Burns - Treatment
Second degree burn; First degree burn; Third degree burn
FOR MINOR BURNS
- If the skin is unbroken, run cool water over the area of the burn or soak it in a cool water bath (not ice water). Keep the area submerged for at least 5 minutes. A clean, cold, wet towel will also help reduce pain.
- Calm and reassure the person.
- After flushing or soaking, cover the burn with a dry, sterile bandage or clean dressing.
- Protect the burn from pressure and friction.
- Over-the-counter ibuprofen or acetaminophen can help relieve pain and swelling. Do NOT give children under 12 aspirin. Once the skin has cooled, moisturizing lotion also can help.
- Minor burns will usually heal without further treatment. However, if a second-degree burn covers an area more than 2 to 3 inches in diameter, or if it is located on the hands, feet, face, groin, buttocks, or a major joint, treat the burn as a major burn.
- Make sure the person is up to date on tetanus immunization.
FOR MAJOR BURNS
- If someone is on fire, tell the person to stop, drop, and roll. Wrap the person in thick material to smother the flames (a wool or cotton coat, rug, or blanket). Douse the person with water.
- Call 911.
- Make sure that the person is no longer in contact with smoldering materials. However, do NOT remove burned clothing that is stuck to the skin.
- Make sure the person is breathing. If breathing has stopped, or if the person's airways are blocked, open the airways. If necessary, begin rescue breathing and CPR.
- Cover the burn area with a dry sterile bandage (if available) or clean cloth. A sheet will do if the burned area is large. Do NOT apply any ointments. Avoid breaking burn blisters.
- If fingers or toes have been burned, separate them with dry, sterile, nonadhesive dressings.
- Elevate the body part that is burned above the level of the heart. Protect the burn area from pressure and friction.
- Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches, and cover the person with a coat or blanket. However, do NOT place the person in this shock position if a head, neck, back, or leg injury is suspected or if it makes the person uncomfortable.
- Continue to monitor the person's vital signs until medical help arrives. This means pulse, rate of breathing, and blood pressure.
- Do NOT apply ointment, butter, ice, medications, cream, oil spray, or any household remedy to a severe burn.
- Do NOT breathe, blow, or cough on the burn.
- Do NOT disturb blistered or dead skin.
- Do NOT remove clothing that is stuck to the skin.
- Do NOT give the person anything by mouth, if there is a severe burn.
- Do NOT immerse a severe burn in cold water. This can cause shock.
- Do NOT place a pillow under the person's head if there is an airways burn. This can close the airways.
Call immediately for emergency medical assistance if:
Call 911 if:
- The burn is extensive (the size of your palm or larger).
- The burn is severe (third degree).
- You aren't sure how serious it is.
- The burn is caused by chemicals or electricity.
- The person shows signs of shock.
- The person inhaled smoke.
- Physical abuse is the known or suspected cause of the burn.
- There are other symptoms associated with the burns
Call a doctor if your pain is still present after 48 hours.
Call immediately if signs of infection develop. These signs include increased pain, redness, swelling, drainage or pus from the burn, swollen lymph nodes, red streaks spreading from the burn, or fever.
Also call immediately if there are signs of dehydration: thirst, dry skin, dizziness, lightheadedness, or decreased urination. Children, elderly, and anyone with a weakened immune system (for example, HIV) should be seen right away.
- Reviewed last on: 1/13/2010
- Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Singer AJ, Taira BR, Lee CC, Soroff HS. Thermal burns. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 60.
Gallagher JJ, Wolf SE, Herndon DN. Burns. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 22.
Bethel CA, Mazzeo AS. Burn care procedures. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 38.
Holmes JH, Heimbach DM. Burns. In: Brunicardi FC, Andersen DK, Billiar TR, et al, eds. Schwartz’s Principles of Surgery. 9th ed. New York, NY: McGraw-Hill; 2010:chap 7.
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