> For the complete documentation index, see [llms.txt](https://handbook.teddwa.xyz/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://handbook.teddwa.xyz/burns.md).

# Burns

Stop the burning process, cool the injury, and identify urgent threats.

### Make the scene safe

1. Remove the patient from the heat, electricity, or chemical source.
2. Do not enter an unsafe area. Request fire or hazardous-material support when needed.
3. Complete the primary assessment before treating the burn.

{% hint style="danger" %}
Treat airway burns, electrical injuries, chemical exposures, and large burns as emergencies.
{% endhint %}

### Cool and cover

Cool a thermal burn with cool running water for 20 minutes when practical. Remove rings, watches, and loose clothing before swelling begins.

Cover the burn loosely with a sterile burn dressing or burn sheet. Keep the patient warm after cooling.

{% hint style="danger" %}
Never apply ice to a burn. Ice can worsen tissue damage.
{% endhint %}

Do not use butter, ointment, adhesive dressings, or attempt to remove melted clothing.

### Identify urgent burns

Seek emergency care for burns affecting the face, neck, hands, feet, genitals, major joints, or a large body area. Urgent assessment is also needed for deep, white, charred, numb, chemical, or electrical burns.

### BLS and ALS care

BLS should estimate affected body surface area, monitor vital signs, and prevent hypothermia. Record the mechanism, exposure time, and treatments provided.

ALS should apply cardiac and oxygen saturation monitoring. Treat severe pain with fentanyl, morphine, or ketamine when appropriate. Establish IV or IO access for significant burns.

For major burns, start warmed isotonic crystalloid resuscitation and titrate to perfusion and urine output. Prepare for early advanced airway management when airway swelling is likely.

### Select a guide

* [Face and airway burns](/burns/face-and-airway-burns.md)
* [Burns on the arms, legs, hands, and feet](/burns/burns-on-the-arms-legs-hands-and-feet.md)
* [Burns on the chest, abdomen, back, and joints](/burns/burns-on-the-chest-abdomen-back-and-joints.md)
* [Chemical and electrical burns](/burns/chemical-and-electrical-burns.md)

{% hint style="warning" %}
Burn depth can worsen over time. Reassess pain, circulation, breathing, and burn appearance during transport.
{% endhint %}


---

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