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Fifteen-minute consultation: Childhood burns: inflicted, neglect or accidental
  1. Stephen Mullen1,
  2. Roisin Begley2,
  3. Zoe Roberts2,
  4. Alison Mary Kemp3
  1. 1Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
  2. 2Paediatric Emergency Department, University Hospital of Wales, Cardiff, UK
  3. 3Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
  1. Correspondence to Dr Stephen Mullen, Royal Belfast Hospital for Sick Children, Belfast BT12 6BE, UK; drsmullen{at}


Burns are a relatively common injury in children accounting for over 50 000 emergency department attendances each year. An estimated 1 in 10 of these are due to maltreatment. These may present in the form of physical abuse or neglect with a reported ratio of 1:9. A burn associated with maltreatment may be a marker for future abuse or neglect and it is paramount that concerns are identified and addressed at the initial visit. Paediatricians need to be confident to identify safeguarding concerns specific to childhood burns and investigate accordingly. In this review, key variables that may aid in differentiating maltreatment from accidental burns are discussed in a case-based format, utilising up-to-date evidence to support the recommendations. Despite a proportion of burns resulting from physical abuse, the rate of child protection investigations in these patients are significantly lower than for children who present with other forms of physical injuries despite a similar proportion of positive findings. Our objective is to review the available evidence to support the safe assessment and management of children presenting with scalds or contact burns.

  • child abuse
  • burns
  • general paediatrics
  • dermatology

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  • Contributors SM conceived this review. SM, RB and ZR were all co-authors on this paper. AMK reviewed the final draft and helped develop this review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SM and AK are undertaking research in the BuRN-Tool.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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