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Distinguishing intentional and unintentional scalds in children

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.


Scalds are the commonest intentional burn injury recorded 1,2. Studies which include all Emergency Department attendances have recorded a higher prevalence of intentional contact burns 3. Apart from abusive head trauma, intentional burns are the most likely injury to cause death or long term morbidity. A child can sustain a full thickness scald in one second from liquids at a temperature of 60°C 4.


Only comparative studies of abusive and non abusive scalds are included for this question


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  1. Ayoub C, Pfeifer D. Burns as a manifestation of child abuse and neglect. American Journal of Diseases in Children. 1979;133(9):910-914 [Pubmed]
  2. Wibbenmeyer L, Liao J, Heard J, Kealey L, Kealey G, Oral R. Factors related to child maltreatment in children presenting with burn injuries. Journal of Burn Care & Research. 2014;35(5):374-381 [Pubmed]

  3. Showers J, Garrison KM. Burn abuse: a four-year study. The Journal of Trauma. 1988;28(11):1581-1583 [Pubmed]
  4. Dressler DP, Hozid JL. Thermal injury and child abuse: the medical evidence dilemma. Journal of Burn Care & Rehabilitation. 2001;22(2):180-185 [Pubmed]

Section navigation

   – Overall results
   – Age
   – Gender
   – Influence of ethnicity and socio-economic group
   – Details of comparative studies
   – Details of non-comparative studies

Characteristics of scald injuries
   – Characteristics of accidental scalds
   – Characteristics of intentional scalds
        – Associated features of intentional scalds
        – Historical and social features of intentional scalds

Scalds triage tool

Implications for practice

Research implications

Limitations of review findings

Current clinical criteria not substantiated by this review

Other useful references


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