Contributor: Aaron Lessen, MD

Educational Pearls:

Burns range in complexity from minor first-degree burns to more severe full-thickness burns.
Initial basic burn management:
- Run the burn under cool running water for 20 minutes.
- Do not scrub the skin.
- Do not use ice water.
- Ideally initiated as soon as possible, but no later than 3 hours after injury.
- Applicable to all burns ranging from superficial to full thickness.
Then apply a non-adherent dressing or sterile gauze.
Can be done at home or upon presentation to the emergency department.
These steps decrease pain and minimize tissue damage.
A study published in Annals of Emergency Medicine found that, out of 371 EMS and emergency medicine providers,
- 90% had not heard of the recommendation to run burns under cool water for 20 minutes.
- The majority of providers interviewed expressed motivation to implement this burn cooling practice but cited barriers such as:
  - Difficulty immersing certain body parts (e.g., chest).
  - Critically ill patients requiring other urgent interventions.

References:

Holbert MD, Singer Y, Palmieri T, et al. Cool Running Water as a First Aid Treatment for Burn Injuries. Annals of Emergency Medicine. 2025;S0196-0644(25)01138-2. doi:10.1016/j.annemergmed.2025.08.003.
Olawoye OA, Isamah CP, Ademola SA, et al. Effect of Prehospital Topical Application of Water and Other Agents on Outcome in Burn Injured Patients: A Prospective Study. Burns. 2025;51(2):107357. doi:10.1016/j.burns.2024.107357.

Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4

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Podcast 1000: Cool Water

Emergency Medical Minute