Management of the burn wound

1. REMOVE

Remove loose clothing and all jewellery. Do not remove anything that is adherent or melted

2. COOL

Irrigate and cool thermal burns with cool (15 C) running tap water for 20 minutes. This can be beneficial up to three hours post-burn injury and should be done in the emergency department if not carried out in full prehospitally.

Irrigate chemicals from skin/eyes immediately with warm running water for at least 15 minutes (though irrigation periods longer than this are usually required).

Do not use ice/iced water/ice packs/gel based cooling products for this purpose.

3. COVER

Clean the wound with normal saline and cover any areas of skin loss with cling film.

Do not use cling film on the face.

Do not wrap cling film circumferentially around a limb (this creates a constrictive eschar).

Cover chemical burns with a non-adherent dressing.

Tetanus status should be considered though latest guidelines would only consider a burn to be tetanus-prone in conjunction with signs of systemic sepsis.^9,10,22