How to Give First Aid for Burns

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Understanding how to give first aid to burn victims is, generally speaking, not something you learn from reading a book or a website. The information you are about to receive is basic, and does not involve any “hands-on” training or role playing.There are online courses out there that can also give you a basic overview, but it’s true that nothing is ever going to be as effective as being trained by an expert.

Consequently, we suggest that if you wish to be truly competent and confident when it comes to first aid, you should enrol in a local community training class or St. John Ambulance course. This is especially relevant for the more complex artificial respiration and cardio resuscitation instructions for electrical burn injuries. With that in mind, it’s also true that people learn in different ways and for some people reading a thorough description with illustrations can go a long way in helping you understand the basics. Nonetheless as a personal disclaimer, Mediscript waives any liability from properly or improperly following the below description. With that out of the way, let’s just begin with the basics:

The basic aims of burn first aid are:

1. To lesson the effects of heat.

2. To reduce pain.

3. To prevent infection of the burned skin area.

The first action to take for a severe burn or scald is to call 911 for an ambulance and any other number that can quickly bring medical help. The severity of a burn can be minimized when appropriate first aid measures are taken at the scene of the accident. The correct sequence of events immediately following a burn injury is suggested by the catch phrase, “Stop, drop, roll and cool”: Stop – don’t run; drop to the ground; roll, to put out the fire, and cool with water to stop the burning.

The following are general first aid tips for all burns:

Do not touch burns – this can cause infection.

Do not break blisters if they are small, look clean and are not around joints. If they do break, carefully cut away the loose skin with a clean pair of scissors and cover the open area with a clean bandage or dressing or a moist cloth until medical care is given.

Do not apply ointments, lotions, or oily dressings; they can have the effect of keeping heat in instead of letting the heat out. NO BUTTER, FLOUR OR TOOTHPASTE, PLEASE.

Do not use gauze, cotton, wool or anything likely to stick when covering a burn.

Do not give anything by mouth to an unconscious person. A person who is conscious and complains of thirst should be given small sips of water only.

Swelling can occur around the burned area, so ensure that anything constrictive – clothing, jewelry, etc. – is removed or loosened as soon as possible.

For large surface area superficial burns, seek medical help.

For all deep burns and electrical burns, seek medical help.

For burns to elderly people or infants, seek medical help.

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The following first aid instructions are recommended for the different categories of burns:

Thermal burns

1. Cool the affected burn area with cold water. This can be achieved by placing it under running water, immersing it in water or by applying a wet cloth to the burn.

2. Remove rings, bracelets or other jewelry as quickly as possible before the swelling begins.

3. Cover the burn with a clean cloth or preferably a sterile, lint-free dressing (even a facial tissue will work) and secure this lightly with a bandage or one that is improvised from an article of clothing.

4. Seek hospital treatment for burns and scalds larger than the size of a quarter in area. If you have any doubts, err on the side of caution and go to the hospital.

5. Do not breathe or cough on the burn.

6. Do not touch the burn.

7. Do not break blisters.

8. Do not remove clothing stuck to a burn.

9. Do not apply medications, ointments or greasy substances to the burn.

Chemical burns

A. Wet chemicals

Corrosive chemicals such as acids and alkalis are always serious because the chemicals will continue to burn the skin for as long as they remain there.

1. Immediately flush the chemical away with water – lots of water!

2. Do not wait to remove clothing around the affected area.

3. Continue flooding the affected area while removing clothing at the same time.

4. Continue flooding until all the corrosive chemical has been washed away.

5. Do not use any so-called chemical neutralizers such as vinegar, baking soda or alcohol to treat any chemical burns.

6. If a corrosive chemical spills on the eye, flush the eye slowly with running water for at least 10 minutes. If necessary, hold the eyelids open with your fingers.

7. Continue the first aid instructions as previously described for a thermal burn from points 2 to 9.

B. Dry chemicals

If the chemical is not wet but dry – like lime, a common corrosive – it should be brushed off before flushing or flooding the burn injury with water. Then, follow all the instructions listed for first aid treatment of a wet corrosive chemical.

Electrical burns

Burns from this type of injury may be far more serious than they appear. There could be life-threatening associated injuries involving breathing or heart difficulties. The injured person may have been violently thrown by the force of the electrical shock, causing serious physical injuries such as broken bones or damage to internal organs. It is vital in these cases to seek emergency medical assistance.

1. Do not touch the injured person until the electricity is turned off.

2. Carefully turn off the electrical source causing the injury.

3. Check the injured person for pulse and breathing.

4. Give artificial respiration or cardiopulmonary resuscitation (CPR) if necessary (see instructions on the following pages).

5. Locate the burn damage area. This is usually located where the electrical current entered and left the body.

6. Apply a clean, dry dressing over the burn areas.

7. If you have not already done so, seek medical aid by calling 911 or other means.

Artificial Respiration Guidelines

Fig. 1

Adult Casualty

A. Give two breaths

1. Open the airway.

2. Cover the casualty’s mouth with your own and pinch nostrils (fig 1).

3. Give enough air to make the chest rise.

Fig. 2

B. Check for carotid pulse for 5-10 seconds (fig 2)

1. If pulse present, give one breath every 5 seconds.

2. If pulse absent, START cardio- pulmonary resuscitation (CPR).

Child Casualty

A. Give two breaths

Fig. 3

1. Open the airway.

2. Cover the child’s mouth with your mouth and pinch the nostrils.(fig 3)

3. Just give enough air to make the chest rise.

B. Check carotid pulse for 5 – 10 seconds

1. If pulse present give one breath every 3 seconds. (fig 4)

Fig. 4

2. If pulse absent START CPR.

Infant Casualty

A. Give two breaths

1. Open the airway.

2. Cover the infant’s mouth and nose with your mouth (fig 5).

3. Give just enough air to make the chest rise.

Fig. 5

B. Check brachial artery (inside upper arm) pulse for 5 – 10 seconds (fig 6)

1. If pulse present give one breath every 3 seconds.

2. If pulse absent, START CPR.

Cardio Pulmonary Resuscitation

Perform CPR ONLY if the casualty is:

Fig. 6

A. UNCONSCIOUS

B. NOT BREATHING

C. PULSELESS

Read more: Introduction to burn care

Fig. 7

Adult CPR

A. Do CPR compressions (fig 7)

1. Place heel of one hand on lower half on breastbone in centre of chest.

2. Place heel of other hand on top of first hand.

3. Press straight down to compress chest 1.5” – 2” (3.8 -5.0cms)

4. Press at the rate of 15 compressions in 9 seconds.

Fig. 8

A. Give 2 breaths every 15 seconds

B. Recheck pulse and breathing after one minute.(Fig 8)

C. If pulse is still absent continue CPR until help arrives.

Child CPR

A. Do CPR compressions (Fig 9)

Fig. 9

1. Tilt back forehead with heel of one hand

2. Place heel of other hand on lower half of breastbone in centre of the chest.

3. Press straight down to compress the chest  1 – 1.5” (2.8 – 3.8cms)

4. Press at the rate of  5 compressions every 3 seconds .

B. Give one breath after every 5 compressions.

Fig. 10

C. Recheck pulse and breathing after one minute of CPR (fig 10).

D. If pulse still absent continue compression until help arrives.

Infant CPR

A. Do CPR compressions ( fig 11)

1. Tilt back forehead with the heel of one hand.

Fig. 11

2. Place two fingers of the other hand in the centre of the chest, one finger width below nipple line.

3. Press straight down to compress chest ½ – 1”.

4. Press at the rate of 5 compressions every 3 seconds or less.

B. Give one breath after every 5 compressions

C. Recheck pulse and breathing after one minute of CPR. (fig 12)

Fig. 12

D. If pulse is still absent continue compressions until help arrives.

Pardon the interruption, but did you know you can get the complete text with quizzes and interactive questionnaires and activities in the full Burn Care: Prevention and Treatment print edition? It’s also available as an downloadable ebook along with other great wound care content.

Radiation burns

There is no specific first aid treatment for radiation burns. However, minor sunburn can be treated as follows:

Wet a towel with tap water and squeeze out the excess water

Cover the burned area with this wet towel. This will soothe and cool the skin.

Only use ointments and creams recommended by a health care professional.

Assessing the burn

The medical team will objectively assess the injury with regard to initial treatment and long term care. However, in order to understand the devastation a burn can cause, it is important to appreciate the role our skin plays in our physical well-being.

Our skin performs the following functions:

1. Protects the body from infection

2. Controls body temperature

3. Retains body fluids.

The severity of a burn depends upon:

1. The amount of body surface affected

2. The location of the burn – around the face or throat could be considered critical since it might affect breathing

3. The depth of the injury

4. The age of the patient and his or her general state of health.

The categories of burn depth are usually described as follows:

1. Superficial partial-thickness burns, also known as mild second-degree burns. These burns and scalds affect the shallow outer layers of the skin. They resemble sunburns and can be very painful, but will usually heal within 10 days.

2. Deep partial-thickness burns, also known as deep second-degree burns. These can be very painful; blisters can form and the injury takes 14 to 21 days to heal.

3. Full-thickness burns, also known as third-degree burns. These involve damage to all layers of the skin including the skin-reproducing cells. The skin will require skin grafting in order for the burn injury to heal.

The two generalized types of burns can be summarized as follows:

1. The burned area is reddish, swollen and may blister. The pain can initially be severe, but the healing is rapid and leaves little scarring.

2. Deep burns are those in which the whole thickness of the skin is affected. There is usually less pain initially because the nerve endings may have been temporarily destroyed. Healing can be slow and scars may develop.

It is not always possible for the medical team to tell the severity of the injury at the time of diagnosis. It often takes several days to find out whether the burn wound will heal on its own or whether grafting is needed. Consequently, it follows that it is not always possible to predict exactly how long it will take for a burn injury to completely heal.

Continue reading: Medical treatment of burn wound