To distinguish a minor burn from a serious burn, the first step is to determine the degree and the extent of damage to body tissues. The three classifications of first-degree burn, second-degree burn and third-degree burn will help you determine emergency care:
The least serious burns are those in which only the outer layer of skin is burned. The skin is usually red, with swelling and pain sometimes present. The outer layer of skin hasn’t been burned through. Treat a first-degree burn as a minor burn unless it involves substantial portions of the hands, feet, face, groin or buttocks, or a major joint.
When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Second-degree burns produce severe pain and swelling.
If the second-degree burn is no larger than 3 inches (7.5 centimetres) in diameter, treat it as a minor burn. If the burned area is larger or if the burn is on the hands, feet, face, groin or buttocks, or over a major joint, treat it as a major burn and get medical help immediately.
For minor burns, including first-degree burns and second-degree burns limited to an area no larger than 3 inches (7.5 centimetres) in diameter, take the following action:
- Cool the burn. Hold the burned area under cold running water for at least five minutes, or until the pain subsides. If this is impractical, immerse the burn in cold water or cool it with cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. Don’t put ice on the burn.
- Cover the burn with a sterile gauze bandage. Don’t use fluffy cotton, which may irritate the skin. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burned skin, reduces pain and protects blistered skin.
- Take an over-the-counter pain reliever. These include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve) or acetaminophen (Tylenol, others). Never give aspirin to children or teenagers.
Minor burns usually heal without further treatment. They may heal with pigment changes, meaning the healed area may be a different colour from the surrounding skin. Watch for signs of infection, such as increased pain, redness, fever, swelling or oozing. If infection develops, seek medical help. Avoid re-injuring or tanning if the burns are less than a year old — doing so may cause more extensive pigmentation changes. Use sunscreen on the area for at least a year.
- Don’t use ice. Putting ice directly on a burn can cause frostbite, further damaging your skin.
- Don’t apply butter or ointments to the burn. This could prevent proper healing.
- Don’t break blisters. Broken blisters are vulnerable to infection.
The most serious burns are painless, involve all layers of the skin and cause permanent tissue damage. Fat, muscle and even bone may be affected. Areas may be charred black or appear dry and white. Difficulty inhaling and exhaling, carbon monoxide poisoning, or other toxic effects may occur if smoke inhalation accompanies the burn.
For major burns, dial 999 or call for emergency medical assistance. Until an emergency unit arrives, follow these steps:
- Don’t remove burnt clothing. However, do make sure the victim is no longer in contact with smouldering materials or exposed to smoke or heat.
- Don’t immerse large severe burns in cold water. Doing so could cause shock.
- Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin cardiopulmonary resuscitation (CPR).
- Elevate the burned body part or parts. Raise above heart level, when possible.
- Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist towels.