donate

Your generous donation to  BC Children's Hospital Foundation will help to support this program in the future.  

To make your donation, contact the Foundation.

The Impact Evaluation of this program was conducted in 2011 by the BC Injury Research and Prevention Unit.  The evaluation results demonstrated a statistically significant increase in caregiver's knowledge, attitudes and practices around burns prevention in the home after exposure to the program.

The evaluation also showed that the program was more effective when presented as a group session. Effectiveness decreased when caregivers were only given the brochure as a take-home resource and encouraged to view the video on line. View the full report or summary.

During the provincial launch of the Too Hot for Tots! program in March of 2012, over 200 Too Hot for Tots! Tool Kits were sent to Public Health units and Early Childhood providers across British Columbia.  Several months later, the recipients were surveyed to gather feedback on these products and to find out whether they were using the resources in their community settings.  Click here to view the Too Hot For Tots! Resource Survey Report.
 
The feedback from this survey showed that front-line educators wanted more guidance on implementing the program.  To address that need, we revised and expanded the Educator's Handbook.  Click here to view sample pages from the revised Handbook.  The second edition of the handbook is now available for purchase online (Free for BC educators).


Resources

Resource orders

Order your resources

Resource questions

For questions about the Too Hot for Tots program or resources, contact the BC Professional Fire Fighters' Burn Fund.  
Phone: 604-436-5617

The Too Hot for Tots! brochure summarizes the information in the Too Hot for Tots! video and serves as a “take home” resource for parents and caregivers. 


The brochure also includes a multi-use hot water Temperature Testing Card. This card provides home owners with a method to test the temperature of their hot tap water to ensure that it is set to a safe delivery temperature.

Brochure

 

Warning: The multiuse temperature testing card contained in this brochure is to be used to test the temperature of your hot tap water, not your child's bath water!
   

Videos

 

Too Hot for Tots! video
Using the power of storytelling and re-enactments this video shows how easily thermal injuries can happen and how serious they can be.  Evidence-based prevention strategies and emergency first aid treatment are also provided in this video. 

 

Adjusting Your Hot Water Temperature video
Whether you are using a high heat candy or meat thermometer or the temperture testing card from the brochure, the instructions are the same.  This video explains how to reduce the temperature of your home hot water tank to a safe delivery temperature using either method.

 

 

Hot Drinks Harm video

The burn team at Frenchay Hospital in Bristol created this film to raise awareness about the dangers of leaving hot drinks around young children.

After the Injury

A burn injury is a frightening event for a child and family. It is normal to feel overwhelmed and worried. Traumatic stress symptoms are common, including feeling anxious, jumpy, angry or empty. Family members are the best individuals to support the child. 

 

Respond to your child in a calm, patient and reassuring way. Use simple words to explain what is happening  and talk about your feelings and thoughts with each other. Try to go back to normal routines and limits as this helps the child feel that life is safe and predictable.

 

If your child's injury is significant or they continue to show behaviour changes months after the traumatic injury, it may be a sign that your child needs professional support. If your child is a patient at BC Children's Hospital, you can access help through the Psychology Department. For more information about helping your family cope read  Burn Injuries: Helping Families Cope

 

The BC Professional Fire Fighters' Burn Fund is a valuable resource available to burn and trauma patients and their families.  We provide funding for burn garments/creams; offer a summer Burn Camp for young Burn Survivors ages 6-18; and have programs for all ages of burn and trauma survivors.  To apply for funding please contact Shelley at the Burn Fund office 604-436-5617.


First Aid for a Burn

Awareness of first aid procedures is helpful before an injury occurs.  Review first aid for a burn.
 

Practice Update

Length of cooling time



Resources


The Too Hot for Tots! resources are complimentary for firefighters and educators working with young families in British Columbia. "Tool Kits" and "Sample Kits" may be ordered online.  These resources may be purchased by those outside BC but this program may only be distributed in Canada.



  

Educator Handbook

The Educator Handbook provides educators with current information and statistics on paediatric burn injuries. The primary goal of this document is to provide educators with consistent, reliable, evidence–based information so they can teach caregivers how to reduce the risk of a burn injury in the home. The Handbook also shares ideas and best practice recommendations on how to effectively deliver this training in your community. The Too Hot for Tots! video is located in the back cover of the handbook.

  • Buy the handbook online (Free for BC educators)
  • View a PDF of sample pages from the Handbook 

 

 Videos

 

 


Too Hot for Tots! video
Using the power of storytelling and re-enactments to show how easily thermal injuries can happen and how serious they can be. Evidence-based prevention strategies and emergency first aid treatment are also provided in this video.

The DVD contains two videos and one power point presentation, and has translated versions of both videos in the following languages: Punjabi, Cantonese, Mandarin, Spanish, Vietnamese, and French.

  1. Too Hot for Tots! video (Running time 16:57).  Warning - Graphic images, not suitable for children under 10 years of age.   Too Hot for Tots! (3 minutes).

  2. Adjusting Your Hot Water Temperature (Running time3:20) teaches caregivers how to use the temperature testing card that comes with the brochure and explains how to reduce the temperature of a home hot water tank to a safe delivery temperature.

  3. Caregiver Discussion This power point presentation highlights the key messages from the videos and are to be shown as a review after caregivers have watched the Too Hot for Tots! and Adjusting your Water Temperature videos. The slides are designed to support group discussion which is a key factor to success.  

Injury Prevention Posters

  

This Posters Set provides injury facts and prevention strategies for thermal injuries that result from Hot Surfaces, Hot Water and Hot Drinks including a poster on Emergency First Aid treatment for a burn. These posters are intended to be displayed prominently in a community setting to generate awareness about these risk factors. The posters are translated into Punjabi, Simple Chinese, Traditional Chinese, Spanish, Vietnamese, and French.

View PDF samples of the Posters: EnglishPunjabiSimple ChineseTraditional ChineseSpanishVietnamese, and French.


Buy this item online (Free for BC Educators)



Display panel loan program

Enhance your Too Hot for Tots! community-based safety campaign with these large, colorful, free standing display panels, which can be borrowed through the BC Injury Research and Prevention Unit.  Phone: (604) 875-3776



New Resource

Hot Water Burns Like Fire:  Post Card.  This resource educates cargivers about the danger of hot tap water and provides passive and active strategies for reducing the risk of a tap water scald.  Ideal for community events that aim to educate the public about preventable pediatric scalds.


Summary of Too Hot for Tots resources​


 

Educator training 

Over the years, countless, well-intentioned, even inspirational programs have attempted to educate the public about health and safety issues and yet, many have failed to create change in their audience. Studies show, that adults will take in new information, remember it and change their behavior if they can personalize the information they are given. Simply watching a video or handing out brochures will have some impact, but this method is too passive to create lasting change. Learn how you can create lasting change in your audience! 

1 Hour Presentation: Frances will provide an overview of pediatric thermal injuries and explains why the Too Hot for Tots! program created statistically significant changes in parental knowledge, attitudes and behaviours after exposure to the program.


2.5 Hour Workshop Description
: In Canada, fire and burn related injuries are the 3rd leading cause of injury-related hospital admissions for children 0-4 years of age, and yet, 70% of Canadian parents do not know that scalding from hot liquids such as tea and hot tap water, rather than fire, is the most common cause of childhood burn injuries. During this workshop you will learn who gets injured, how they get injured and why. Current statistics and evidence based prevention strategies will be shared and recommendations on how to effectively implement and deliver this program in your community settings.


Schedule
 your workshop today! 

Frances MacDougall, RN

Program Developer – Too Hot for Tots!


Educator support

On April 30th 2014 Parachute, the National Injury Prevention Program of Canada, launched Child Injury Prevention (Ages 0-6).  This new section on Parachute's website provides educators with a free on-line course Introduction to Child Injury Prevention, evaluation tools, sample surveys and supplementary resources to guide and support caregiver education.  The "Child Injury Prevention Listserv" is a group email which provides educators with an avenue to connect, share and learn with others working in this area.  Join today


Loan display panels

  

Enhance your Too Hot for Tots! community-based safety campaign with large, colorful, free standing display panels, which can be borrowed through the BC Injury Research and Prevention Unit. 

To Request Panels: Print and complete the booking form and email it to bcinjury1@cw.bc.ca or call 604-875-3776. 


Summary of Too Hot for Tots resources

 
Questions

Burn Prevention Tips for the home

  

How can I prevent a devastating burn injury from happening to my child?

Answer:

  • The most effective way to reduce the risk of a burn injury to your child is to use a combined approach called the 3B’s;
  • Be Aware - Watch the Too Hot for Tots! video located in the “for parents” section to learn about the common burn hazards in your home and the threat they pose to your child.
  • Burn Proof -your home using the recommendations suggested in this video.
  • Be Close - when your child is near or around a burn hazard.

Burn proofing is an important step toward reducing the likelihood, and severity of a burn injury but it is not a replacement for constantclose supervision.

If your child is in an environment that is not burn proofed, the other two strategies need to be heightened: Being Aware of the hazard and Being Close.

Burn Prevention Tips for the Bathroom

  


Hot tap water set at 60°C (140°F) will cause a serious burn in less than 1 second, whereas tap water that is set to 49°C (120°F) will take 10 minutes to cause the same damage.

British Columbia adopted national building code standard in 2012 to reduce the risk of scald injuries when bathing or showering. This new code requires that the hot water delivery temperature to bathtub faucets and showers in all newly built or renovated homes is no greater than 49°C (120°F).


How do I check my child’s bath water to make sure it’s a safe temperature?

Answer:

  • If the water temperature feels comfortable on your inner arm or elbow, it is a safe temperature for your child.  Bath thermometers that check the water temperature for you are not recommended because there is no way of knowing if they are working properly.

What temperature should my hot tap water be?

Answer:

  • 49°C (120°F)

What is the factory set temperature for most hot water tanks?

Answer:

  • 60°C (140° F)

How do I adjust the temperature of my hot tap water?

Answer:

  • This will depend on the type of water tank you have and whether you live in a multiple dwelling such as an apartment.  To learn how to reduce the temperature of your home hot water tank to a safe temperature, read this brochure and watch this video.

How can I tell whether I have a electric or gas hot water tank?

Answer:

  • Gas tanks have a temperature dial in front and electric tanks have a metal plate that must be unscrewed to reach the temperature control dial.

Which tank can you turn down?

Answer:

  • Gas - you can do this yourself. Refer to the Owner’s Manual for your water heater.

Which tank has to be kept at 60°C (140° F)?

Answer:

  • Electric - a plumber will need to either install a mixing valve to the water line or replace the existing faucet and shower head with one that contains a mixing valve.Lowering the temperature of an electric tank can lead to the growth of bacteria because the water at the bottom of the tank doesn’t get hot enough.

Why can’t the tank temperature in a multiple dwelling be lowered?

Answer:

  • The tanks are large therefore; the water may not heat up enough to prevent the growth of bacteria. In order to lower the temperature at the taps or faucet, a plumber will have to install a mixing valve to the water line or replace the existing faucet and shower head with one that contains a mixing valve.

My landlord says it’s too expensive to install mixing valves and I can’t afford to do this myself. What can I do to prevent a scald?

Answer:

  • Put a childproof knob cover on the door to the bathroom to prevent your child from gaining unsupervised access to the bathroom.
  • Run cold water to cool off the faucet after you have filled the tub.
  • After filling the tub, mix the water with your hand to eliminate any hot spots.
  • Check the water temperature with your inner arm or elbow before putting your child in the tub.
  • Put your child at the other end of the tub, facing away from the tap and stay within arm’s reach at all times!
  • Never leave your child unsupervised in the bathtubeven if you are only going to be out of the bathroom for a minute- these injuries happen in seconds!
  • Never leave a young child alone in the tub with an older sibling who may turn on the hot water tap in your absence. Teaching pre-schoolers about safety is important but pre-school children often don’t remember, follow the rules and aren’t capable of understand the consequences of their actions.
  • If you must leave the bathroom take your child with you.

When can I start leaving my child unsupervised in the bathtub?

Answer:

  • Children mature at different rates. One child may be mature enough at 6 to be left unsupervised, while another child might not be ready until they are 8 and a child with special needs may never be ready.

When your child consistently demonstrates an ability to remember and follow instructions, they are able to manage their impulsivity and make good decisions in everyday situations like crossing the road or waiting until their hot drink has cooled off, they may be ready for this next step.

Burn Prevention Tips in the Kitchen

  

Hot beverages like tea and coffee are responsible the majority of scalds in young children. Most of these injuries happen during meal preparation when parents are often busy and distracted.

A hot drink, that most adults consider comfortable to drink, will cause a serious scald to a child in 10 seconds.

If the tea is freshly brewed or from an espresso machine, the scald will be instant!

A child’s skin is 4 times thinner than adults. When hot liquids or food is spilled on a child’s skin, the damage moves quickly into the deeper layers of the skin causing serious damage in seconds!

How can I protect my child from a hot liquid spill?

Answer:

  • Use a mug with a screw on lid. If the cup gets knocked over, only a small amount of the hot liquid will spill on your child.
  • Keep a travel mug with you when you are out and about. The cardboard cups used by coffee shops are not full proof. If these cups get knocked over, in most cases the lid will pop off.
  • Never hold your child or let anyone else hold your child when you are drinking something hot.
  • Avoid putting hot drinks or hot food on the table unless an adult present to supervise.
  • Use a highchair or playpen in the kitchen when you are cooking so your child is close, but not underfoot.
  • Keep all appliances, cords and hot liquids away from the edge of the counter.
  • Avoid using mats and table cloths.
  • Use the rear stove burners and turn pot handles inward.
  • Don’t put treats in cupboards above the kettle, coffee pot or stove.

 

Burn Prevention Tips for the Living Room

  

The glass of a gas fireplace heats up to 200°C (400°F) in just 6 minutes and takes 45 minutes to cool to a safe temperature.

This is hot enough to cause a third degree burn on contact.

Be aware, the fireplace can take as long as an hour to cool down to a reasonable temperature after it has been turned off.

As of January 2015, all gas fireplaces sold in North America must be sold with a safety screen or protective barrier.

How can I keep my child safe around the fireplace?

Answer:

  • Contact the fireplace manufacturer to obtain information on available safety proofing products specifically designed for your unit.
  • Some manufacturers already provide heatproof screens with new units and will retrofit these screens to fit older units.
  • Be aware the metal frame surrounding the glass gets very hot, therefore, a fireplace safety gate should also be installed if there are young children in the home.
  • Keep the remote control (if your fireplace has one) out of your child’s reach. 
  • Install switch protectors to prevent your child from turning on the fireplace without your knowledge, or don’t turn the fireplace on until your child has gone to bed.

What can I do to keep my child safe when I am in a home where the fireplace is on and there is no protective barrier?

Answer:

  • Keep your child as far away as possible away from the fireplace.  Be close, no more than an arm’s reach away from your child at all times

First Aid Treatment for a Burn


  

 
What's the first thing I should do if my child is burned?
Answer:

  • Remove any hot, wet clothing unless it is stuck to the skin, at the same time, find cold water or a cold liquid to immediately cool the skin and any clothing that can’t be removedEvery second counts!

When should I call 911, before or after cooling the burn?
Answer:

  • After! Cooling the skin quickly will help reduce the damage and improves the skin’s ability to heal.

How long should I cool the skin for?
Answer:

  • To prevent further or deeper damage, cool the burned skin for a minimum of 1 minute and/or until it is cool to touch.  Your child will be very upset but cool the skin even if it peels or blisters. 
  • Keeping the burn cooled for up to 10 or 15 minutes may also help ease your child's pain. 
  • If the burn area is larger than the size of several of your child's palms put together, cool for at least 1 minute, and then call for an ambulance. 
  • Remember to keep your child warm while cooling only the skin that has been burned to prevent hypothermia. 

What should I put on the burn after I have cooled the skin?
Answer:

  • If this is a small burn, cover with a clean face cloth or gauze.  If this is a large burn, the size of several of your child's palms put together, cool for 1 minute, cover with a clean dry sheet or towel and call for an ambulance.  NEVER put butter, toothpaste, cream, oil or ice on a burn.

Why shouldn't I put ice on a burn?
Answer:

  • The damaged skin needs blood flow in order to heal and repair.  Putting ice on the skin causes the blood vessels to constrict and reduces the blood flow to the area.

My mother always told me to put butter on a burn.
Answer:

  • Butter and other home remedies don't have any known benefits and may contain bacteria or inflame and irritate the burn.  Also, if your child requires medical treatment, these products will have to be removed so the skin can be properly assessed, and that can be painful.

When does a burn need to be seen by a doctor?
Answer:

  • If the burn is on the face, hands, feet or groin
  • If large blisters develop and
  • If the burn is larger than the size of a loonie or one inch in diameter.

Should I drive to the hospital myself or call an ambulance?
Answer:

  • If this is a large burn, call an ambulance after you have cooled the burn.
  • If this is a smaller burn and you are alone, have a family member, neighbour or friend drive you to the hospital after you have cooled the burn so you can give your child your full attention, otherwise call for an ambulance.

What should I do if this is a minor burn?

  1. Cool the burn with cold water or cover with a cold cloth for 10-15 minutes.
  2. Then, apply a mild first aid ointment and band aid to protect the skin.
  3. Wash the area with mild soap and water and appy a new band aid and ointment every day.
  4. If the skin becomes red, painful or you see pus, see a doctor.   

Trouble Shooting - Temperature Testing Card

  

I don’t see a number on the black strip of the temperature testing card.

Answer:

Ensure these steps are followed before testing your hot water with the temperature card:

1. Run your hot water tap for 2 minutes to ensure the maximum hot water temperature is reached

2. Fill a cup with the hot water and insert card (3 seconds)

3. Remove card and read number on the black strip of the card. 

If the number on the card registers above 60°C (140°F), follow the instructions on page 2 of the Too Hot for Tots! brochure to learn how to reduce your water to a safe delivery temperature. 

I followed the steps above but I still don’t see a number on the black strip of the card

The card only reads temperatures between 49°C (120°F) and 60°C (140°F).

If your water temperature is below 49°C (120°F) you will not see a number on the card. Another method of temperature verification, such as a high heat meat or candy thermometer should be used. Water temperature set below 49°C (120°F) can lead to the growth of bacteria in the water supply which can cause serious health issues therefore, the water temperature should be increased.

If the water temperature is above 60°C (140°F) no number will appear on the card until the water has cooled down to 60°C (140°F) or lower.

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SOURCE: Too Hot for Tots! ( )
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