Burns range in complexity from minor first-degree burns to more severe full-thickness burns.
Initial basic burn management:
Run the burn under cool running water for 20 minutes.
Do not scrub the skin.
Do not use ice water.
Ideally initiated as soon as possible, but no later than 3 hours after injury.
Applicable to all burns ranging from superficial to full thickness.
Then apply a non-adherent dressing or sterile gauze.
Can be done at home or upon presentation to the emergency department.
These steps decrease pain and minimize tissue damage.
A study published in Annals of Emergency Medicine found that, out of 371 EMS and emergency medicine providers,
90% had not heard of the recommendation to run burns under cool water for 20 minutes.
The majority of providers interviewed expressed motivation to implement this burn cooling practice but cited barriers such as:
Difficulty immersing certain body parts (e.g., chest).
Critically ill patients requiring other urgent interventions.
References:
Holbert MD, Singer Y, Palmieri T, et al. Cool Running Water as a First Aid Treatment for Burn Injuries. Annals of Emergency Medicine. 2025;S0196-0644(25)01138-2. doi:10.1016/j.annemergmed.2025.08.003.
Olawoye OA, Isamah CP, Ademola SA, et al. Effect of Prehospital Topical Application of Water and Other Agents on Outcome in Burn Injured Patients: A Prospective Study. Burns. 2025;51(2):107357. doi:10.1016/j.burns.2024.107357.
Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4