First Phase of Acute Care of Burn

First Aid: COOL, COVER, and CALL 

• The burn is one of those emergencies that can occur any time of the year in or out of the house. 

• First aid of a burn injury helps minimize pain and provide relief before the specialized professional's takeover. 

• It should always include: 

For Thermal Burns:

• Cool all burns with lukewarm to cool water, regardless of degree. 

• Continue flushing the area for up to 15 minutes. 

• Do not apply ice, ointments, butter, or other "home remedies". 

• Remove all clothing and jewelry to reduce contact time with hot items. 

• Cover affected areas with a clean dry cloth, towel, or blanket to protect the burn from contamination and to minimize pain. 

• Keep blisters intact. 

• Do not apply unsterilized dressings. 

For Chemical Burns:

• Wash the chemical burn wound profusely with running water for 20 minutes.

• Monitor for hypothermia while irrigating.

• Preserve the victim's clothing for chemical analysis to identify the chemical agent responsible for causing the burn. 

Emergency Treatment of Burns: 

• Prehospital burned patients must be removed from the source of injury and the burning process stopped.

• Inhalation injury must always be suspected and 100 percent oxygen given by facemask.  

• Burning clothing, all rings, watches, jewelry, and belts are removed because they retain heat and can produce a tourniquet-like effect.

• Water at room temperature can be poured on the wound within 15 minutes of injury to decrease the depth of the wound, but any subsequent measures to cool the wound should be avoided to prevent hypothermia during resuscitation. 

Stabilization, Wound Care, and Transport: 

• The patient should be wrapped in a sheet or blanket to minimize heat loss and for temperature control during transport. 

• The first step in diminishing pain is to cover the wounds to prevent contact with exposed nerve endings. 

• Small doses of intravenous (IV) morphine may be given after a complete assessment of the patient and once it is determined to be safe by an experienced practitioner. 

• Mode of transport needs to be of appropriate size with emergency equipment available, along with nurses, physicians, paramedics, or respiratory therapists who are familiar with trauma patients.