Understanding Burns and Skin Injuries: A Comprehensive Guide to First Aid and Treatment



  • Tough, elastic sheath covering the body
  • Protection against microbes
  • Protection against shocks and temperature variations
  • Sensation of cold, heat, pain, etc.
  • Waste disposal (toxic substances)
  • Regulation of body temperature


Burns are injuries that affect the integrity of the skin and other tissues caused by exposure of any body part to a much higher energy level than the body can absorb without damage.

Burn Classification

By Depth

  • First-degree burns: Affect only the outer layer of the skin and cause pain, redness, and inflammation.
  • Second-degree burns: (Partial thickness) Affect the outer layer and the underlying layer of skin, producing pain, redness, swelling, and blisters.
  • Third-degree burns: (Full thickness) Deeper burns extending to tissues, producing a whitish or dark, charred skin discoloration that may be numb.

By Extension

  • Mild: The burned area is less than 10%, and its depth does not exceed the 2nd degree.
  • Moderate: Between 10% and 30%, regardless of whether the depth is 2nd or 3rd degree.
  • Severe: Between 30% and 50%.
  • Almost always fatal: Exceeding 50%.

The chance of survival in a burn is directly related to the breadth and depth of the burn.

Rule of Nines

The adult body surface is divided into 11 areas, each part representing 9% or a multiple of 9:

  • Head and neck: 9%
  • Trunk: Front (chest and abdomen), 9×2 (18%); Rear (back), 9×2 (18%)
  • Arms (including hands): 9% each
  • Legs (including feet and buttock): Each 9×2 (18%, 9% front and 9% back)
  • Genital and perianal area: 1%

By Affected Area

Burns are considered severe, regardless of their extension, when they are deep burns that affect the hands, feet, face, eyes, and genitals, and all 2nd and 3rd-degree burns in children, the elderly, and accident victims with significant pre-existing conditions.

By Subject Characteristics

Factors that may modify the severity of burns:

  • Age
  • Fitness
  • Previous diseases (diabetes, heart patients, etc.)

First-Degree Burns

First-degree burns affect only the epidermis, or outer layer of skin. The burn site is painful, has no blisters, and has a red and dry appearance. An example would be a mild sunburn. Permanent tissue damage is not common, and usually, after the injury, skin color variation occurs.


  • Mild sunburn
  • Flash burns – caused by exposure to brief, sudden, and intense heat


  • Redness
  • Dry skin
  • Pain from touching the skin (usually lasts between 48 and 72 hours and then decreases)
  • Peeling skin

Second-Degree Burns

Second-degree burns affect the epidermis and part of the dermis. The burn site is blistered and reddened, may be swollen, and painful.


  • Scalding
  • Flame injuries
  • Brief skin contact with a hot object


  • Blisters
  • Intense redness
  • The affected area appears wet and shiny
  • Pain from touching the skin
  • The burn may have white or discolored spots

Third-Degree Burns

Third-degree burns are also known as full-thickness burns. This type of burn destroys the outer layer of skin (epidermis) and the entire layer beneath (dermis).


  • Scalding liquid
  • Skin contact with a hot object for an extended period
  • Flames of fire
  • Contact with electricity
  • Contact with a chemical


  • Dry and leathery skin
  • The color of the skin may be white, brown, or yellow
  • No swelling
  • No pain due to the destruction of the nerve endings

Treatment for Minor Burns

  1. Soak the affected area with plenty of fresh water for 10 minutes to stop the burn and relieve pain.
  2. Remove rings, bracelets, and watches due to possible subsequent edema with circulatory compromise. Preserve these objects as they retain heat.
  3. Cover the burn. Protect it with clean sheets and, if possible, sterile towels.
  4. Elevate the affected limb to reduce edema.

Treatment for Severe Burns

  1. Assist the casualty to lie down. Avoid contact of the burned area with the ground.
  2. Soak the affected area with plenty of fresh water for 10 minutes to stop the burn and relieve pain. Do not delay transfer to the hospital for cooling.
  3. Follow up once pain is relieved.
  4. Remove rings, bracelets, and watches due to possible subsequent edema with circulatory compromise. Remove burned clothing, but not if it is attached to the wound.
  5. Cover burns. Protect them with clean sheets and sterile pads if possible.

Treatment for Airway Burns


  • Soot around the mouth and nose
  • Singed nose hairs
  • Redness, swelling, and itching of the tongue
  • Skin lesions around the mouth
  • Breathing difficulties


  1. Call emergency services.
  2. Make every effort to improve the victim’s ventilation.
  3. Give ice-cold water to sip.
  4. Reassure the victim.
  5. Maintain an unobstructed airway.
  6. Urgent transfer to the hospital.

Chemical Burns

These are produced by contact with a strong acid or base, commonly used in cleaning products, industrial processes, and laboratories.


  • Intense, stabbing pain
  • After some time of exposure to the chemical, discoloration, blistering, skin peeling, and swelling of the affected area may occur.


  • Secure the area against the chemical.
  • Remove the harmful chemical.
  • Transfer to the hospital.

If in Eyes

  • Flush with water for at least 20 minutes.
  • Cover both eyes.
  • Urgent transfer to a specialized center.

General Treatment for Chemical Burns

  • The rescuer must be protected while providing care and avoid contact with the chemical (gloves, safety glasses).
  • Wash the affected area with cool water for 20-30 minutes to eliminate harmful substances. Use a water jet.
  • Remove clothing soaked with the chemical.
  • Remove contact lenses, watches, rings, and bracelets for possible decontamination.
  • Remove shoes and socks due to the possibility of poison introduction.
  • Cover with sterile gauze or clean cloths.
  • Do not try to neutralize the chemical with other toxic chemicals.
  • Assess the level of consciousness and breathing. Apply basic life support if necessary.
  • Transfer the patient to a health center.


Not to be confused with hypothermia, which is a decreased body temperature due to prolonged exposure to cold. When a person is frozen due to excessive exposure to cold, they have the following symptoms: numbness, chills (defense mechanism to produce heat), staggering, lightheadedness or semiconsciousness, drowsiness, and loss of vision.

Moments before declaring a freeze, the victim’s skin may look normal, but as the freezing progresses, the skin becomes white or yellowish-gray, there is numbness, tingling, and excessive sleepiness.


General Measures

  • Cover the area with blankets or warm clothes.
  • Implement emergency care in case of injuries.
  • If the individual is conscious, give them hot drinks but not overly sugary beverages: tea, coffee, soup, etc.
  • Encourage exercise when warmed. DO NOT rub the affected area. This increases tissue damage due to sharp vasodilation.

If the Freeze is Widespread

  • Place the victim in a room and gradually increase the temperature at a rate of 2 degrees per hour.
  • Or, dip the victim in warm water (23 to 27 degrees Celsius), slowly increasing the temperature by 4 degrees per hour. DO NOT perform local friction (not even with snow). The frozen areas become fragile and can break.

Electrical Burns

These occur when an electrical current flows through the body, causing internal injuries and visible wounds.


  • Ensure that the victim is no longer connected to the power source.
  • Soak the entry and exit wound zones with cool water.
  • Apply a sterile dressing or clean cloth (triangular bandage) over the wound.


Any break in the skin, secondary to trauma. As a result of the aggression of this tissue, there is a likelihood of infection and the possibility of injury to adjacent organs or tissues: muscles, nerves, blood vessels, etc. Wounds can be serious in terms of one or more of these characteristics: depth, extension, location, obvious dirt, foreign bodies, or signs of infection.

First Aid for Minor Injuries

  • Stop the bleeding (if any).
  • Disinfect the wound.
  • Disinfect the rescuer’s hands.
  • Clean the wound with peroxide or soap and water, from the center outwards.
  • If the wound is deep, use saline for cleaning.
  • If there is significant separation of the edges, a healthcare professional may need to suture the wound. If not, brush with antiseptic and allow it to air dry.
  • Recommend immunization against tetanus.
  • DO NOT USE directly on the wound: alcohol, cotton

First Aid in Case of Serious Injury

  • Perform an initial assessment of the victim.
  • Control bleeding and prevent the onset of shock. Improve cerebral blood flow: Place the victim in a supine position with lower limbs elevated (taking care if there is a possible fracture), loosen clothing around the neck and chest, and keep the person warm with blankets and clothing.
  • Cover the wound with a sterile dressing and seek transfer to the hospital, checking vital signs.
  • Do not let the person eat or drink. In case of thirst, moisten the lips.
  • DO NOT neglect the person or try to warm them with direct heat, as it increases the risk of complications.