Pain (How much pain you have is unrelated to the level of burn. The most serious burns can be painless.)
Shock (watch for pale and clammy skin, weakness, blue lips and fingernails, and a drop in alertness)
Red, white or charred skin
If you have burned your airways, you may have:
Burns on the head, face, neck, eyebrows, or nose hairs
Burned lips and mouth
Dark, black-stained mucus
Before giving first aid, it is important to determine what type of burn the person has. If you aren't sure, treat it as a major burn. Serious burns need immediate medical care. Call your local emergency number or 911.
If the skin is unbroken:
Run cool water over the area of the burn or soak it in a cool water bath (not ice water). Keep the area under water for at least 5 minutes. A clean, cold, wet towel will also help reduce pain.
Calm and reassure the person.
After flushing or soaking the burn, cover it with a dry, sterile bandage or clean dressing.
Protect the burn from pressure and friction.
Over-the-counter ibuprofen or acetaminophen can help relieve pain and swelling. Do NOT give aspirin to children under 12.
Once the skin has cooled, moisturizing lotion also can help.
Minor burns will usually heal without further treatment. Make sure the person is up to date on tetanus immunization.
If someone is on fire, tell the person to stop, drop, and roll. Then, follow these steps:
Wrap the person in thick material such as a wool or cotton coat, rug, or blanket. This helps put the flames out.
Pour water on the person.
Call 911 or your local emergency number.
Make sure that the person is no longer touching any burning or smoking materials.
Do NOT remove burned clothing that is stuck to the skin.
Make sure the person is breathing. If necessary, begin rescue breathing and CPR.
Cover the burn area with a dry sterile bandage (if available) or clean cloth. A sheet will do if the burned area is large. Do NOT apply any ointments. Avoid breaking burn blisters.
If fingers or toes have been burned, separate them with dry, sterile, non-sticky bandage.
Raise the body part that is burned above the level of the heart.
Protect the burn area from pressure and friction.
You will also need to prevent shock. If the person does not have a head, neck, back or leg injury, follow these steps:
Lay the person flat
Raise the feet about 12 inches
Cover the person with a coat or blanket
Continue to monitor the person's pulse, rate of breathing, and blood pressure until medical help arrives.
Do NOT apply ointment, butter, ice, medications, cream, oil spray, or any household remedy to a severe burn.
Do NOT breathe, blow, or cough on the burn.
Do NOT disturb blistered or dead skin.
Do NOT remove clothing that is stuck to the skin.
Do NOT give the person anything by mouth, if there is a severe burn.
Do NOT place a severe burn in cold water. This can cause shock.
Do NOT place a pillow under the person's head if there is an airways burn. This can close the airways.
When to Contact a Medical Professional
Call 911 or your local emergency number if:
The burn is very large - about the size of your palm or larger
Gallagher JJ, Wolf SE, Herndon DN. Burns. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 22.
Bethel CA, Mazzeo AS. Burn care procedures. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 38.
Holmes JH, Heimbach DM. Burns. In: Brunicardi FC, Andersen DK, Billiar TR, et al, eds. Schwartz’s Principles of Surgery. 9th ed. New York, NY: McGraw-Hill; 2010:chap 7.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.