This study comprises a continuous (1981-1995) unselected series of all children who died from thermal
injuries in the State of Queensland, Australia. One hundred and six children, so identified, died from incineration (35 per cent), respiratory
burns with
smoke or
carbon monoxide inhalation (33 per cent), body surface area
burns comprising greater than 60 per cent (9 per cent) and electrocution (20 per cent). The
burn fatality rate was 0.98 per hundred thousand children (0-14 years) per year, with no secular trend and, specifically, no reduction in the annual rate of such fatalities. Eighty-two children (49 males) had concomitant
facial injuries, both thermal and nonthermal; of whom 55 per cent were under the age of five years. Sixty (73 per cent) child
burn victims died in house fires. Forensic odontology is important in confirming the age of such victims in single incinerations but is of limited value when larger numbers of children are incinerated, because of the relative lack of dental restorations in the infant and pre-school age group. Of the 82 children with facial and airway
injuries, 12 per cent had only mild or superficial facial damage and only seven (8 per cent) were alive or resuscitable at the time of rescue from the conflagration or burning injury. child deaths from
burns contributed an annual loss rate of 506 years of potential life lost (YPLL) in a population of 3 million of whom 21.5 per cent were children under the age of 15 years.
Airway management and
resuscitation, in the context of managing surviving
burn victims of any age with
facial injuries, pose special difficulties. Inhalational
burns (
smoke and the
gases of conflagration) result in a mortality greater than 60 per cent. Although 81 per cent of children showed evidence of
airway obstruction, analysis of current data indicates that a maximum of 8 per cent could have survived with airway maintenance and protection. Inhalational
burns (to both upper and lower airways) grossly reduce survivability. Primary prevention would seem vital and thus remains a major challenge to reduce the incidence of such deaths. Some strategies include advocacy to promote the compulsory installation of
smoke alarms, family drills to practise escape and the teaching of '
first aid for all'