First Aid – Changes to Management of Burns

The recommended First Aid Treatment for Burns has recently been updated by our awarding body – Qualsafe Awards.

This change follows advice from The British Burns Association and Faculty of Pre-Hospital Care.

Each year, approximately 13,000 burns injuries require hospital attention across England & Wales. This has been gradually increasing year on year through the first decade of this century.

Burns patients form a significant group of trauma patients cared for by first aiders.

Burn Cooling

Cool running water has been demonstrated to the most effective method of burn cooling and has beneficial effects on burn healing outcome. The optimal duration of burn cooling has now increased to 20 minutes. Durations of cool water application shorter than 20 minutes have a limited effect on improved burn healing outcomes. Cool water temperatures should be less than 20°C, with optimal healing benefit achieved with water approximately 12°C. Ice water (<8°C) should be avoided, due to increased tissue necrosis.

Water should preferably be drinkable to reduce risk of wound infection, non-pottable water should be avoided for burn cooling.

For effective cooling to be performed, fluid volumes ranging between 20 – 120 litres of water may be required and at rates of application of at least, 1 – 1.5 L per minute to the burn area(s).

Whilst burn cooling is effective up to three hours after injury, it should be applied as rapidly as possible, ideally within 10 minutes. Cooling should only be delayed or omitted in circumstances of immediate life threat or severe trauma complications.

All jewellery and clothing covering the burnt areas should be removed. If any material is adherent to the skin it should be left in situ, however cooling should continue undeterred.

Burn cooling appears not to directly contribute to patient hypothermia. However, burn cooling treatment should be attentively monitored during the pre-hospital phase of care and measures instigated to actively warm patients to avoid hypothermia.

Burn Dressings

Burn wounds should be dressed with loosely applied polyvinyl chloride dressings (cling film), in order to aid with wound hygiene. Cling film should be laid over the wound and not applied in a completely circumferential manner, to avoid a constrictive effect. If cling film is not available, wounds may be dressed with clean damp cloth or non-adherent dressings.

The use of hydrogel dressings is not recommended. Evidence demonstrating the efficacy of hydrogels for burn cooling when compared to water is limited. Cooling temperatures to aid healing are not sufficiently achieved and such dressings need to remain uncovered to allow air movement for cooling.

The above advice is taken from the following source:

The Management of Burns in Pre – Hospital Trauma Care Consensus

available to download here:burns-consensus-2019 (2)

Essential 6 Ltd strongly recommends that you attend a practical training course in First Aid and one that leads to a regulated qualification. We are increasingly seeing customers move to fully regulated qualifications providing assurance and quality control. A selection of our fully regulated First Aid Courses can be found here.

Essential 6 Ltd provides this information as guidance only and not liable for any diagnosis made or actions taken based on this information.

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