Burn Injury Treatment
The proper treatment for a burn injury is to immediately cool the burn with clean running water for 5-20 minutes to limit tissue damage and reduce pain. 1, 2, 3
Initial Management
- Immediately cool the burn with clean running water for 5-20 minutes 1, 2
- Remove any jewelry from the affected area before swelling occurs to prevent constriction and vascular ischemia 1, 2
- Monitor children closely for signs of hypothermia during cooling, especially with larger burns 1, 3
- If clean running water is not available, cooling superficial burns (with intact skin) using ice wrapped in cloth may be reasonable 1, 3
Treatment Based on Burn Severity
Superficial (First-Degree) Burns:
- After cooling, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera 1, 2, 4
- Cover with a clean, non-adherent dressing 2, 4
- Administer over-the-counter pain medications like acetaminophen or NSAIDs for pain control 1, 4
Partial-Thickness (Second-Degree) Burns:
- After cooling, loosely cover with a clean cloth or non-adherent dry dressing 1, 2
- For small burns being managed at home, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera 1, 2
- Cover with a non-adherent dressing 2, 3
Full-Thickness (Third-Degree) Burns:
- After cooling, cover with a clean, dry, non-adherent dressing while awaiting medical care 2, 3
- All full-thickness burns require immediate medical attention 2, 3
Pain Management
- Over-the-counter analgesics such as acetaminophen or NSAIDs are well tolerated and generally recommended for burn pain 1, 4
- For severe burns, multimodal analgesia should be used with medications titrated based on validated comfort and analgesia assessment scales 2
Common Pitfalls to Avoid
- Do not apply ice directly to burns as this can cause further tissue damage 1, 2
- Do not apply butter, oil, or other home remedies to burns 2, 3
- Do not break blisters, as this increases infection risk 1, 2
- Do not delay cooling - research shows that cooling is still beneficial even when delayed up to 60 minutes post-injury 5, 6
When to Seek Medical Attention
- Seek immediate medical care for burns that involve the face, hands, feet, or genitals 1, 2, 3
- Seek immediate medical care for partial-thickness burns covering >10% body surface area (>5% in children) 1, 2
- Seek immediate medical care for all full-thickness (third-degree) burns 2, 3
- Seek immediate medical care for burns showing signs of infection or that are very painful 2, 3
- Seek immediate medical care for burns with signs of inhalation injury (soot around nose/mouth, singed nasal hairs, difficulty breathing) 1, 4