Hesperian Health Guides
Burns
Minor burns
A minor burn is small, does not form blisters, does not affect the face, hands, feet, genitals or any joints, and is the only injury a person has sustained. To lessen pain and damage, put the burned area in clean cool water (not ice or ice water) right away for no longer than 20 minutes. Then keep the burn clean and dry and take aspirin, paracetamol (acetaminophen), or ibuprofen for pain (avoid giving aspirin to children). Minor burns should heal by themselves within about 2 weeks.
Severe burns
A burn is severe when any of the following is true:
- The burn is large. A large burn covers 10% or more of the body. You can estimate how much of the body is burned based on the size of the palm of the hand of the burned person. The size of one palm is about 1% of their body surface. 10 palms is about 10%.
- The burn affects a joint, the face, the hands, the feet, or the genitals. These can scar and cause disabilities.
- The burn is combined with other injuries.
- The burn is deep. Deep burns affect many layers of skin. It is often difficult to tell how deep a burn is right after it has happened.
- The burn is on a child. Children have much more difficulty recovering from burns and whenever possible should be cared for in hospitals equipped to treat burns.
Treatment
To prevent infection, wash a severe burn with water that has been boiled and cooled, and add povidone iodine if you can (mix 4 parts boiled/cooled water with 1 part povidone iodine). Scrub gently so the burn does not bleed and rinse with more boiled and cooled water. Then dry the burn by blotting with sterile gauze or sterilized cloth. Wearing sterile gloves, put one of the following directly on the burn to kill germs:
- silver sulfadiazine: Use a thin layer. Do not use for burns on eyelids or lips, or to burns on children younger than 2 months old.
- honey: Use a thin layer.
- sugar: Pour granulated sugar to cover the burn. Throw away any sugar that does not stick to the burn.
Then gently cover the burn with sterile gauze or sterilized cloth and secure this with tape or bandages. If the burn is on an arm or leg, keep the limb elevated to lessen swelling.
 |
 |
Clean the burn, reapply the antimicrobial agent, and change the covering once each day. Burns are extremely painful. As needed, give strong pain medicine such as morphine or other opiates. Always give pain medicine before cleaning or changing a dressing on a serious burn. As burns heal they can start to itch. An antihistamine can provide some relief.
Never put ice, grease, fat, hides, coffee, herbs, or feces on a burn. If signs of infection appear—pus, bad smell, fever, or swollen lymph nodes—put an antibiotic ointment such as Polysporin on the burn and get medical attention as soon as possible. The person needs surgery to clean the wound and intravenous antibiotics to treat the infection.
Special precautions for very serious burns
- A person with a large or deep burn can easily become dehydrated because body fluids are lost as they ooze from the burn. Give intravenous (IV) fluids if you can. Otherwise, give large quantities of rehydration drink to someone who is alert and able to swallow. Watch for danger signs of shock that can come from dehydration.
- When someone is badly burned between their fingers, in their armpit, or at other joints, put gauze pads with petroleum jelly between the burned surfaces to prevent them from scarring together as they heal.
- Plenty of nutritious food, including extra protein, is needed to help a burn heal. While healing, try to eat at least 4 meals each day that have protein (such as chicken, other meats, eggs, milk, fish, beans, and nuts), as well as snacks.
- Burned parts of the body may become stiff and immobile as they heal and scar tissue forms, especially if the burn is on a joint. Help the person gently move the burned part of their body immediately after the injury, and do this 2 to 3 times each day until the burned skin no longer tightens and shrinks (usually many months to years after a burn).
As with any serious injury, get help if the person gets worse or you cannot provide needed care.