What is the best first aid for reducing burning inflammation?

First Aid Treatment for Reducing Burning Inflammation

The best first aid for reducing burning inflammation is to immediately cool the burn with clean running water for 5-20 minutes. 1

Initial Assessment and Management

• Immediately cool the burn with clean running water as soon as possible to limit tissue damage and reduce pain 1
• Continue cooling for at least 10 minutes, with optimal duration between 5-20 minutes 1
• Remove any jewelry from the affected area before swelling occurs to prevent constriction 2
• Monitor children closely for signs of hypothermia during cooling, especially with larger burns 1, 2
• If clean running water is not available, a clean cool or cold (but not freezing) compress can be used as an alternative 1
• For superficial burns with intact skin, ice wrapped in cloth may be reasonable as an alternative when running water is unavailable 1, 2

Treatment Based on Burn Severity

For Superficial (First-Degree) Burns:

• After cooling, it's reasonable to administer over-the-counter pain medications like acetaminophen or ibuprofen for pain relief 1, 3
• Apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera to small burns being managed at home 1, 2
• Cover with a clean, non-adherent dressing 1
• These burns generally heal without scarring and have low infection risk 2, 4

For Partial-Thickness (Second-Degree) Burns:

• After cooling, loosely cover with a clean cloth or non-adherent dry dressing 1
• Seek medical attention if the burn involves the face, hands, feet, or genitalia 1, 2
• Seek medical attention if the burn covers more than 10% body surface area (5% in children) 2, 4
• Do not break blisters as this increases infection risk 2

For Full-Thickness (Third-Degree) Burns:

• All full-thickness burns require immediate medical attention 2, 4
• After cooling, cover with a clean, dry, non-adherent dressing while awaiting medical care 1, 2

Scientific Evidence Supporting Cooling

• Cooling burns with running water has been shown to reduce burn depth and the need for skin grafting 1, 5
• A retrospective study of 695 patients showed an association between cooling and superficial burns (33.2% vs 48.5% deep burns in non-cooled group) 1, 5
• A prospective observational study with 48 patients showed a significant reduction in the number and depth of burns in those who received cooling versus those who did not (12.5% vs 83.3%) 1
• Even delayed cooling (up to 60 minutes post-burn) has been shown to be effective compared to no cooling 6

Common Pitfalls to Avoid

• Do not apply ice directly to burns as this can cause tissue ischemia and further damage 1
• Do not apply butter, oil, or other home remedies to burns 2, 7
• Do not break blisters, as this increases infection risk 2
• Do not delay seeking medical attention for burns with blistering or broken skin, difficulty breathing, or burns involving the face, neck, hands, or genitals 1
• Avoid natural remedies such as potato peel dressings unless in remote settings where commercial options are unavailable 1

When to Seek Medical Attention

• Burns associated with blistering or broken skin 1
• Burns causing difficulty breathing or signs of inhalation injury 1, 2
• Burns involving the face, neck, hands, or genitals 1
• Burns covering a large surface area (trunk or extremities) 1
• Burns that appear infected or are very painful 1, 2

Temperature Considerations

• The temperature of cooling water affects pain relief and reduction in skin surface temperature 8
• Care should be taken to monitor for hypothermia when cooling large burns, particularly in children who have a larger body surface area for their weight than adults 1
• Tap water below 24°C has been shown to be more effective at reducing both skin surface temperature and pain compared to warmer water 8