Portable guides to Investigating Child Abuse    http://www.ncjrs.com

Burns:  A General Overview

    Although general awareness of the magnitude of child abuse is on the rise, deliberate injury by burning is often unrecognized.  burn injuries make up about 10 percent of hospital admissions of children to burn units are the result of child abuse.  In comparison with accidentally burned children, abused children are significantly younger and have longer hospital stays and higher mortality rates.  

    The child burn victim is almost always under the age of 10, with the majority under the age of 2.  Children are burned for a variety of reasons.  Immersion burns may occur during toilet training, with the offender immersing the child in scalding water for cleaning or punishment.  Hands may be immersed in pots of water for playing near the stove.  A person may place a child in an oven for punishment or with homicidal intentions.  .

THE BURN CLASSIFICATIONS

    The preferred classification of burns used by most physicians is "partial" or  " full thickness".  There are some features of partial and full thickness burns that can be observed immediately after the incident.  

* Patches of reddened skin that blanch with fingertip pressure and refill are shallow partial thickness burns.  blister usually indicate deeper partial thickness burning, especially if the blisters increase in size just after the burn occurs.

* A leathery or dry surface with a color of white, tan, brown, red or black represents a full thickness burn.  The child feels no pain because the nerve endings have been destroyed.  

THE BURN FORMULA

    Let me simplify.  How hot is the water?  How long were they in the water?  How sensitive is the skin that was in the water?  The victim did not have to be in the water.  How long was the water in contact with the victims skin.  Did clothing keep the liquid on the skin longer?  Was the liquid allowed to cool while moving across the skin?   What was the room or outside temperature at the time which would affect the cooling of the liquid?  These are just a few of the questions involved in working out the formula.

    Of course this doesn't apply only to liquid burns.  How hot was the stove, steam iron, car engine, or anything capable of holding heat?  

PITFALLS:

     You may think skin sensitivity is determined by the age of the victim.  This is not entirely correct.  Obviously a 6 month old has more sensitive skin than that of a 50 year old adult.  However, if you wear shoes and socks as a rule and the 5 year old across the street from you has spent his/her entire life playing bare foot in the street, whose feet are more sensitive on the bottom?

PHOTOGRAPHIC  EVIDENCE

Recently I have added digital photography to my presentations.  Regardless of the type of photo format you are using there are some things that never change.  Use a scale in every photo.  Without one to one photography it is difficult if not impossible to match weapons to mirror or contact injuries.  All photos should be shot perpendicular or at right angle to the injury.  If this is not done properly, the scale will be distorted and be of little use.  Photograph the entire victim, not just the current injured area.  There may be clues to determining accidental vs. non accidental in different stages of healing on a different part of the body. 

SPARING

SPARING

    What does that quote above mean?  If the buttocks of an infant is burned, then the doctors consider how to treat the burn and possibly consult with the caretaker to prevent reoccurrence.  However, if the center of the buttocks is spared from burning, then you have to ask yourself, "how did the first part to touch the water, never show signs of burning.  The answer is the buttocks was protected from the scalding liquid by the opposing force of the bathtub or container.  This is referred to as  doughnut pattern (not a cop joke) because there is a hole in the middle of the burn.  The same is true if a person is kneeling in hot liquid.  The area behind the knee is spared because the back of the lower leg and upper leg are compressed together,  sealing out the hot liquid.  The sparing pattern left behind is a large diamond as it appears in the photo below.

TIME AND TEMPERATURE  SENSITIVITY

SHARP LINE OF DEMARCATION

TIME OF EXPOSURE

TIME AND TEMPERATURE SENSITIVITY

    The sharp of distorted line of demarcation can be affected by the time of exposure to the heat source.  When the line is crisp, the exposure to the source is usually longer because the water had time to stabilize.  Frequently when the line is wavy or distorted the immersion is brief disturbing the surface of the water and removing the victim while the water is still active.

The rapidity of scalding increases drastically above 127 degrees where one minute is required to cause full- thickness or third degree burns of adult skin.  At 130 degrees, similar burns occur in thirty seconds and at 140 degrees in approximately ten seconds and at 150 degrees in a very brief two seconds.  At temperatures above 140 degrees, children's thinner skin will result in burns in about one fourth of the time compared to adult burns.  

To reference the above data refer to:

Moritz, A.R., and Henriques, F.C. 1947.  Studies of Thermal Injury:  The Relative Importance of Time and Temperature in the Causation of Cutaneous Burns.  Am. J. Pathology 23:695-720

CIGARETTE LIGHTERS

CIGARETTE LIGHTERS

There are several types of cigarette and cigar lighters.  All of them leave a mirror or contact image behind that can be matched to the specific lighter.  This is one area where one to one photography is imperative.  

 Frequently Asked Questions

*     How old to operate?

*     Is the lighter equipped with a child proof device?

*     How much time with flame contact to metal before a burn will occur.