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My 30-year-old first-aid manual has the following instructions for treating minor burns:

  • Apply cold water or ice until the pain goes away, but not for less than five minutes or more than one hour.
  • Leave blisters alone. If they pop, leave the overlying skin on to act as a dressing.
  • Do not use anesthetic creams or sprays.
  • Do not apply butter or any ointment.
  • Antibiotic creams are unlikely to help or harm.

Is this still the recommended way of dealing with them?

2 Answers 2

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Burn treatment has changed over the years. When I was in the USMC Air Wing many decades ago, I suffered some pretty bad burns on both hands by trying to push a jet engine starter (turbine engine) with my hands. (Yeah, I know, pretty stupid.) They rushed me to sick bay and drenched my hands in ice water for 30 minutes. My hands never did blister. Since then I have always used ice to cool a burn.

That said, ice is no longer recommended for treatment of a burn, as it can cause further damage to the underlying skin, and it's just about impossible to apply ice to only the burn without affecting the surrounding area.

From MedlinePlus:

    First aid for Minor Burns

  • First, calm and reassure the person who is burned.
    If clothing is not stuck to the burn, remove it. If the burn is caused by chemicals, take off all clothes that have the chemical on them.

  • Cool the burn
  • Use cool water, not ice. The extreme cold from ice can injure the tissue even more.
  • If possible, especially if the burn is caused by chemicals, hold the burned skin under cool running water for 10 to 15 minutes until it does not hurt as much. Use a sink, shower, or garden hose.
  • If this is not possible, put a cool, clean wet cloth on the burn, or soak the burn in a cool water bath for 5 minutes.

  • After the burn is cooled, make sure it is a minor burn. If it is deeper, larger, or on the hand, foot, face, groin, buttocks, hip, knee, ankle, shoulder, elbow, or wrist, seek medical care right away.

    If it is a minor burn.

  • After the burn is cooled, make sure it is a minor burn. If it is deeper, larger, or on the hand, foot, face, groin, buttocks, hip, knee, ankle, shoulder, elbow, or wrist, seek medical care right away.
  • DO NOT break blisters. An opened blister can get infected.
  • You may put a thin layer of ointment, such as petroleum jelly or aloe vera, on the burn. The ointment does not need to have antibiotics in it. Some antibiotic ointments can cause an allergic reaction. DO NOT use cream, lotion, oil, cortisone, butter, or egg white.
  • If needed, protect the burn from rubbing and pressure with a sterile non-stick gauze (petrolatum or Adaptic-type) lightly taped or wrapped over it. DO NOT use a dressing that can shed fibers, because they can get caught in the burn. Change the dressing once a day
  • For pain, take an over-the-counter pain medicine. These include acetaminophen (such as Tylenol), ibuprofen (such as Advil or Motrin), naproxen (such as Aleve), and aspirin. Follow the directions on the bottle. DO NOT give aspirin to children under 2, or anyone 18 or younger who has or is recovering from chickenpox or flu symptoms.
Also from WebMD and Mayo Clinic

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Your manual is doing well despite its old age, but:

Do not use ice to cool a burn. Ice can cause frostbite very quickly when used on a burn because the skin is already damaged.

Don’t apply burn ointments. Like butter (or mayonnaise), these ointments, usually oil-based, won’t relieve pain but instead will trap heat, slow down healing, and increase the risk of infection.

  • Creams, etc, are not listed at all in current first-aid guidelines as they only appear at a later stage in the process, should doctors determine it can be useful. So your guidelines are not wrong on that standpoint as they instruct not using such products.

What the current guidelines state: The first thing to do is to stop this internal reaction using flowing water.

According to official guidelines for general public in France (section 1.1.2), and sticking to thermal burns here (not chemical nor electrical), you should:

  1. Quickly water the burn

    • Act right after the burn if safely possible. (You are not supposed to put yourself in danger to save someone: this is the best way to end up with two victims instead of one)
    • Put the burn under flowing water. The temperature should be balanced (15~25°C is fine). The tap is fine to to that, just keep in mind to keep the water pressure low enough not to press the burn.
    • While watering, remove the clothes of the victim unless they adhere to the burn (should they adhere, don't pull on clothes).
  2. Evaluate the burn

    • No blister or blister smaller that 1/2 of the victim's palm ; far from natural orifices ; not on the neck, face or joints ; just red, not black and white: this is a minor burn
    • Any burn that does not match the criteria above, or any large red area on a children, is a major burn
  3. Should it be a minor burn

    • Keep on watering as long as the burn hurts and the victim doesn't feel cold. Not just a couple of seconds: 5 or 10 minutes is not surprising, it's actually fine. Watering is what prevents (more) blisters from appearing later on.
    • Depending on the pain, aspect and victim's age: watch over the burn or ask a doctor or a physician.
    • Don't pierce blisters should there be any. Cover them with a sterile plaster.
    • Should blisters, fever, heat, pain, etc, appear later on, ask for medical advice.
  4. Should it be a major burn

    • Call the medical emergency services, and, without hurrying (very important! Being calm is gaining time.)
      • Tell your name, phone number, current location,
      • Tell this is for a burn, and tell the victim's gender and age
      • Describe the result of the evaluation you made.
      • They will guide you in accordance to the protocols applicable in your country. This guidance will certainly include watering, covering the victim if he/she feels cold...)
      • Do NOT hang up the phone before they tell you to do so
    • Keep on watering as instructed by the medical assistance.
    • Make the victim to lie down in a way he/she cannot fall (floor, bed...). Sitting down is OK the victim has difficulties to breathe. The victim should NOT sit on a chair but on the ground to prevent him/her from falling.
    • Protect the victim with a clean linen. The burnt body parts should remain visible.
    • Watch over the victim until the arrival of the ambulance.

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