Mechanisms and prevention of tap water scald injuries - Tips from Other Journals

Date: Feb 1, 1994

Tap water scald injuries are the second most common cause of serious burn injuries in all age groups. Scald burns may be accidental or nonaccidental, as in cases of child abuse, and often cover a large area of the body, leading to high rates of morbidity and mortality. Scald injuries are especially likely to occur in certain populations, particularly children less than five years of age, adults more than 65 years of age and persons with handicaps such as sensory neuropathies. Weaver and colleagues reviewed the mechanisms leading to tap water burns, as well as strategies for prevention.

Water temperatures may be kept high for a number of reasons. In institutional settings, a large volume of hot water may be required. For dishwasher use, water may need to be kept hot to improve solvent action. Another reason for keeping temperatures higher is prevention of bacterial overgrowth in the water supply. However, tap water delivered at 140[degrees]F (600[degrees]C) can cause a full-thickness bum in 10 seconds.

Education about the need to regulate water temperature has not decreased the number of scald injuries, and other prevention techniques are necessary. A number of systems exist to control tap water temperature. The most typical is a manually regulated system in which the user turns two valves to mix different amounts of hot and cold water, although this is not an accurate way to regulate water temperature.

Another system relies on uneven water pressures in the water lines to adjust temperature. If the pressure in the cold water line decreases, the pressure in the hot water line will decrease as well. The flaw in this system is that scald injury can still occur if the water temperature is set too high. Yet another method uses a spring housed in an antiscald cartridge. The spring will expand when exposed to water temperatures greater than 110[degrees]F (43.3[degrees]C), thus reducing the stream of water. The water will not flow again until the temperature of the water is adjusted.

The authors believe that thermoregulation devices are essential to prevent scald injuries since education alone has not been as effective as desired. (Journal of Emergency Medicine, July/August 1993, vol. 11, p. 397)

EDITOR'S NOTE: People at high risk of scald injury often rely on family physicians for information about devices that can make their lives safer. Thermoregulation devices should be discussed with these patients or their caretakers.

COPYRIGHT 1994 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

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