Treatment for Scalding Hot Coffee Burns
Immediately cool the burn with clean running water (15-25°C) for at least 10-20 minutes, then cover with a non-adherent dressing and antibiotic ointment for superficial burns. 1, 2
Immediate Cooling (First Priority)
- Begin cooling as soon as possible with cold tap water (15-25°C) for a minimum of 10 minutes, ideally continuing until pain is relieved 1
- Cooling reduces pain, edema, burn depth, speeds healing, and may reduce the need for skin grafting 1, 3
- Evidence shows that adequate cooling (≥10 minutes) significantly reduces hospital admission rates (RR 0.55) and decreases burn depth (RR 0.68) 1, 3
- Never apply ice directly to the burn as this causes tissue ischemia and further injury 1, 4
- Remove jewelry and constrictive items immediately before swelling occurs 2, 5
Treatment Based on Burn Severity
Superficial (First-Degree) Burns
- After cooling, apply petrolatum-based antibiotic ointment, honey, or aloe vera 2, 5
- Cover with a clean, non-adherent dressing 2, 5
- Administer over-the-counter NSAIDs or acetaminophen for pain control 2, 5
Partial-Thickness (Second-Degree) Burns with Blisters
- After cooling, clean the wound with tap water, isotonic saline, or antiseptic solution 1, 2
- Leave blisters intact as this improves healing and reduces pain 1
- Apply thin layer of petrolatum-based antibiotic ointment 2
- Cover with non-adherent dressing such as Xeroform or Mepitel 2
- Avoid silver sulfadiazine for prolonged use on superficial burns as it delays healing 1, 6
Full-Thickness (Third-Degree) Burns
- After cooling, cover with clean, dry, non-adherent dressing 2, 5
- Seek immediate medical attention - all full-thickness burns require professional care 2, 5
Critical Pitfalls to Avoid
- Do not use ice or ice water directly on burns - causes cold injury and tissue ischemia 1, 4
- Do not apply butter, oil, or home remedies - these worsen outcomes 2, 5
- Do not break blisters - significantly increases infection risk 2, 6
- Do not use external cooling devices (Water-Jel) for prolonged periods - risk of hypothermia 1
- Do not use topical antibiotics routinely - reserve for infected wounds only 1
When to Seek Immediate Medical Care
- Burns involving face, hands, feet, or genitals 2, 5
- Partial-thickness burns covering >10% body surface area (>5% in children) 2, 5
- All full-thickness burns 2, 5
- Signs of infection or severe pain 2, 5
- Signs of inhalation injury (soot around nose/mouth, difficulty breathing) 2, 5
Special Considerations
- For burns <20% TBSA in adults and <10% TBSA in children, cooling is safe in absence of shock 1, 2
- Monitor children closely for hypothermia during cooling, especially with larger burns 2, 5
- Dressings should be re-evaluated daily and prevent tourniquet effect on limbs 1, 2
- Multimodal analgesia with titrated short-acting opioids or ketamine may be needed for severe pain 1, 2