Cool running water, 20 minutes, as soon as possible. That single step does more for a burn than anything else available to you, and most people stop far too early.
Twenty minutes means twenty minutes
Hold the burn under cool running water for at least 20 minutes. Not two, not five. Twenty is the number that limits how deep the burn goes, and it is the step most often cut short because it feels like a long time when someone is in pain.
Start as soon as you can — but cooling still helps for up to three hours after the burn. If you did not manage it at the time, it is not too late.
Keep the rest of the person warm while you cool the burn. Cooling a large area, a small child or an elderly person for 20 minutes can drop their body temperature, so cover everything that is not burnt.
What not to put on a burn
- No ice or iced water. It causes further tissue damage.
- No creams, lotions, ointments or oils. Nothing from the pantry.
- Do not break blisters. Intact skin is a sterile barrier; popping it invites infection.
- Do not pull off anything stuck to the burn. Cool over the top of it and leave removal to the hospital.
Do remove rings, watches and tight clothing from the area before swelling starts, as long as they are not stuck to the skin.
Covering it afterwards
Use a light, loose, non-stick dressing. Plastic cling film is a good option and is what many ambulance services use — lay it over the burn rather than wrapping tightly around a limb. Do not use cling film on a burn to the face.
Chemical and electrical burns
- Chemical — brush off any dry chemical first, carefully remove contaminated clothing, then rinse with running water for up to 60 minutes. Avoid contaminating yourself.
- Electrical — turn the power off before touching the person, if it is safe to do so. Electrical burns can be far deeper than they look, and the current may have affected the heart.
Both need an ambulance or an emergency department.
If someone is on fire
Stop, drop, cover and roll. Lay them on the ground and smother the flames with a blanket, then start cooling.
When to call 000
- The burn is deep — even if it is not painful. Loss of pain means nerve damage, not a minor burn.
- The skin has brown, black or white patches.
- It involves the face, hands or genitals.
- It was caused by chemicals or electricity.
- It affects the throat or airway, or breathing is harder than normal.
When to see a doctor
- A partial thickness burn larger than about 3 cm — roughly a 20-cent coin
- Blisters have formed
- You are worried about it
A full thickness burn covering more than 10% of an adult’s body, or 5% of a child’s, needs urgent hospital care and may require skin graft surgery.
Water matters more than what is in your kit
A workplace first aid kit is expected to provide access to clean running water for 20 minutes, or hydrogel sachets where running water is not available. If your site has no tap within reach of where burns are likely, that gap is worth closing before it is tested — see what goes in a workplace first aid kit.
This is a summary of what is taught in class, not a substitute for training. Skills like this are assessed practically for a reason — reading about them is not the same as having done them. In a real emergency, call 000.
Learn it properly
Burn management is taught in HLTAID011 first aid including CPR and HLTAID012 childcare first aid. Best First Aid Training runs both at Parramatta, Penrith, Blacktown and Liverpool, and supplies first aid kits and burn modules.
Source: Healthdirect Australia, Burns and scalds.
