Burns and Scalds are tissue injuries caused by heat sources such as hot liquids, flames, the sun, chemicals, electricity, or steam. Scalds specifically refer to burns from hot liquids or steam. The severity ranges from superficial (first-degree) to full-thickness (third-degree) injuries, depending on depth and area involved.
Types of Burns by Cause
| Type | Cause | Examples |
|---|---|---|
| Thermal Burns | Contact with heat sources | Flames, hot liquids, steam, hot metals |
| Chemical Burns | Exposure to corrosive substances | Acids, alkalis, solvents |
| Electrical Burns | Contact with electrical current | Faulty wiring, lightning, power lines |
| Radiation Burns | Exposure to radiation | Sunburn, X-rays, radiation therapy |
| Friction Burns | Skin abrasion with heat from rubbing surfaces | Road rash, carpet burn |
| Cold Burns | Prolonged exposure to freezing temperatures | Frostbite |
When to Seek Emergency Help
Seek immediate medical attention for any of the following:
- Deep burns involving all skin layers, appearing white, brown, or charred
- Burns larger than 3 inches (8 cm) or covering hands, feet, face, genitals, or a major joint3
- Chemical or electrical burns, or burns with smoke inhalation
- Burns accompanied by shock signs (cool, clammy skin; weak pulse; rapid breathing)
Immediate First Aid Steps
- Stop the burning process Remove the person from contact with hot surfaces, flames, chemicals, or electricity—ensure your own safety first.
- Cool the burn Hold the area under cool (not cold) running water for 10–20 minutes. If running water isn’t available, apply cool, wet compresses until pain eases3.
- Remove constricting items Gently take off rings, bracelets, or tight clothing near the burn before swelling begins. Do not remove fabric stuck to the wound.
- Cover the burn Lay a clean, non-stick sterile dressing or cling film loosely over the area to protect against infection and reduce pain.
- Elevate the injured part If possible, raise the burn above heart level to help limit swelling and fluid accumulation.
- Manage pain Offer over-the-counter analgesics such as paracetamol or ibuprofen, following dosing guidelines. Children under 16 should not receive aspirin.
- Monitor and refer Watch for signs of infection or shock, and arrange transport to hospital if the burn meets emergency criteria.
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Remove the source of heat safely before helping the victim | Use ice, iced water, butter, or greasy substances on the burn |
| Cool under running water for 10–20 minutes | Break blisters or peel away loose skin |
| Gently remove rings or tight clothing before swelling | Forcefully remove clothing stuck to the wound |
| Cover with non-stick sterile dressing or cling film | Wrap the burn tightly or use adhesive dressings directly on the wound |
| Elevate the burned area if feasible | Delay seeking professional care for any deep or extensive burns |
Symptoms of Burns and Scalds
Symptoms of burns and scalds depend on the degree of damage. Accordingly, a patient can display the following symptoms:
First-degree burns: First-degree burns usually cause red and painful blisters.
Second-degree burns: Blisters can develop in second-degree burns, too, and can be quite painful. Along with swelling and scarring, the patient can also display skin that is white, red, or splotchy.
Third-degree burns: Third-degree burns can cause a person’s skin to appear brown, black, or white. The skin can develop a leathery appearance.
Causes of Burns and Scalds
Burns and scalds can be caused due to various reasons. Some of them are as follows:
- Contact with fire or flames
- Hot beverages and hot steam or water from pots, kettles, or taps
- Contact with hot appliances, such as irons, stoves, and hair straighteners or hair curlers
- Chemicals such as bleach, acids, gasoline, batteries, or drain cleaners
- Exposure to UV rays from sunlight or tanning beds
- Electrical currents
Treatment for Scalds
- Immediately flood the burn area with cold water (under a tap or hose – low pressure) for up to 20 minutes to limit tissue damage.
- If no water is readily available, remove clothing immediately as clothing soaked with hot liquids retains heat.
- Evaluate how serious the scald is and call for EMS if necessary for transport to medical aid.
Treatment for Flame Burns
- Smother the flames with a coat or blanket, get the casualty on to the floor or ground, that is, Stop, Drop and Roll.
- Prevent the victim from running if their clothing is on fire.
- If water is available, immediately cool the burn area with cold water (under a tap or hose – low pressure) for up to 20 minutes. If no water is available, remove smoldering clothing (if it is not stuck to the skin) but avoid pulling clothing across the burnt face.
- Cover the burn area with a loose, clean, dry cloth (pillow-case, handkerchief, sheet) to prevent contamination.
- Do not break blisters. Do not remove clothing that is stuck to the injury. Do not apply lotions, ointments, creams or powders – these make the assessment of a burn difficult. 6. Evaluate how serious the burn is and call EMS for transport without delay to hospital.
REFERENCES
- Kermott CA, et al., eds. Emergencies and urgent care. In: Mayo Clinic Guide to Self-Care. 7th ed. Mayo Foundation for Medical Education and Research; 2017.
- Purdue GF, et al. Acute assessment and management of burn injuries. Physical Medicine and Rehabilitation Clinics of North America. 2011; doi:10.1016/j.pmr.2011.01.004.
- Thompson DA. Burns. In: Adult Telephone Protocols: Office Version. 4th ed. American Academy of Pediatrics; 2018.
- Tiwari VK. Burn wound: How it differs from other wounds? Indian J Plast Surg. 2012;45(2):364-373. doi:10.4103/0970-0358.101319
- First aid for burns and scalds, Page last reviewed: 10 November 2022, https://www2.hse.ie/babies-children/first-aid/burns-scalds/
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