What is the next best course of action for a resident with a coffee burn on her forearm, presenting with skin stinging but no redness or open wound?

Management of Coffee Burn on Forearm

For a coffee burn with only skin stinging and no redness or open wound, the next best course of action is to cool the area with cool or cold potable water for at least 10 minutes. 1

Initial Management

1. Cool the burn immediately:

   • Apply cool or cold potable water to the affected area for at least 10 minutes 1
   • This halts the burning process, reduces pain, and may prevent burn progression 1, 2
   • Ensure water temperature is comfortable (not freezing) to avoid vasoconstriction

2. Assessment of the burn:

   • Even though there is currently no redness, monitor the area as burn injuries can evolve over time
   • The absence of visible skin changes with only stinging sensation suggests a very minor burn
   • This presentation is consistent with a superficial (first-degree) burn or even pre-burn heat exposure

Follow-up Care

After cooling the burn:

• Gently pat the area dry (do not rub)
• It may be reasonable to loosely cover the burn with a sterile, dry dressing 1
• Avoid applying ice directly to the burn as this can cause tissue damage
• Avoid home remedies such as butter, oils, or toothpaste

When to Seek Medical Attention

While this appears to be a minor burn, medical evaluation should be sought if:

• Redness, blistering, or skin breakdown develops later
• Pain persists or worsens after initial cooling
• The burn involves a large surface area, face, hands, feet, or genitals 1
• There are any signs of infection (increasing pain, swelling, discharge)

Important Considerations

• Timing matters: Immediate cooling is most effective when applied as soon as possible after the burn occurs
• Monitoring: Even minor burns can evolve over 24-48 hours, so continued observation is important
• Documentation: For workplace incidents, document the injury and interventions provided

Pitfalls to Avoid

• Don't use ice water: While cooling is beneficial, extremely cold water or ice can cause vasoconstriction and potentially worsen tissue damage 2
• Don't apply adhesive dressings: These can stick to the burn and cause damage when removed
• Don't ignore evolving symptoms: What appears minor initially may develop into a more serious burn

In this case, with only stinging sensation and no visible skin changes, the burn is likely very minor, but proper cooling remains the standard first aid approach to prevent progression and provide comfort.