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A baby drowning after being placed in a bath seats is a rare but definite cause of death. Bath seats appear to give a false sense of security (even if not encouraged by the manufacturers). It is unclear whether putting a baby in a bath seat represents an increased risk of drowning compared with a baby without a seat. Without knowing the numbers of mothers that use bath seats it is difficult to come to firm conclusions on the risks to babies. New research is needed to clarify this issue. Whether in a seat or not it is clear that the main risk to babies in the bath is being left unsupervised.

AimsTo identify the causes and mechanisms of unintentional non-scald burns among children presenting to hospital, and their associated clinical and social characteristics.MethodsA prospective cross-sectional study was conducted across two UK centres (four Emergency Departments (ED), two Minor Injury Units and one burns unit) between 15/01/2013–31/12/2014. Standardised data collection was performed for all children aged 0–16 completed years with a burn (contact, flame, caustic, electric, radiation, friction). Data recorded included: demographics, burn agent, mechanism and environment, location of the burn on the body, severity, total body surface area (TBSA) and first aid applied. House fires, fatalities and burns due to maltreatment were excluded.ResultsData was ascertained on 85% of children presenting with burns. Of 424 children identified, 34 were excluded due to safeguarding concerns, and one had multiple missing data. The 389 cases (59% boys) included: 86.6% (337/389) contact burns, 3.6% (14/389) sunburns, 3.3% (13/389) caustic burns, 3.1% (12/389) flame burns, with remaining 3.3% (13/389) other causes. The mean age of children sustaining non-scalds burn was 4 years (SD 4.3), the median age was 2 years (CI 2–3). Peak prevalence was at one year (27%, 105/390), while 74.3% (289/389) were aged 5 years or younger. The most common agents causing contact burns are hairstyling devices (67/337, 19.9%) including hair straighteners (15.4%, 52/337), curling tongs (4.2%, 14/337) and hair dryers (0.3%, 1/337). While 85.1% (57/67) of burns from hairstyling devices were to children aged ≤ 5 years old, in contrast, 75% (9/12) of flame burns and 46.1% (6/13) of caustic burns occurred in children >5 years old. TBSA was <2% in 92% (292/317) cases overall, two cases had TBSA >5%, both being flame burns (0.6%, 2/317) (72 cases had TBSA missing). First aid was given to 90.5% (352/389) of children, but only 23.6% (61/258) used cool running water for ≥20 min as recommended by national guidelines.ConclusionsHairstyling devices pose a major threat to children aged less than five years, warranting a targeted prevention campaign. While first aid was frequently attempted, appropriate first aid was uncommon.

Aims Every year in the UK, 50 000 children <5 years sustain burns. Health visitor (HV) follow-up after injury attendances to emergency departments (ED) signifi cantly reduces further injury, improves home safety practices and reduces hazards, and may identify potential safeguarding concerns. We evaluated ED burns referrals to HV, to identify what follow-up occurs and the factors infl uencing this decision. Methods All pre-school burn attendances to ) were identifi ed. A postal questionnaire was sent to HVs, supplemented with telephone interview. χ 2 , Student's t test and OR at 95% CI were performed. Results Of 176 cases identifi ed, 140 questionnaires were sent (25 outside catchment, 11 no available records) and 97 (69%) responded. There were no signifi cant differences in burn type and severity between responders and non-responders, although responders patients were younger (13.7 vs 22.3 months, twosample t (138)=3.76, p<0.001). Among responders, scalds accounted for 57%, the commonest agent was hot drinks (39%) followed by hair straighteners (14%). The ED notifi ed HVs in 82% of cases. Information in the referral varied greatly: 90% detailed the burn agent, 68% the burn mechanism and 40% whether the child was supervised. Half the cases were followed-up by a HV, 30% by home visit. Knowledge of the family, routine follow-up, the age of the child and severity of the burn were the main reasons given by HVs for deciding to follow-up. However only increased percentage burn surface area (two-sample t (88)=2.15, p=0.034) and 'burns follow-up was routine' (OR=3.54, 95% CI 1.30 to 9.70) were actually associated with a home visit. After knowledge of the family, caseload (15%) and ambiguous or absent referrals (15%) were the commonest reasons given for not following-up. Conclusions Despite a policy to refer all burns cases, almost a fi fth are not referred and vital information is often omitted; only half of cases are followed-up. Making burns follow-up routine and improving inter-professional communication may reduce the risk of missing these important follow-up opportunities. Further studies should identify other ways of improving follow-up and maximizing the impact of burn prevention advice.group.bmj.com on June 20, 2015 -Published by http://adc.bmj.com/ Downloaded from