Burns Treatment and Severity Classification

Remove from heat source. Smother flames with blanket or dirt—do not use water on clothing fires outdoors. Remove burning clothing only if not fused to skin. For chemical burns, immediately remove contaminated clothing. For electrical burns, disconnect power safely or remove with non-conductive object.

Do not remove clothing that adheres to skin—risk of tissue damage worsens.

Immerse in cool running water or pour water over burn for 10–20 minutes. Use tap water temperature (15–25°C / 59–77°F). This stops progression of deep tissue damage. Do NOT use ice directly on skin—causes ice burns. Do NOT use ice water—increases risk of hypothermia and complications.

Never apply ice directly. Cold water below 15°C increases tissue injury risk.

First-degree (superficial): Red, dry, painless or mildly painful (sunburn-like). Second-degree (partial thickness): Blistered, wet, very painful, pink or red. Third-degree (full thickness): Charred, white, leathery, painless (nerve damage). Estimate body surface area using Rule of 9s (each arm 9%, each leg 18%, front/back torso 18% each, head 9%). Burns >10% body surface area or on face, hands, genitals are serious.

Third-degree burns and second-degree burns >5% body surface area require emergency transport if possible.

After cooling, cover with clean dry cloth or sterile bandage to prevent infection and reduce pain. Do NOT apply ice packs, butter, oil, or ointments. Elevate burned limbs above heart if possible to reduce swelling. For large burns, cover loosely with clean sheet. Remove rings and jewelry before swelling begins.

Never cover with plastic wrap directly on skin—traps heat and causes bacterial growth.

Do NOT pop blisters—they protect underlying tissue. If blister ruptures, gently clean with soap and water, pat dry, apply thin antibiotic ointment (if available), and rebandage. Change dressing daily. Watch for spreading redness, warmth, pus, or fever—signs of infection requiring antibiotics if accessible.

Infection in burn wounds can become systemic and life-threatening without antibiotics.

Chemical burns: Remove contaminated clothing. Flush with large amounts of cool water for at least 15 minutes. Do NOT neutralize acids or bases with opposite chemicals—generates heat and worsens injury. Electrical burns: Check for entry and exit wounds (often small and deep). Assess for heart arrhythmias; if available and trained, perform CPR. High-voltage burns (>1000V) always require evaluation for internal organ damage.

Electrical burns damage muscle and organs internally—may appear minor externally but be life-threatening.

Seek emergency help if: burns >15% body surface, any third-degree burn, burns on face/hands/genitals/joints, loss of consciousness, difficulty breathing, severe pain, signs of shock (pale, weak, rapid pulse), or electrical/chemical burns. Do not delay. If stranded without help, maintain hydration, manage pain, monitor for infection, and keep wounds clean and covered.

Large or deep burns cause fatal fluid loss (shock), infection, and organ failure. Survival depends on early cooling and preventing infection.