Burns: First aid

Burns are tissue damage from a variety of sources. Examples are hot liquids, the sun, flames, chemicals, electricity and steam. Kitchen-related injuries from hot drinks, soups and microwaved foods are common among children.

Major burns need emergency medical help. Minor burns can usually be treated with first aid.

Call 911 or seek immediate care for major burns, which:

• May be deep, involving all layers of the skin.
• May cause the skin to be dry and leathery.
• May appear charred or have patches of white, brown or black.
• Are larger than 3 inches (about 8 centimeters) in diameter.
• Cover the hands, feet, face, groin, buttocks or a major joint, or encircle an arm or a leg.
• Are accompanied by smoke inhalation.
• Begin swelling very quickly.

Electrical burns, including those caused by lightning, and major chemical burns need emergency medical care. A minor burn might need emergency care if it affects the eyes, mouth, hands or genitals. Babies and older adults might need emergency care for minor burns as well.

For major burns, apply first aid until emergency help arrives:

• Protect the burned person from further harm. If you can do so safely, make sure the person you’re helping is not in contact with the source of the burn. For electrical burns, make sure the power source is off before you approach the burned person.
• Make certain that burned person is breathing. If needed, begin rescue breathing if you know how.
• Remove jewelry, belts and other tight items, especially from the burned area and the neck. Burned areas swell quickly.
• Cover the burn. Loosely cover the area with gauze or a clean cloth.
• Raise the burned area. Lift the wound above heart level if possible.
• Watch for symptoms of shock. Symptoms include cool, clammy skin, weak pulse and shallow breathing.

For minor burns, follow these first-aid guidelines:

• Cool the burn. Hold the area under cool — not cold — running water for about 10 minutes. If this isn’t possible or if the burn is on the face, apply a cool, wet cloth until the pain eases. For a mouth burn from hot food or drink, put a piece of ice in the mouth for a few minutes.
• Remove rings or other tight items. Try to do this quickly and gently, before the burned area swells.
• Apply lotion. After the burn is cooled, apply a lotion, such as one with aloe vera or cocoa butter. This helps prevent drying.
• Bandage the burn. Cover the burn with a clean bandage. Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
• If needed, take a nonprescription pain reliever, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others).

• Don’t use cold water to cool the burn.
• Don’t break blisters. Blisters help protect against infection. If a blister does break, gently clean the area with water and apply an antibiotic ointment.
• Don’t try to remove clothing stuck in the burn.

If you haven’t had a tetanus shot in the past five years and the burn is deep, you may need a booster shot. Try to get this within 48 hours of the injury.