Warning: This information is intended for general educational purposes only and should not replace professional medical diagnosis or treatment. Some burns may be more severe than they appear externally, especially electrical burns and chemical burns.

Proper Burn First Aid

Burns and scald injuries are common accidents that can occur in daily life, ranging from minor injuries to severe burns that may become life-threatening. Providing proper first aid early may help reduce the severity of tissue damage, lower the risk of infection, and support better wound healing.

However, burn severity can vary from person to person. This information is intended for basic educational purposes only and should not replace medical evaluation or treatment. If symptoms are severe or there is any uncertainty, medical attention should be sought immediately.

Basic Burn First Aid Steps

1. Stop the Burning Process Immediately

Move the injured person away from the heat source as soon as possible. If clothing is on fire, use the “Stop, Drop, and Roll” technique to extinguish the flames, or cover the flames with a thick blanket or cloth.

2. Remove Clothing and Jewelry Around the Burn

Carefully remove clothing or jewelry exposed to heat to reduce heat retention and prevent swelling.

Precautions:

• Do not remove clothing that is stuck to the burn wound.
• Avoid directly touching the burned area.

3. Cool the Burn With Clean Water

Run clean, room-temperature water over the burn for approximately 10–20 minutes to help reduce tissue temperature and relieve pain.

Precautions:

• Do not apply ice or very cold water, as this may worsen tissue damage.
• Avoid soaking the burn for too long, especially in children or older adults, as it may increase the risk of hypothermia.

4. Cover the Burn Temporarily

Use a clean cloth or a non-stick dressing to loosely cover the burn and reduce contamination from dirt and bacteria.

5. Chemical Burns

If the burn is caused by chemicals, rinse the area thoroughly with large amounts of clean water and avoid direct contact with the chemical substance.

What Not to Do With a Burn

To reduce the risk of infection and further tissue damage, avoid the following:

• Do not apply ice directly to the burn.
• Do not pop blisters.
• Do not apply butter, oil, toothpaste, turmeric powder, or herbal remedies to the wound.
• Do not use loose cotton directly on the burn.
• Do not scratch, rub, or peel the burned skin.

Degrees of Burn Severity

First-Degree Burn

A superficial burn affecting only the outer layer of skin.

Symptoms may include:

• Redness
• Mild pain or stinging
• No blisters

These burns often heal within a few days and may not leave scars.

Second-Degree Burn

A deeper burn involving part of the dermis (inner skin layer).

Symptoms may include:

• Redness
• Swelling
• Blisters
• Moderate to severe pain

These burns may take several weeks to heal, and some cases may result in scarring.

Third-Degree Burn

A severe burn involving all layers of the skin and possibly deeper tissues.

Symptoms may include:

• Brown or blackened skin
• Leathery or hardened skin texture
• Reduced or absent pain in some areas due to nerve damage

These burns usually require prompt medical evaluation and treatment.

Fourth-Degree Burn*

A very severe burn that may extend into muscles, tendons, or bones. These burns carry a high risk of serious complications such as bloodstream infection or organ failure and require urgent specialized medical care. *The term “fourth-degree burn” is used in some medical references to describe burns extending into deeper tissues such as muscles or bones.

How to Reduce the Risk of Burn Scarring

Scar formation depends on burn depth, severity, and proper wound care.

Methods that may help reduce scarring include:

• Keeping the wound clean
• Avoiding picking at scabs
• Preventing infection
• Following medical advice
• Protecting the area from sun exposure

For severe burns, doctors may consider additional treatments such as debridement or skin grafting.

How Are Electrical Burns Different From Other Burns?

Electrical burns are unique injuries that may be more dangerous than ordinary burns, even when the external wound appears small. Electrical current can travel through the body and damage internal tissues, organs, the heart, and the nervous system. Do not use water to extinguish fires involving electricity or touch electrical sources before the power has been disconnected, as this may increase the risk of electric shock. If high-voltage electricity is involved, wait for trained professionals or emergency responders and avoid approaching the area.

1. Different Injury Mechanism

Thermal Burns

Thermal burns are commonly caused by external heat sources such as:

• Fire
• Hot water
• Steam
• Hot objects
• Chemicals

Damage usually begins at the skin surface and extends deeper depending on burn severity.

Electrical Burns

Electrical burns occur when electric current passes through the body, causing internal tissue damage from electrical energy and heat generated inside the body.

Although the external wound may appear minor, internal damage may affect:

• Muscles
• Blood vessels
• Nerves
• The heart
• Internal organs

2. Severity May Not Be Visible Externally

Electrical burns may have “entry” and “exit” wounds, but the actual damage may occur deep inside the body.

For example:

• skin injury may appear small externally
• Internal muscles may be severely damaged
• In some cases, complications such as muscle breakdown or organ failure may occur.

For this reason, electrical burns should always be medically evaluated, even if the visible injury appears mild.

3. Possible Effects on the Heart and Nervous System

One serious complication of electrical shock is cardiac arrhythmia, which may become life-threatening.

Electrical current may also affect:

• The brain
• The nervous system
• Breathing
• Muscle control

Some individuals may experience:

• Loss of consciousness
• Seizures
• Weakness
• Numbness in the hands or feet
• Difficulty breathing

These symptoms may not appear immediately after injury, so close observation is important.

4. First Aid Must Prioritize Rescuer Safety

The most important rule when helping someone experiencing electrical shock is: do not touch the person directly until the electrical source has been disconnected.

Basic first aid steps:

• Turn off the power source first
• Use non-conductive materials such as dry wood, plastic, or rubber to separate the person from the electrical source
• Call emergency medical services immediately
• Check the person’s breathing and responsiveness

Prepared by: พญ. นัทจิรา จียาศักดิ์

source: American Red Cross, World Health Organization, Mayo Clinic, Cleveland Clinic,