Burns
Cool a burn under cool running water for 20 minutes, cover it loosely, and know when it needs a hospital.
FIRST
Stop the burning
Start as always with danger: don't get burned yourself. Then move the person away from the heat source. If their clothes are on fire: Stop, Drop and Roll. They stop moving, drop to the ground, cover their face with their hands and roll to smother the flames. Or smother the flames with a heavy blanket or coat. Running makes the fire burn harder.
A spark from a barbecue catches Daniyal's sleeve. His cousin shouts "Stop, drop, roll" and throws a coat over the flames, then walks him to the tap.
THE ONE THING THAT MATTERS MOST
Cool it: 20 minutes of running water
Hold the burn under cool or lukewarm running water for 20 minutes. That's the standard in the UK, Europe and the Red Cross; some US guidance says at least 10 minutes. The shared message: long, and not ice-cold. Cooling takes heat out of the skin that would otherwise keep damaging it, and it eases the pain. If the burn is big, call the emergency number and keep cooling while you wait.
Twenty minutes feels far too long. Most people stop after two, when it stops hurting. Set a timer on your phone.
Ice or the tap?
Ice or iced water
Feels like the obvious choice for heat. But very cold can damage the burnt skin further, and nobody can keep a burn on ice for 20 minutes.
Cool or lukewarm running water
Cold enough to take the heat out, gentle enough to keep going for 20 minutes. A shower works for a large area.
Check yourself
Leila tips boiling water from the kettle over her forearm while making tea. What's the best first aid?
- Cool running water from the tap for 20 minutes
- Ice-cold water for two minutes, until it stops hurting
- An ice cube held on it until the skin goes numb
- A minute under the tap, then a layer of butter
Show the answer
Cool running water from the tap for 20 minutes
Right. Twenty minutes under cool or lukewarm running water takes the heat out of the skin. It's the single most useful thing you can do for a burn.
While the water runs
- Keep the rest of them warm. A big burn plus cold water can make someone dangerously cold, especially a child. Cool the burn, not the person.
- Take off rings, watches and bracelets near the burn now, before it swells. Swelling can turn a ring into a tourniquet.
- Remove clothing near the burn, but not anything stuck to the skin: leave that and cool around it.
- Look at the burn while you cool it: its size and where it is decide whether it needs a hospital.
Then cover it loosely
- Cling film, laid on in strips
Lay pieces of kitchen cling film along the burn. Don't wrap it tightly round an arm or leg: the burn will swell.
- A clean plastic bag for a hand
Slip the hand into a clean food bag. It keeps the burn clean and lets you see it.
- Or a clean, non-fluffy dressing
No cotton wool and no fluffy towels: fibres stick to a burn.
- Leave blisters alone
Don't burst them. The skin over a blister protects what's underneath.
Check yourself
Sara has a kitchen burn on her hand. Sort what people suggest.
- Cool running water for 20 minutes
- A layer of butter or oil
- Taking her ring off before it swells
- Toothpaste or yoghurt on the burn
- A clean plastic bag over the hand afterwards
- Popping the blister so it heals faster
- Holding ice on it
Show the answer
Helpful: Cool running water for 20 minutes, Taking her ring off before it swells, A clean plastic bag over the hand afterwards
Harmful: A layer of butter or oil, Toothpaste or yoghurt on the burn, Popping the blister so it heals faster, Holding ice on it
Get medical help for
- A burn larger than the person's own hand (palm and fingers).
- A deep burn: white, leathery, charred, or oddly painless.
- A burn on the face, hands, feet, genitals or over a joint, or one that goes all the way round an arm or leg.
- Electrical and chemical burns, and smoke inhalation: soot around the mouth or nose, a hoarse voice, coughing.
- Any burn in a young child, an older person or a pregnant woman. For a big burn, call the emergency number and cool while you wait.
Check yourself
Which of these burns most clearly needs a hospital?
- A red mark smaller than a coin on an adult's forearm, already cooled for 20 minutes
- A scald on a toddler's chest about the size of two of her hands
- A pink patch on an adult's shin that stopped hurting after cooling
- Brief redness on Reza's arm from leaning on a warm radiator
Show the answer
A scald on a toddler's chest about the size of two of her hands
Yes. It's bigger than her own hand, it's on a young child, and it covers a large part of her chest. Call the emergency number, and keep cooling while you wait, keeping the rest of her warm.
ELECTRICAL BURNS
Power off before you touch
If someone may still be in contact with electricity, don't touch them until the power is off at the source: pull the plug or switch off at the main switch or fuse box. With high-voltage lines, stay well away and call for help. Electrical burns can look small on the skin and be deep underneath, and the current can affect the heart. So anyone with an electrical burn needs to be checked at a hospital, even if they feel fine.
A small mark where the current went in, and another where it came out, can hide damage all along the path between them.
Chemical burns
- Protect yourself
Gloves on. Don't get the chemical on your own skin.
- Brush off any dry powder
Before the water: some powders react with water.
- Flush with plenty of running water
For at least 20 minutes, and take off clothing the chemical has soaked into.
- Eyes: flush from the inside corner outward
Tilt the head so the unaffected eye is uppermost, and the water runs away from it.
- Get medical help
Call the emergency number. Keep the container, or note the product's name, for the professionals.
Check yourself
Daniyal finds his grandmother on the kitchen floor, one hand still on a sparking kettle cord. He should pull her away from it straight away.
Show the answer
False
False. If the current is still flowing, it can pass into him too. Switch off at the socket, the main switch or the fuse box first, then help her. Then call the emergency number: electrical burns always need checking, and if she's unresponsive, he follows the danger, response, call, breathing steps.
Lesson recap
- Stop the burning first: move away from the heat; clothes on fire, Stop, Drop and Roll or smother the flames.
- Cool the burn under cool or lukewarm running water for 20 minutes. Not ice, and keep the rest of the person warm.
- Take off rings and watches before swelling starts, then cover loosely with cling film or a clean plastic bag.
- No butter, oil, toothpaste, yoghurt or creams, and don't burst blisters.
- Get medical help for burns bigger than the person's hand, deep burns, burns on the face, hands, feet, genitals or joints, electrical and chemical burns, smoke inhalation, and burns in children, older people or pregnant women.
- Electrical: power off before you touch. Chemical: brush off powder, then flush for at least 20 minutes.