
About this episode
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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Emergency Medical Minute — Podcast 1000: Cool Water. Machine-transcribed; use the interactive transcript above to jump the player to any line.
This is the emergency medical minute sponsored by CarePoint and HCA Health One. All right. Well, good morning, everybody. So, just kind of a quick little medical minute about some very basic burn care and then a interesting study about how well people know about this part of burn care or not. So, you know, we talk about burns. Sometimes it's a major kind of burn activation and pretty sick critical patients, potential critical care and surgical management, but there's some pretty simple things. And one of the basic first aid care of burn management, then they can be done at home. It can be done here is a recommendation that pretty much all burns, even full thickness burns, should be run under cool running water for 20 minutes, not ice cold water. It doesn't need to be scrub, just kind of run under cool running water, and then simply put some non adherent dressing and some gauze on it. The cool running water people can do at home a lot of times they don't, and it's something that if they haven't had done, and it's been about less than three hours
since the burn has happened, it can be really significant for decreasing pain, decreasing ongoing tissue damage, and something we can do here when patients come in. So, that's kind of a basic burn recommendation that should be done. And there was an interesting study that asked almost like 400 EMS and emergency medicine providers of whether they even knew about this recommendation and whether they did it. And interestingly, almost 90% of the providers did not know that this was a recommendation even though it's kind of like a basic first management of burns. Most of them said that if they did know about it, they would do it. Obviously, sometimes there's barriers like you can't put someone's whole chest under cool running water or someone's really sick, otherwise there's other priorities. But in general, for most burns, whether it's one of us at home or someone that comes in here, it's a good basic thing to do and good awareness. So, any questions or comments? Did you say, sorry, I didn't hear the first one. Do you see what thickness? Oh. Yeah, even full thickness and simple minor ones that can be helpful for all of them. Three hours.
Up to three hours. Yeah, I mean, if someone's still having pain, it's not going to be harmful, but it's probably most helpful in those first three hours. But it's not like if someone walks in and they say, I burnt myself two hours ago, we can say, nothing we can do. It can still be helpful. All right, thanks, everybody. This has been The Emergency Medical Minute. Thank you to our sponsor's CarePoint and HCA Health One. Support from them and listeners like you helps us to continue providing free medical education to the masses. If you found this episode valuable, consider supporting our work and check out the link in our show notes.
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