Nurse Knowledge: Dealing with Burns

This past week I made the mistake of leaving an open travel mug out in reach of my daughter Eva. The tea inside was very hot, but the mug itself was cold. She grabbed it to take a drink and boiling hot tea poured down her chin and chest. While I was sitting beside her, I didn’t notice her grab it and only heard her screams as she felt the boiling hot water pour on her. I’m so lucky Jarrett was on the other side of her, because he leaped into action. He took off her shirt while I was still looking to see who was screaming. He put cold water on the wound and then put a new shirt on her that covered the burn to make sure she couldn’t touch it. Then he took her to the hospital. As we were about 45 minutes from the hospital at the time, he gave her some tylenol to help her with the pain. She only ended up with first degree burns, and she wasn’t bothered by them at all, which was, in my eyes, a miracle.

I can’t be more thankful that Jarrett was there to take care of Eva while I sat in shock, trying to deal with the guilt of what I had just accidentally done to my daughter. I can’t describe the amount of guilt that I have felt this past week looking at her burns. I know that accidents happen, and I am starting to forgive myself as she begins to heal. It isn’t easy though and I will never forget the pain I put her through. Lesson. Learned.

So, what do you do when your child gets burned? It depends on the kind of burn, but I’ll go through the different kinds and degrees of burns. My husband, who is a RN, helped me with this article and made sure the information is accurate. These are general guidelines, but as many injuries can be different, it is always a good idea to call health link (811)  or 911 if you are unsure.

Degrees of Burns

It’s always a good idea to be able to distinguish the different kinds of burns so that you know how to react to a burn. There are three different degrees of burns.

First Degree

This is the least severe of the degrees of burns but it is the second most painful. First degree burns are also called superficial burns. This means that only the epidermis or the top layer of skin has been burned. This can be very minor from a slight sunburn to a bit more painful like a scalding burn. It is common misconception that only second degree burns make a blister. First degree burns can make small blisters or you may also see a small layer of skin slough off. Usually a first degree burn can be seen as reddened skin. This skin may blister or scab over if they are bad enough first degree burns.

Second Degree

This is the most painful burn that you can have. Second degree burns are also called partial thickness burns. This is when the burn goes down into the second layer of skin called the dermis. The dermis is where most nerves are, which is why it is the most painful because you fray and damage nerves and leave them exposed. Almost all second degree burns blister over with large fluid filled blisters. These blisters usually have red skin around them (first degree burns)

Third Degree

This is the worst type of burn that you can get. Third degree burns are also called full thickness burns. This is when a burn reaches past the dermis layer of the skin and can burn down to the Subcutaneous layer (fatty layer) or even down to bone. Third degree burns actually have no pain as the nerves have been completely burned away. The second degree burns around the third degree burns are where all the pain comes from with this type of burn.

Types of Thermal Burns

While there are different ways you can burn yourself, it is possible to get all three degrees with thermal burns. We’re focusing on thermal burns.

Direct Heat

This burn occurs when you touch something hot, like the oven, an iron, or a hair straightener.

What to Do

Remove the child (or yourself) from the heat source.


Fluid burns can include water, oil, tar or anything else that comes in a liquid form.

What to Do

The first thing you must do is remove any clothing that has the hot liquid on it. Cut around any melted clothing. You should immediately pour cold water over the wound because liquids (especially oils) can continue to burn the skin until it is cooled down and washed off.


If you are being burned by fire, the first thing you must do is put it out.

What to Do

Stop drop and roll if your entire body is on fire. If it is a child, throw a blanket on them and smother the fire. The goal is to cut off oxygen to the flame. Water works on certain fires, but not on oil fires, so be careful if you decide to use water. Don’t run. Remove clothing from the skin, but cut around any melted clothing once the fire is out.

Dealing with the Wound

After any burn you should pour cold tap water (not ice water) over the wound and try to remove any substance that may still be burning the wound by wiping it away with a clean cloth if the skin isn’t broken, or dabbing with a cloth if the skin is broken.

First degree burns can generally be treated at home with supportive measures. i.e. Pain medication and soothing lotions and ointments (aloe vera). If the skin is broken open do not put any lotions or creams on it. If it is a first degree burn that is open, polysporin and a bandage is generally all you need for the wound.

Second Degree burns should be seen by a doctor. If your hands, face, or any joints have a second degree burn, you should go to the emergency department as the burn has to heal properly or you may have deficits in the future. If you have a large area of your body (generally anything bigger then 2 inches square), you should also go the nearest emergency department. Anything outside those parameters should be seen by at least your family doctor as you may require medicated ointments or prescribed pain medication.

Third degree burns are an emergency and all need to be seen in an emergency department. If you or someone else gets a third degree burn you should call 911 right away.

When in doubt, you can always call Health Link (811) and ask. This article only covers thermal burns, but there are many other burns that you can get. For more information, you can check out Health Link BC’s website.

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