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Health Swansea West Wales

Burns patient’s stark warning about the potential dangers of hot water bottles

Warning: Graphic images of burns in this article:

A burns patient has issued a warning to anyone thinking of reaching for a hot water bottle this winter as the fuel crisis bites.

Helen Cowell speaks from painful experience after the hot water bottle she was using to combat back pain perished, resulting in “horrendous” burns to her legs and bottom.

The warning is being supported by staff at the Welsh Centre for Burns and Plastic Surgery in Morriston Hospital, who are bracing themselves for an increase in such cases as people look for alternatives to putting on the heating to keep warm this winter.

Last April Helen was using a hot water bottle to help with chronic pain due to a back condition.

“I put it on the side of my leg while I was laying on the couch and it perished in the middle and went all over me,” she said.

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“I can’t even explain the pain. I was just screaming. The skin was off the back of my legs and my bottom. It was horrendous. I will never forget it for the rest of my life.”

Helen Cowell received “horrendous” burns to her legs and bottom after the hot water bottle she was using to combat back pain perished (Image: Swansea Bay NHS)


The 45-year-old from Brynamman admitted she had broken one of the most important rules by using boiling water.

She said: “Most people will tell you that unless you boil the water you can’t feel the heat – no matter how many times the doctors tell you that you shouldn’t be using hot water.”

Unable to wait for an ambulance her daughter rushed her to Morriston Hospital.

She said: “I went to hospital in the back of my daughter’s car, face down screaming all the way to Morriston.

“Everyone, in all fairness, just stepped aside and I went straight in. I just remember being in a room in the intensive care unit and don’t remember much else – just the pain.

“It’s not just a little burn, it’s horrendous. I couldn’t walk properly for a while, because of the nerve damage in my legs, and had to use a Zimmer frame.

“I’ve got severe scarring – all inside my legs, my buttocks and the back of my calves – and it may never go away. If I wear shorts it’s very visible. Horrible, crumpled, crusty and dry. That upsets me too, but it could have been my face.”

There is also the trauma related to such accidents.

Helen said: “It’s not a case of being burnt and getting over it. It doesn’t work like that.

“It’s traumatised me. I can’t have a bath, I’m too scared. I have to have a lukewarm shower. If I’m boiling potatoes or veg I can’t drain them. My daughter has to do all that. I won’t pour a kettle.

“People don’t think about these things. The fear of a boiling kettle – I couldn’t drink coffee or a cup of tea for nearly three months because of the fear. That’s how it has affected me.”

Helen, who said she would never use a hot water bottle again, wants others to follow the guidelines if they must use one.

She said: “I was in a supermarket the other day and saw this little old lady buying one and I said, ‘Please don’t buy that. If you are going to use them, make sure you use warm water and not hot water.’ Then I showed her my scarring.

“The sad part of it was she said, ‘I have to buy them because I can’t afford my heating.’ Which is so sad.

“Some people are sleeping with them and that gives me so much anxiety. They put them in their bed and cwtch up with them. It doesn’t matter how much air you bring out of them – I did it all properly – it will perish eventually.

“Mine was only around six months old. What about older people who are using hot water bottles that are years old? When you put them in an airing cupboard they harden and when you put hot water in them they crack.

“It’s just not worth it. It’s something people really need to think about before they do it.

“It is hard. I understand why they are using them because it’s expensive to put the heating on right now. But I’d rather put a dressing gown on. And a blanket. Extra layers. That’s all I’m doing from now on. It’s just not worth it. It’s really not.”

Janine Evans, an advanced practitioner occupational therapist at the Morriston centre, said: “We’re not saying not to use hot water bottles, we’re saying that if you must use them, to ensure to use them safely. It’s all about minimising the risk of an accident happening.

“Ultimately, people are filling them with boiling water, which they shouldn’t be doing. We get patients who sustain a boiling water scald to their hand, as when filling it they miss the bottle and pour the hot water over their hand.

“Also, people are not checking whether the rubber is perished before filling it. And then the hot water either leaks out slowly, or in some cases it explodes.

“They can be quite big injuries. A lot of people use hot water bottles on their tummies or their lower back for pain relief. So the water can leak onto their groin or buttocks and that can be really painful and uncomfortable as you can imagine.

“If you have any sort of peripheral neuropathy you should be extra cautious. People with diabetes, for example, often use hot water bottles to warm up their feet. But because of their reduced sensation they don’t always notice when the hot liquid is leaking out. So the contact time is longer and they sustain more significant injuries.”

Staff nurse John Davies (Image: Swansea Bay NHS)
Staff nurse John Davies (above) said the burns centre saw 20-30 patients with scalds from hot water bottles every year.

He said: “Even superficial burns, such as scalds, are very, very painful because the nerve endings are still exposed. The deeper the burn the less the pain, but the more likely you will need skin grafting and be left with a permanent scar.

“During the fuel crisis I think people will be using hot water bottles to keep warm rather than putting the central heating on.

“They are safe to use if you look after them and learn how to fill and store them correctly.”

Safety tips:

Always refer to the manufacturer’s instructions.

Ensure your hot water bottle complies with British Safety Standard BS 1970:2021.

Check your hot water bottle for signs of wear, damage and leaks before each use.

Ensure that the stopper screws on and stays in place prior to filling.

Don’t use tap water to fill your hot water bottle as the impurities it contains can cause the rubber to perish more rapidly. Use boiled water that has been allowed to cool for a few minutes.

Do not fill your hot water bottle more than two thirds full.

Ensure excess air is expelled before replacing the stopper.

Always use a cover on your hot water bottle.

DO NOT sit, lie or put excess pressure on your hot water bottle when it is filled.

DO NOT allow direct contact with one area of the body for more than 20 minutes.

When not in use, your hot water bottle should be completely drained of water and the stopper removed.

Store away from direct sources of heat or sunlight.

Replace your hot water bottle every two years.

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