Modeling the Distribution of Scald Type Burns in a Child.

Splash or spill scald burns may be seen by medical examiners in the setting of intentional trauma or accidental injury. In order to model various scald burn scenarios, an 8-year-old subject dressed in white had colored water spilled or dropped onto her. The results were recorded by video and still photography. Five trials were performed and included: liquid in a cup thrown towards the anterior body surfaces; liquid in a cup thrown towards the posterior body surfaces; a cup of liquid spilled across a table into the lap of a seated subject; a saucepan pulled down onto the anterior torso; and a cup of liquid spilled onto the top of the head. In each of the spill and splash models described above, a large often confluent zone of staining at the site of initial liquid contact with the body was often accompanied by elongate runoff patterns following gravity; droplet staining was often noted on adjacent areas. When seated, an inverted U-shaped staining pattern was on the buttocks. Anticipation of the splash event in one trial resulted in the subject instinctively turning the anterior body away from the oncoming liquid. When presented with a scalded victim, modeling of the reported history may provide a pattern of staining that supports or refutes the explanation offered for the burn. A mobile and neurologically intact subject who can anticipate an incipient scald injury may move prior to and during contact with the liquid resulting in unique staining patterns on multiple surfaces of the body.