A burn is a traumatic injury where skin and underlying tissues are damaged by an external agent, most often excessive heat, but also chemicals, electricity, or radiation. The severity depends on the depth of tissue destruction and the total body surface area affected. Immediate first aid is paramount because skin tissue continues to “cook” after the initial contact. Rapid intervention can significantly limit the final extent of the damage, minimizing pain, reducing scarring, and preventing further tissue destruction.
Stopping the Burning Process Safely
The first priority is to remove the victim from the source of the burn while ensuring rescuer safety. For electrical burns, the power source must be turned off before touching the victim, or the victim should be separated from the current using a non-conductive object like wood. If clothing is on fire, the victim should immediately follow the “Stop, Drop, and Roll” procedure to smother the flames.
Any smoldering or chemically-soaked clothing must be removed quickly to stop the agent from damaging the skin. If any fabric is stuck to the skin, it should be cut around, leaving the adhered portion intact to avoid tearing the damaged tissue. For chemical burns, brush off any dry chemicals before flushing the area with water to prevent activation or increased spread.
Assessing the Burn and Immediate Cooling
After removing the heat source, the next step is to cool the burn using running water. The injured area should be held under cool, but not icy cold, running water for a minimum of 10 to 20 minutes. This rapid cooling helps draw heat out of the deep tissue layers, reducing inflammation and limiting the progression of the burn depth. Never use ice, butter, oils, or any greasy substances, as these can cause hypothermia or trap heat, potentially worsening the injury.
Following the cooling period, a quick assessment helps determine the severity and need for professional care. Superficial burns, similar to a sunburn, cause redness and pain, affecting only the outer layer of skin. Partial-thickness burns damage the first two layers, often resulting in blisters and intense pain. Full-thickness burns destroy all layers of the skin, may appear white, charred, or leathery, and may be painless due to nerve destruction.
Protecting the Wound and Managing Pain
Once the burn is cooled, the focus shifts to protecting the exposed tissue and managing comfort. The wound should be covered loosely with a clean, non-adhesive dressing or a sterile bandage to prevent infection and keep air off sensitive nerve endings, which helps reduce pain. Cling film, applied in a flat layer rather than wrapped tightly, is an effective temporary barrier for burns on limbs.
Blisters should be left unbroken, as the fluid-filled sac provides a sterile, protective layer against infection. For pain relief, over-the-counter medications like ibuprofen or acetaminophen may be administered if safe. It is also important to monitor for signs of shock, which can accompany severe burns. This is done by keeping the victim warm with a blanket over uninjured areas, and elevating the burned area if possible to reduce swelling.
Recognizing When Professional Medical Help is Necessary
Certain burn characteristics demand immediate, professional medical attention beyond initial first aid. A major burn requires an emergency call and includes any full-thickness burn, or a partial-thickness burn larger than the size of the victim’s palm. All electrical and chemical burns must be evaluated by a healthcare professional due to the potential for deep, unseen tissue damage.
Burns are considered severe regardless of size and require urgent care if located on:
- The face
- The hands
- The feet
- The genitals
- Over a major joint
Any burn on an infant, young child, or elderly person also warrants medical review because of their increased vulnerability to fluid loss and hypothermia. If the victim shows any signs of smoke inhalation, such as a sore throat or difficulty breathing, they need emergency care immediately.