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A systematic review of the features that indicate intentional scalds in children

Maguire, Sabine Ann, Moynihan, Sian, Mann, Mala K., Potokar, T. and Kemp, Alison Mary ORCID: 2008. A systematic review of the features that indicate intentional scalds in children. Burns 34 (8) , pp. 1072-1081. 10.1016/j.burns.2008.02.011

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Background Most intentional burns are scalds, and distinguishing these from unintentional causes is challenging. Aim To conduct a systematic review to identify distinguishing features of intentional and unintentional scalds. Methods We performed an all language literature search of 12 databases1950–2006. Studies were reviewed by two paediatric/burns specialists, using standardised methodology. Included: Primary studies of validated intentional or accidental scalds in children 0–18 years and ranked by confirmation of intentional or unintentional origin. Excluded: neglectful scalds; management or complications; studies of mixed burn type or mixed adult and child data. Results 258 studies were reviewed, and 26 included. Five comparative studies ranked highly for confirmation of intentional/unintentional cause of injury. The distinguishing characteristics were defined based on best evidence. Intentional scalds were commonly immersion injuries, caused by hot tap water, affecting the extremities, buttocks or perineum or both. The scalds were symmetrical with clear upper margins, and associated with old fractures and unrelated injuries. Unintentional scalds were more commonly due to spill injuries of other hot liquids, affecting the upper body with irregular margins and depth. Conclusions We propose an evidence based triage tool to aid in distinguishing intentional from unintentional scalds, requiring prospective validation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Academic & Student Support Service
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > R Medicine (General)
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Uncontrolled Keywords: Intentional scalds; Accidental scalds; Triage tool; Child abuse; Systematic review; Thermal injury; Burns
Publisher: Elsevier
ISSN: 0305-4179
Last Modified: 19 Oct 2022 10:21

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