Cooling the burn wound is a very effective way of decreasing pain, and can minimize the extent of damage (depth of burn) caused by the injury. Evidence regarding the necessary duration of cooling is unclear (17). Consensus recommendations are:
- Cool the burn with clean running water for up to 20 minutes
- Prolonged cooling of large burn injuries can cause hypothermia
- Duration of cooling should be considered in:
- Large burn injuries (> 10%TBSA burns)
- Burns in children or the elderly
- Prolonged cooling of deep burns is unlikely to be helpful
- 20 minutes of cool running water is most beneficial for minor partial thickness burns where the risk of hypothermia is minimal.
- Cooling the burn surface may be useful for up to 3 hours post injury (4).
COOL THE BURN. WARM THE PATIENT.
During and after burn wound cooling the patient must be kept warm.
There is a greater risk of hypothermia with increasing % TBSA burn (19) and in the extremes of age.
Immerse in water or use wet towels if there is no access to running water (4).
Do not use ice or iced water on burns. The extreme cold causes constriction of the blood vessels and can worsen injury by reducing blood supply (4).
Do not use butter, ointments, oil, salves or creams acutely as they may retain heat and worsen injury (18).