The prevalence of cerebral arteriopathy in children with NF1 in this study was at least 6% and was associated with young age and optic glioma. Arteriopathy causes stroke with resultant neurologic deficits. Medical and/or surgical interventions may prevent these complications. Therefore, the addition of vascular imaging (MRA/conventional angiography) to brain imaging studies for early detection of arteriopathy should be considered for children with NF1, particularly young patients with optic glioma.

The BuRN-Tool is a potential adjunct to clinical decision-making, predicting which children warrant investigation for child maltreatment. The score is simple and easy to complete in an emergency department setting.

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Methods: A prospective cross-sectional study was conducted across Cardiff, Bristol and Manchester, including six emergency departments, three minor injury units and one burns unit between 13/01/2013-01/10/2015. Data collected for children aged <16 years with any burn (scald, contact, flame, radiation, chemical, electrical, friction) included: demographics, circumstances of injury and clinical features. Scalds and burns due to maltreatment were excluded from current analysis.Results: Of 564 non-scald cases, 60.8% were male, 51.1% were <3 years old, 90.1% of burns affected one anatomical site; Contact burns accounted for 86.7%, 34.8% of which were from objects placed at >0.6meters and 76.5% affected the hands. Hairstyling devices were the most common agent of contact burns (20.5%), 34.1% of hairstyling devices were on the floor. 63.7% of children aged 10-15 years sustained contact burns of which 23.2% were preparing food, and in burns from hairstyling devices, 73.3% were using them at the time of injury. Conclusions:Parents of toddlers must learn safe storage of hazardous items. Older children should be taught skills in safe cooking and hairstyling device use.

Burns are common causes of paediatric emergency care attendance; approximately ten per cent result from maltreatment. Following emergency department (ED) attendance with a burn by 232 under five‐year‐olds, 11 risk factors for maltreatment were collected via health visitor (HV) telephone surveys. Three of these risk factors (domestic violence, social care involvement and developmental impairment) were also available in ED records, and information collected was compared between the two. Non‐parametric Fisher's exact tests were applied. Fifty‐nine per cent of children lived in families with risk factors for maltreatment. Prominent risk factors known by HVs included: prior injuries (n = 55, 23.7%), carer/parent mental health problems (n = 48, 20.7%), domestic violence (n = 47, 20.3%) and social care involvement (n = 45, 19.4%). A total of 158 cases had complete data for all 11 risk factors: 49 (31.0%) lived in households with one factor, 22 (13.9%) with two factors and 27 (17.1%) with three or more risk factors. In cases where HVs recorded the following risk factors as present, EDs recorded five of 47 (10.6%) for domestic violence, ten of 45 (22.2%) with social care involvement and four of 23 (17.4%) with developmental impairment. Many risk factors that were known to HVs were not identified by EDs staff despite being part of a standardised proforma. Maltreatment risk assessment could be improved if EDs staff had access to HV information.Key Practitioner Messages Fifty‐nine per cent of pre‐school children who attended an ED with a burn live in a family with one or more maltreatment risk factors, as identified by HV records. ED staff should be able to access a child's HV record electronically at the time of presentation, to identify known maltreatment risk factors. The lack of integration of community and acute setting health records is a barrier to comprehensive assessment and treatment decisions for children in EDs, especially in relation to safeguarding risks.

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.