Burn First Aid & Aftercare: Evidence-Based Steps by Severity

Immediate Assessment

• Minor: <10% BSA, superficial/partial-thickness, not face/hands/feet/genitals/joints
• Major: >10% BSA, full-thickness, critical areas, inhalation, electrical, chemical, extremes of age

Minor Burn First Aid

1. COOL: Cool running water (15–25°C / 59–77°F) × 20 minutes. NOT ice.
2. REMOVE: Jewelry, clothing (unless adhered)
3. COVER: Sterile non-adherent dressing (paraffin gauze, silicone) + loose bandage
4. PAIN: Acetaminophen/ibuprofen
5. ELEVATE if extremity
6. DO NOT: Pop blisters, apply butter/oil/toothpaste/egg whites

Major Burn – Emergency Protocol

1. CALL 911
2. STOP BURNING – remove from source, smother flames
3. ABCs – Airway (inhalation?), Breathing, Circulation
4. REMOVE hot/wet clothing, jewelry
5. COOL burn areas with water (avoid hypothermia – stop if shivering)
6. COVER with clean, dry sheet
7. DO NOT: Ice, ointments, break blisters, feed

Aftercare & Follow-Up

• Tetanus update if >5–10 yrs
• Monitor for infection (spreading redness, fever, odor)
• Scar management (silicone, pressure garments, PT/OT)
• Sun protection (SPF 30+ × 1–2 yrs)
• Psychological support (appearance, trauma)

Referral Criteria (ABA)

• Partial-thickness >10% BSA
• Full-thickness any size
• Face, hands, feet, genitalia, perineum, major joints
• Inhalation, electrical, chemical
• Pre-existing conditions complicating care
• Children <10 / elderly >60