Bathroom Safety - Preventing Scalding Injuries in the Elderly

Scald injuries can be life threatening, with complications such as infection and sepsis increasing the mortality rate. The elderly are a particularly vulnerable group to scalding so it is important for older people and their carers to be aware of ways to minimise the risk of injury.

Why are the Elderly Especially Vulnerable?

Fatal tap burns occur disproportionately in older persons. The risk of burn injury increases as the body ages due to a variety of factors. Older people tend to be less able to quickly move out of harm’s way, their skin is thinner and more injury-prone and memory can decrease. Age-related changes can also affect the ability to feel temperature so feeling how hot bath water is can be difficult and medications can cause dizziness and sleepiness, leading to falls in hot baths or showers. These factors result in the elderly being a vulnerable group, so carers must take steps to prevent burns and fatal injuries.

How can we Prevent Scald Injuries?

Most burns occur in the home and whilst these injuries can happen in a matter of seconds, recovery can take weeks and even up to years in serious cases. It is, therefore, important to take the following precautions to minimise risk of injury.

Thermostatic Mixing Valves

Hot water from a non-regulated tap can reach temperatures of 60˚C, which requires only 1 second of exposure time to develop a full thickness burn injury.

Thermostatic Mixing Valves blend hot and cold water to ensure that a pre-selected maximum water temperature is maintained, preventing water from reaching harmful temperatures.

Always ensure that your temperature regulator is set to 50˚C. At this temperature, it would take 5 minutes of exposure to cause a full thickness burn injury, as opposed to 1 second at 60˚C. This small difference in temperature can mean the difference between hospitalisation and scarring for life.

Grab Bars and Non-Slip Mats

To prevent scalds in the bathroom, installing grab bars and using non-slip rubber mats in baths or showers can be very effective as they prevent falls which lead to burns.

Shower Chairs or Stools

Similar to grab bars and non-slip mats, a shower stool can be useful for those who find standing unassisted difficult as it prevents slips and falls under scalding water.

Avoid Fixed Shower and Bath Screens

A fixed shower or bath screen makes it more difficult to quickly move out of harm’s way if water is scalding hot. Installing a movable screen or curtain makes bathing and showering much safer as it becomes easier to move away from hot water.

Check Bath and Shower Water Temperature

It is important to use a thermometer, not your hands or feet, to check the temperature of shower and bath water before getting in.

What to do in the Event of a Scald Injury

In the event of a scald injury, it is important to take the following steps, recommended by the NHS:

Move the person away from the heat source
Cool the burn with cool or lukewarm running water for 20 minutes – don't use ice, iced water, or any creams or greasy substances such as butter
Remove clothing or jewellery near the burnt area of skin, but don't move anything that's stuck to the skin
Keep the person warm with a blanket, but do not rub it against the burnt area
Cover the burn with a layer of cling film
Use painkillers such as paracetamol or ibuprofen to treat any pain
If the face or eyes are burnt, sit up as much as possible to reduce swelling

Some burns can be treated at home. For minor burns, keep the burn clean and don't burst any blisters that form. For more serious burns which are large, deep, or cause white or charred skin, you should go to a hospital A&E department.

References

American Burn Association, National Burn Repository 2011

www.dhhs.tas.gov.au/service_information/information/preventing_hot_water_burns_and_scalds

Moritz A.R. and Henriques F.C., ‘Studies of Thermal Injury II. The Relative Importance of Time and Surface Temperature in the Causation of Cutaneous Burns’, American Journal of Pathology, Sept 1947, 23(5)