How to Treat a Burn - First Aid in 5 Steps

Burns come in three levels of severity, and the level changes what you do next. A first-degree burn is red and painful, like a sunburn - the skin is intact. A second-degree burn is red, blistered, and weeping. A third-degree burn is charred or whitish through the full thickness of skin and may reach into muscle or bone. Third-degree burns are often painless in the center because the nerves are destroyed.

Real burns are almost always mixed. The middle of the wound is the deepest, the edges are the shallowest. Look at the worst part to decide how to respond.

Get jewelry off the burned limb before the swelling starts. Watches, rings, bracelets, anklets - if you wait, you may have to cut them off later. Lift the limb to help blood flow back to the body.

For clothing over the burn: if the fabric is loose, cut it away with scissors. If it's stuck to the burn, leave it alone. Pulling fused fabric tears more skin off with it. The hospital has the right tools to remove stuck clothing safely.

Then run the burn under cool tap water for at least 10 minutes. Not freezing water, not ice - just cool tap water. Most people stop after 30 seconds or a minute and walk away, and the burn keeps cooking from residual heat for several minutes. Ten minutes is the floor, not the goal.

If you have a burn kit at work or in a vehicle, this is the moment to open it. Burn kits contain water-gel dressings - gauze pads pre-soaked in a cooling gel that draws heat out of the wound. You can feel the cold through the sealed packet.

Tear the packet open, unfold the dressing, and lay it directly over the burn. Don't wrap it tight - the dressing is doing its job by lying in contact with the skin, not by compression. Burn kits typically include arm-size, hand-size, and face-size dressings. For larger burns, use more than one.

At home you probably don't have a burn kit. Plain kitchen cling film is the emergency substitute - and it's surprisingly good at the job.

Peel off the first inch from the roll (it may be dusty) and discard. Then wrap the cling film loosely around the burn. Don't pull tight - you're not bandaging it, you're creating a barrier against infection while letting the skin breathe.

Cling film has two real advantages: it doesn't stick to the wound the way cotton or gauze does, and the hospital can remove it cleanly. You can also keep cooling the burn with water right through the cling film, which is something a cotton dressing won't let you do.

Call 911 (or 999 in the UK) for any burn that meets these criteria: bigger than the palm of the victim's hand, on the face, hands, feet, genitals, or a major joint, caused by chemicals or electricity, or showing full-thickness charring of any size.

While you wait, keep the person warm with a blanket - burn victims lose body heat fast. Monitor their breathing and consciousness. If they become pale, sweaty, weak, or confused, those are signs of shock; lay them down and elevate their legs (unless that's not possible due to the burn location).

For chemical burns, find out what chemical caused the burn before you start washing - some chemicals need specific handling. For powder chemicals, brush off as much as possible before adding water, because some powders become more corrosive when wet.