A burn is tissue damage caused by energy sources like heat, chemicals, or electricity. Immediate action is necessary to stop the burning process and limit the extent of the injury. Rapid cooling reduces pain and prevents heat from spreading deeper into the body’s layers. This initial step significantly influences the final outcome.
The Ideal Cooling Method
First aid for a burn requires the immediate application of tepid or cool running water. The water should run for 10 to 20 minutes to achieve maximum benefit. Continuous flow is more effective than still water because it constantly draws heat away from the wound, preventing the water temperature from rising as it absorbs heat.
Cooling the burn mitigates injury severity by dissipating thermal energy and stabilizing blood vessels. This action also helps reduce the release of inflammatory chemicals at the injury site. The water temperature must be cool or lukewarm, not cold, as excessively low temperatures can cause other problems.
The goal is to lower the temperature of the damaged tissue without overcooling the person, especially if the burn covers a large area. Applying cool running water for 20 minutes within the first three hours can lead to improved outcomes, including a reduced need for skin grafting. This sustained cooling minimizes tissue damage and provides pain relief by soothing irritated nerve endings.
Dangers of Using Ice or Freezing Water
The instinct to use the coldest possible option, such as ice or ice-cold water, is harmful and must be avoided. Applying ice directly to a burn causes rapid vasoconstriction, the narrowing of blood vessels. This constriction severely restricts blood flow to the already compromised tissue.
Limiting the blood supply prevents oxygen and nutrients from reaching the burn, potentially worsening tissue damage and delaying healing. Extreme cold can also lead to secondary injuries, such as frostnip or frostbite, on the damaged skin. This dual injury makes the final wound significantly worse than the burn alone.
Using freezing water or ice packs, especially over a large area, increases the risk of inducing hypothermia, a dangerously low body temperature. This risk is particularly high in small children and older adults. The body’s inability to regulate temperature is compounded by skin damage, as skin normally plays a role in thermoregulation.
Assessing Burn Severity and Seeking Care
Once cooling is complete, assess the burn’s severity to determine if professional medical attention is needed. First-degree burns affect only the outer layer of skin, causing redness, mild swelling, and pain, much like a mild sunburn. Second-degree burns penetrate deeper, resulting in intense pain, significant redness, and fluid-filled blisters.
Third-degree burns are the most severe, extending through all layers of skin and potentially damaging underlying tissue. These deep injuries may appear dry and leathery, with a waxy white, charred, or dark brown color. They may cause little or no pain due to the destruction of nerve endings.
Immediate emergency medical care is necessary for any burn that is deep, larger than three inches, or involves the face, hands, feet, genitals, or major joints. All chemical or electrical burns require professional evaluation regardless of their appearance. After cooling, cover the burn loosely with a clean, non-fluffy dressing, like cling film, and do not apply butter, oil, or home remedies.