Burns & Scalds

What is the first action in treating a burn?

• ACool the burn with cool (not iced) running water for 20 minutes✓
• BApply butter or oil
• CApply ice directly to the burn
• DCover with a dark bandage

Answer: Cool the burn under cool (not iced) running water for a firm 20 minutes to reduce pain and limit tissue damage — this is the most important first action.

What is a first-degree (superficial) burn?

• AThe most severe type of burn
• BCauses charring of the skin
• CAffects only the outer layer of skin, causing redness and pain but no blistering✓
• DCharacterised by blistering and deeper tissue damage reaching well into the dermis and the nerve endings

Answer: A first-degree burn affects only the epidermis (outer skin layer), causing redness, pain, and possible slight swelling but no blistering.

What is a second-degree (partial thickness) burn?

• AOnly involves redness of the outermost layer of skin, with no pain and no blistering at all
• BAlways requires surgery and amputation of the affected limb once blisters have appeared
• CInvolves blistering, severe pain, and deeper tissue damage affecting the dermis✓
• DA burn so shallow that no treatment is needed beyond keeping the area covered for a day

Answer: A second-degree burn damages the dermis layer, causing severe pain, blistering, redness, swelling, and possible weeping of fluid.

What is a third-degree (full thickness) burn?

• AAlways heals without scarring because the deeper layers of the skin regrow within a few weeks
• BAffects all skin layers and underlying tissues, appearing white, brown, or charred✓
• CThe most minor type of burn, which heals in a few days without any medical treatment at all
• DOnly causes minor redness

Answer: A third-degree burn destroys all skin layers and may damage underlying muscle and bone. The skin appears white, brown, or charred and may be painless.

When should you remove clothing from a burned area?

• ANever remove clothing
• BOnly if the clothing is stuck to the skin
• CImmediately and forcefully
• DGently remove loose clothing, but leave any that is stuck to the skin✓

Answer: Remove loose clothing from the burned area, but do not attempt to remove clothing that is stuck to the skin as this can cause further damage.

What should be used to cool a chemical burn?

• ASpecific neutralising agents matched to the chemical, applied before any water is used
• BCool running water for 20-30 minutes to dilute and remove the chemical✓
• CDry cloth only
• DOil or cream

Answer: Flush the chemical burn with cool running water for 20-30 minutes to dilute and remove the chemical. Continue until paramedics arrive.

What is the correct treatment for an electrical burn?

• AEnsure the electrical source is switched off, cool the burn with water, and call 999✓
• BApply ice directly to the burn straight away in order to bring the skin temperature down
• CApply a tourniquet above the burn to stop the electricity travelling further up the limb
• DGive the casualty a stimulant drink such as strong coffee or an energy drink to counter the shock

Answer: For electrical burns, switch off the electrical source, cool the burn with water, and call 999. Electrical injuries can cause internal damage.

What should you do if someone's clothing is on fire?

• APat the flames out with your hands, then peel the burnt clothing away from the skin
• BUse a fire blanket or have them 'stop, drop, and roll', then cool the burns✓
• CLeave them to cool naturally in the open air and do not touch or remove any of the burnt clothing
• DRun off to find water and bring it back to throw over the burning clothing

Answer: Smother the flames with a fire blanket or have them stop, drop and roll, then cool the burn with cool running water for at least 20 minutes. Never use bare hands, and never peel away clothing that is stuck to the skin.

How should you treat a severe scald from boiling water?

• AApply ice directly
• BImmerse in very cold water
• CCool under cool (not iced) running water for 20 minutes, remove wet clothing, and call 999 for extensive burns✓
• DApply oil or butter

Answer: Cool under cool (not iced) running water for a firm 20 minutes. Gently remove wet clothing that is not stuck to the skin. Call 999 for extensive scalds.

What should not be applied to a burn?

• ACool running water from a clean tap, applied for at least twenty minutes
• BKitchen cling film laid loosely over the burn rather than wrapped around the limb
• CIce, butter, oil, or toothpaste✓
• DSterile gauze

Answer: Do not apply ice, butter, oil, cream, or toothpaste to burns. These can trap heat and cause further damage. Use cool water and sterile dressings.

What size burn requires emergency medical attention?

• AEvery burn, however small, requires assessment at a hospital emergency department before any dressing is put on
• BBurns larger than the casualty's hand (3% body surface area) or affecting the face, joints, genitals✓
• COnly burns measuring more than 5 cm across, once the area has been cooled under running water for 20 minutes
• DOnly third-degree burns, since partial thickness burns can always be managed with a dressing at the workplace

Answer: Seek emergency help for burns larger than 3% of body surface area, or affecting sensitive areas like the face, hands, joints, or genitals.

How should you dress a burn after cooling?

• ALeave it exposed to the air so that a scab can form over the burn naturally
• BApply a tight bandage straight away to keep the air off the burn and stop it weeping
• CApply a sterile, non-adhesive dressing that won't stick to the burn✓
• DApply an antiseptic cream or a burn ointment, then cover the area with cotton wool

Answer: Use a clean, sterile, non-adhesive dressing (cling film can be used for larger burns). Do not apply creams, ointments, or adhesive dressings.

What is the rule of nines for assessing burn size in adults?

• AHead 9%, each arm 18%, each leg 9%, front/back torso 18%
• BAll body parts equal 9%
• CHead 9%, each arm 9%, each leg 18%, front torso 18%, back torso 18%, genitals 1%✓
• DHead 9%, each arm 9%, each leg 18%, front/back torso 9%

Answer: The rule of nines: Head 9%, each arm 9%, each leg 18%, front torso 18%, back torso 18%, genitals 1%. This helps estimate burn size.

How should you treat a casualty with a severe burn covering more than 15% of body surface area?

• AImmerse in cold water for an extended period
• BApply ice directly to the entire burn
• CLeave the casualty uncovered so that the air can reach the burn and cool it naturally while you wait for help
• DCool with water, remove tight clothing, cover with clean dressings, call 999, and monitor for shock✓

Answer: Cool with water, remove any tight items that could restrict swelling, cover with clean dressings, call 999, keep warm, monitor for shock, and elevate burnt limbs if possible.

What is the correct treatment for a chemical burn to the eye?

• AFlush continuously with cool water for at least 15-20 minutes, then seek medical help✓
• BApply oil or a soothing ointment to the injured eye and then cover it with a sterile eye pad
• CUse the specific chemical antidote named on the Safety Data Sheet before any water goes near the eye
• DHold the eyelid closed and cover it with a pad so that the chemical cannot spread further

Answer: Flush the eye continuously with cool water for at least 15-20 minutes to dilute and remove the chemical. Call 999 or seek immediate medical help.

How should you treat sunburn?

• AApply butter or oil
• BExpose the skin to more sun to toughen it, and cover the area with a warm blanket afterwards
• CCool with tepid water, avoid further sun exposure, use loose clothing, and offer fluids✓
• DApply ice or a frozen gel pack to the reddened skin until the burning sensation has gone away

Answer: Cool the skin with tepid water, avoid further sun exposure, wear loose protective clothing, and drink plenty of water to prevent dehydration.

What should you do if a burn covers joints or affects movement?

• AEncourage exercise to maintain mobility
• BPrevent any movement of the affected area
• CApply tight bandages
• DCool, dress carefully, immobilise if needed, and seek medical advice✓

Answer: Cool and dress carefully, immobilise if needed to prevent movement that could cause pain, and seek medical advice for burns affecting joints.

What is the significance of pain level in burn assessment?

• AHigh pain indicates superficial burns; no pain may indicate full thickness burns with nerve damage✓
• BPain level does not affect treatment
• COnly severe pain requires treatment
• DPain always shows that the burn is superficial and not serious, so no medical assessment is ever needed

Answer: Superficial burns are very painful. Deep or full-thickness burns may be painless because nerve endings are destroyed. Pain level helps assess burn depth.

How long should you cool a burn for?

• A20 minutes, or longer for extensive burns✓
• BOnly until the pain stops, which is usually within two or three minutes
• COne minute is sufficient, provided the water is as cold as the tap will run
• D2-3 minutes under a running tap, then dress the burn and send the casualty home

Answer: Cool the burn under cool (not iced) running water for a firm 20 minutes to limit tissue damage. For extensive or chemical burns, cooling may need to continue for longer.

What complications can arise from severe burns?

• AOnly damage to the skin itself, with no effect on the rest of the body
• BThere are never any complications once the burn has been cooled and dressed
• CShock, dehydration, infection, and respiratory problems✓
• DOnly pain

Answer: Severe burns can cause shock, dehydration, fluid loss, infection, respiratory damage, and organ failure. Prompt medical care is essential.