TL;DR
Not every burn is an emergency, but some need immediate medical attention. If a burn is deep, covers a large area, affects the face, hands, feet, genitals, or major joints, or was caused by chemicals or electricity, don’t wait to get help. This guide explains how to tell the difference between minor and serious burns, what first aid to provide right away, and when it’s time to call 911 or head to the emergency room.
Burns can range from a small injury you can treat at home to a life-threatening emergency that requires prompt professional care. It all depends on where on the body the burn is, how deep the damage is, and how the burn occurred.
Knowing when to seek emergency medical care can prevent or reduce serious complications. First, stop the burning process, make sure the scene is safe, and then assess the injury.
Understanding Burn Degrees
You’ve probably heard burns described as first, second, or third-degree. Medical professionals may also use the terms superficial, partial-thickness, and full-thickness.
First-Degree Burns
A first-degree, or superficial, burn affects only the outer layer of skin, known as the epidermis. Sunburn and brief contact with a hot object may cause this type of injury.
Signs include:
- Red or pink skin
- Pain or tenderness
- Mild swelling
- Dry skin without blisters
Small first-degree burns can usually be treated at home with proper cooling and wound care. Seek professional advice is the first-degree burn covers a very large area, or is not healing as expected.
Second-Degree Burns
A second-degree, or partial-thickness, burn damages the outer skin (epidermis) and part of the layer underneath (dermis).
Signs may include:
- Red, swollen skin
- Blisters
- A wet or shiny appearance
- Significant pain
- Peeling or broken skin
While some smaller and shallower second-degree burns may heal on their own with proper wound care, larger and deeper burns should always be treated and monitored by a professional. Do not break blisters, since doing so will delay healing and increase the likelihood of infection.
Third-Degree Burns
A third-degree, or full-thickness, burn destroys the full thickness of the skin and may extend into deeper tissue including the fat, muscle or bone.
The skin may appear:
- White, brown, black, or charred
- Dry, leathery, or waxy
- Deeply damaged
A third-degree burn may cause little pain in the center. This is because they often damage the body’s nerve endings. Third-degree burns are always medical emergencies.
How to Cool a Thermal Burn
For burns caused by heat, hot liquid, steam, or a hot surface, begin cooling as soon as it is safe.
Follow these steps:
- Move the person away from the heat source.
- Remove rings, watches, and loose clothing near the burn before swelling develops.
- Do not attempt to remove clothing stuck to the skin. Doing so risks worsening the damage.
- Hold the burn under cool but NOT cold, clean running water for about 20 minutes.
- Keep the rest of the person warm, especially with large burns or in young children.
- After cooling, loosely cover the burn with a clean, nonstick dressing or cloth.
Never place ice directly on a burn. Ice and extremely cold water can further damage tissue. Do not apply butter, oil, toothpaste, or other home remedies. These may trap heat or contaminate the wound.
Electrical Burns
Electrical burns can be more serious than they look. Electricity may travel through the body, damaging muscles and organs while the skin itself may only look to have a minor burn.
Do not attempt to touch someone if they’re still in contact with a source of electricity. Shut off the electricity if it can be done safely and call 911.
Electrical injuries require medical evaluation, especially after:
- High-voltage exposure
- Lightning
- Loss of consciousness
- Chest pain
- Breathing problems
- Seizures
- Visible electrical burns
If the person is unresponsive and not breathing normally, begin CPR and use an AED if available.
Chemical Burns
Chemical burns may be caused by acids, alkalis, cleaners, industrial products, and other corrosive substances. Damage can continue as long as the chemical remains on the body.
For a chemical burn:
- Protect yourself from exposure.
- Remove contaminated clothing and jewelry.
- If the chemical is a dry powder, carefully brush away excess material before rinsing, unless product instructions say otherwise.
- Rinse the skin with large amounts of running water for at least 20 minutes.
- Do not try to neutralize the chemical with another substance.
- If the eyes are involved, begin flushing immediately and seek urgent medical care.
Chemical burns need prompt medical evaluation when the substance is unknown, the injury is deep or extensive, the eyes are affected, or the person has breathing problems.
When to Call 911 or Seek Emergency Care
Call 911 or seek emergency medical care for:
- Any third-degree burn
- A large or deep burn
- Burns involving the face, eyes, hands, feet, genitals, or major joints
- Burns that completely circle an arm, leg, chest, or neck
- Electrical burns or serious electrical shocks
- Significant chemical burns
- Burns caused by explosions
- Burns associated with smoke inhalation or breathing difficulty
- Burns with loss of consciousness, confusion, or signs of shock
- Serious burns in infants, young children, older adults, or people with significant medical conditions
Seek medical care if a smaller burn becomes increasingly red, swollen, painful, begins draining pus, or is accompanied by fever. These may indicate infection.
Final Thoughts
Never judge the severity of a burn by pain alone. Deep burns may hurt less than minor ones, and electrical burns may not appear serious on the surface.
For minor thermal burns, stop the heat source, cool the area with running water for about 20 minutes, and cover it loosely. Avoid ice and sketchy home remedies. For deep, large, electrical, chemical, or critical-area burns, seek immediate medical care. When in doubt, have the burn professionally evaluated.
Have a well stocked first-aid kit on hand. Completing a First Aid course can give you the knowledge and confidence to act quickly in an emergency.