How to treat a burn

Contact with any source of heat can cause a burn injury. Act quickly when someone has been burned. The key things to do are stop the burn, cool the burn and cover the burn.

Learn what to do when someone is burned and also what not to do so you don’t make the burn injury worse:

Thermal burns

A thermal burn is a type of burn resulting from making contact with heated objects or liquid, such as boiling water, steam, hot cooking oil, fire and hot objects. When a burn is caused by contact with hot liquid, it is called a scald.

Hot water scalds are the most common type of thermal burn affecting children. In adults, thermal burns are most commonly caused by fire.

What are the signs someone has been burned?

Signs someone has been burned include the following, although they may not experience all of these:

  • severe pain – although a deeper burn may be less painful due to destruction of nerve endings
  • red, peeling or blistered skin (or blackened or waxy white) – exact appearance depends on both depth of burn, what caused it and time from initial injury
  • watery fluid weeping from the injured area
  • pale, cold and sweaty, feeling faint and dizzy, and complaining of nausea or vomiting, ie, signs of shock
  • swelling of the injured area may appear later.

What do I do if someone has a thermal burn?

There are 3 key steps to follow if someone has a burn injury:

  1. Stop the burn.
  2. Cool the burn.
  3. Cover the burn.
1. Stop the burn

Remove the heat source from the person or the person from the heat source, whichever is easiest and safest. If any clothing is wet with hot liquid or a chemical splash, remove it quickly and carefully as part of stopping the burn. Don’t remove clothes that are stuck to the burn.

2. Cool the burn

Immediately cool the affected area for up to 20 minutes using cool running water from a tap or shower. If there is no water, use any cool clean fluid, such as beer or soft drink. The burned part can be put in a bowl or bucket of cold water if this is easier than pouring water over the burn. Remember to keep the person warm.

A first aid burn gel may be used if water is not available.

Remove any tight clothing, watches, rings or jewellery from the burned area, if possible, because of the risk of swelling and tightening.

If the person is feeling faint lie them down.

Call 111 for an ambulance if:  

  • the person is badly injured
  • the burn is causing significant pain
  • the burn involves their eyes
  • the burn is larger than half the person’s arm.

See a doctor if:

  • the burn is causing ongoing significant pain
  • involves the face, hands, joints or genitals.
3. Cover the burn

After cooling the injured area for up to 20 minutes, apply a sterile dressing. Use a dressing that doesn’t stick to the skin. Clean plastic kitchen wrap can be used as a temporary dressing. Cover the burn but don’t wrap the dressing around the area.

What should I not do when someone is burned? 

  • Don’t apply ice to the burn.
  • Don’t try to remove fabric that is stuck to a burn.
  • Don’t break blisters or remove peeled skin
  • Don’t apply creams, ointments, lotions, toothpaste or butter to a burn. This will have to be removed later and may cause an infection and delay healing.
  • Don’t put small children or babies in a cold bath or shower for a full 20 minutes. This can cause hypothermia.
  • Don’t use adhesive (sticky) tape on the skin around the burn because this may cause further tissue damage.

Clothing on fire

If someone's clothing is on fire:

  1. STOP, DROP and ROLL the person before checking for burns and cooling the injury.
  2. Stop the burn by smothering the flames with a coat or blanket and then get the person onto the ground and roll them to extinguish the flames.

Burns of the mouth or throat 

If someone has been accidentally exposed to fire or heated gases, their mouth and airway may be damaged. There may be signs of burning around their lips, nose, mouth, eyebrows or eyelashes. A dry cough or hoarse voice is an early sign of airway injury. 

  1. Move the person to a safe area if it is safe for you to do so – preferably into fresh air.
  2. Cool the skin injury. Pour running water over the burn for 20 minutes.
  3. If there is any breathing difficulty, help them find the best position for easy breathing, with their head and chest raised.
  4. Call 111 for an ambulance.

Electrical burns

An electrical burn is the result of electricity passing through the body. It may be caused by a number of sources of electricity, such as household current, power lines and lightning. The type of burn or damage depends on the amount, type and strength of the electrical current. An electric burn may appear minor or not show on the skin at all but may have caused more extensive internal injury.

If someone has an electrical burn, call 111. 

  1. Look first. Don't touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you.
  2. Turn off the source of electricity if possible. If not, move the source away from both you and the injured person using a non-conducting object made of cardboard, plastic or wood.
  3. Check for signs of circulation (breathing, coughing or movement). If they are not there, begin cardiopulmonary resuscitation (CPR) immediately. Keep doing CPR until the ambulance arrives. 
  4. If CPR not required, prevent shock by lying the person down with the head slightly lower than the trunk and the legs elevated.
  5. Cover any burned areas with sterile dressings or temporarily with clean plastic kitchen wrap. Don't use a blanket or towel. Loose fibres can stick to the burns.

Chemical burns

A chemical burn is a burn to internal or external organs of the body caused by a corrosive or caustic chemical substance that is a strong acid or base (also known as alkali). Chemical burns are usually the result of an accident and can occur in the home, at school or, more commonly, at work, particularly in manufacturing plants that use large quantities of chemicals.

If someone has a chemical burn:

  1. Quickly remove any contaminated clothing. Avoid touching yourself or the person with the chemical as you do that. If the chemical is a powder brush it off without touching it yourself and before flushing the burned area with water.
  2. Cool the injury. Flood the burned area with lots of water and continue for at least 20 minutes. First aid for alkali burns can take up to an hour to return skin pH to normal.
  3. If a chemical solution has splashed into their eyes, hold the eyelids open so that water washes thoroughly under the lids to remove any trapped chemical.
  4. Call 111 for an ambulance urgently.

Sunburn

Sunburn is a burn to the skin caused by excess exposure to ultraviolet (UV) radiation in the sun. It can also be caused by other sources of UV, such as sun beds. 

If someone has severe sunburn:

  • Run a cool shower or cool running water over the burn area for 20 minutes.
  • Don’t burst large blisters.
  • Use sunburn ointment for minor burns that are not severely blistered and have no broken skin.
  • Drink plenty of fluid (non-alcoholic).

See a doctor:

  • for sunburns over a large area as these will be very painful
  • if the person is feeling unwell
  • if there are large blisters in the sunburn.

Read more about sunburn

Learn more

The following links provide further information about first aid for burns. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
    
Burns
SafeKids, NZ
Burns – key facts KidsHealth, NZ
First aid handbook St John, NZ
Burns and scalds NHS Choices, UK, 2015
Burns and scalds Patient Info, UK, 2018
National Burn Service NZ

References

  1. First aid Australia and New Zealand Burn Association
  2. Burns St John, NZ
  3. Chemical burn Dermnet, NZ, 2007
  4. Electrical burns Triple One Care, NZ
Credits: Health Navigator Editorial Team . Reviewed By: Dr Richard Wong She, Clinical Leader for Burns, National Burn Centre, Middlemore Hospital Last reviewed: 27 Mar 2019