Symptoms and signs – Not all may be present

• Severe pain
• red, blackened, peeling or blistered skin 
• watery fluid weeping from the injured area
• the patient may be pale, cold and sweaty, feeling faint and dizzy, and complaining of nausea or vomiting
• swelling of the injured area may appear later

How you can help

1.    Remove the heat source from the patient, or the patient from the heat source, whichever is easiest and safest.

2.   Cool the injured area

• Immediately cool the injured area for a minimum of 20 minutes using cool running water from a tap or shower. In the absence of water use any cool clean fluid such as beer or soft drink.
• A first aid burn gel may be applied,providing it is big enough to cover the entire burn.    
• If any clothing is wet with hot liquid or affected by a chemical splash, remove it quickly and carefully. 
• Remove any tight clothing, watches, rings or jewellery from the injured area, if possible, because of the risk of swelling. 

If the patient is badly injured, or the burn is causing significant pain, or involves the eyes, or is larger than half the patient’s arm – call 111 for an ambulance.

See a doctor if the burn is causing ongoing significant pain, or involves the face, hands, joints or genitals.

Call Healthline on 0800611 116 if you are uncertain

 3.    Position patient

• If the patient is feeling faint lay them down.
• The injured part (depending on the location of the burn) can be placed in a bowl or bucket of cold water if this is easier than pouring water over the burn.

4.    Apply a sterile dressing

• After cooling the injured area for up to 20 minutes, apply a sterile dressing. 
• Use a non-adherent dressing or a piece of cling film.

DO NOT break blisters or remove peeled skin.
DO NOT try to remove any fabric that is stuck to a burn.
DO NOT apply creams, ointments, lotions or butter to any burn injury because infection may occur and complicate the injury.
DO NOT place small children or babies in a cold bath or shower for a full 20 minutes, as this can cause hypothermia.

Remember that any substance applied to a burn injury may have to be removed later in hospital and may also delay the healing process.
Avoid using adhesive tape on the skin around the burn because this may cause further tissue damage.

Chemical burns

How you can help

1.    Quickly remove any contaminated clothing

• Avoid contact with any chemical and further injury to the patient.
• If the chemical is a powder brush it off, avoiding contact, before flushing with water.

2.    Cool the injury

• Flood the burned area with copious amounts of water and continue for up to 20 minutes.

3.    If a chemical solution has splashed into the eyes

• Hold the affected eyelids open to ensure water washes thoroughly under the lids to remove any trapped chemical.

Call 111 for an ambulance urgently.

Bitumen burns

• If a limb or finger is involved, flood the area with cool water for at least 20 minutes.
• Cover any explosed burns with a non-stick dressing.
• Do not apply lotions or ointments.
• Do not pop blisters
• Do not attempt to remove the bitumen
• If the bitumen is reducing circulation, carefully attempt to crack the bitumen with heavy scissors. Do not damage the underlying skin.
• Seek urgent medical assistance

Burns involving the mouth or throat

If the patient has been accidentally exposed to fire or heated gases, damage may occur to the mouth and airway. There may be signs of burning around the lips, nose, mouth, eyebrows or lashes.

A dry cough or hoarse voice is an early sign of airway burns and prompt medical care is essential.

How you can help

1.    Remove the patient to a safe area

• If in a closed area, and if safe for the first aider, it is vital to remove the patient to a place free of the risk of further injury and preferably into fresh air.

2.    Cool the injury

• If smoke or toxic gases may have been inhaled – including carbon monoxide from a vehicle exhaust, chlorine, ammonia or hydrochloric acid – remove the patient from any enclosed or restricted area into an open area, pour running  water over any contaminated area of skin for 20 minutes.
• If there is any breathing difficulty allow the patient to find the position enabling easy breathing with the head and chest raised.

After an inhalation incident the patient may suffer from a severe lack of oxygen due to internal damage to the throat, upper airway and lungs.

Call 111 for an ambulance.

Clothing on fire

How you can help

• Smother the flames with a coat or blanket and set the patient onto the ground to remove oxygen from the burning area.
• The rule is to STOP, DROP and ROLL the patient before checking for burns and cooling the injury.

Sunburn

Background
Sunburn is common in Aotearoa. Prevention is better than cure, and people should remember to be SunSmart:

1. Slip into a shirt (and into shade between 11 a.m. and 4 p.m.).
2. Slop on some sunscreen.
3. Slap on a hat.
4. Wrap on a pair of sunglasses.

How you can help

• Cool shower or cool running water over the burn area for 20 minutes.

DO NOT burst large blisters.

• Sunburn ointment can be applied for minor burns that are not severely blistered and have no broken skin. (Check the expiry date of the ointment.)
• Patient should drink plenty of fluid (non alcoholic).
• Seek medical assistance for large-area sunburns, or if the patient is feeling unwell, or if large blisters are associated with the burn.

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