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 cooking oil to the area
• 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 a person can sustain
• BCauses blistering, weeping and charring of the skin surface
• 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?

• ARedness of the outermost layer of skin, with pain but no blistering, as with mild sunburn
• BCharred or white, leathery skin that may be painless because the nerves are destroyed
• 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
• DCauses only minor redness that fades within hours

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?

• ARemove all clothing from the area, including anything stuck to the skin
• 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 is the correct first aid to cool a chemical burn?

• AA sugary drink given in small sips, as used to treat a diabetic hypo
• BCool running water for 20-30 minutes to dilute and remove the chemical✓
• CThe casualty's own reliever inhaler, as used during an asthma attack
• DLying down with the legs raised, as used for someone who has fainted

Answer: Flood a chemical burn with cool running water for at least 20 minutes to dilute and wash the chemical away, continuing on the way to hospital if needed, and call 999 or go to A&E. Protect yourself with gloves, brush off any dry powder first, and remove contaminated clothing that is not stuck to the skin. Never try to neutralise the chemical, and do not use ice, creams or oils. The other options are first aid for a diabetic hypo, an asthma attack and a faint.

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, then cover the burn with a dry dressing
• 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, then cover with a sterile dressing and elevate
• BImmerse the area in very cold or iced water
• CCool under cool (not iced) running water for 20 minutes, remove wet clothing, and call 999 for extensive burns✓
• DApply oil or butter to the scald, and then wrap the whole area in a dry towel

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?

• ASmall burns, however minor, which need assessment at a hospital emergency department before a dressing is applied
• BBurns larger than the casualty's hand (about 1% of body surface area) or on the face, hands, feet or genitals✓
• CMild sunburn causing redness of the skin, once the area has been cooled with a damp towel for 20 minutes
• DBurns where the skin is red but unbroken, and where the casualty's pain settles within minutes of cooling

Answer: The casualty's hand, palm and fingers together, is about 1% of their body surface area (the 'rule of palms'), which makes it a quick size guide. Burns larger than that, deep burns, burns to the face, hands, feet or genitals, and all chemical or electrical burns need emergency care: call 999 or go to A&E. Small superficial burns that settle after 20 minutes of cooling can usually be treated with first aid, but a burn to a child always needs medical advice.

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%
• BEvery body part counts as 9% each
• 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 to the whole area, then wrap it tightly to retain the cold
• 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, cover it with a pad and take them to hospital

Answer: Flush the eye continuously with cool, clean running water for at least 15-20 minutes to dilute and remove the chemical, then call 999 or seek immediate medical help. Never put oils, ointments or so-called antidotes or neutralisers in the eye - they can worsen the injury and delay irrigation - and do not hold the eye closed before it has been flushed.

How should you treat sunburn?

• AApply butter or a greasy ointment to soothe the skin
• 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, so that the joint cannot move while it heals
• 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
• CSevere pain means the burn is full thickness
• DPain level is used to decide how long to cool the burn under running water

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
• 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?

• ADamage to the skin itself, with no effect on the rest of the body
• BHigh blood pressure and a slow pulse caused by the excess fluid
• CShock, dehydration, infection, and respiratory problems✓
• DPain alone, which settles quickly

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