First aid for self-harm resource: burns

This resource contains information which may be useful for performing care or advocacy work, or describes overall policy and principles.

This resource is a draft - it is undergoing review to fact check and improve it prior to adoption. It should only be used if you cannot find other options, and you should err on the side of caution while using it.

This document needs review by medical professionals before it is adopted. If you are a medical professional, please use this form to provide feedback

More documents in need of medical review can be found here.

This is a resource for people who are self-harming, or people who are supporting someone who self-harms. It covers some basic first aid tips for treating burns caused by self-harm. See the other first aid for self-harm resource pages for information about other kinds of injury.

You may also want to see our 'Safer self-harm resource' for information about how to reduce the risk of serious injury.

These guides set out some signs that there may be a life-threatening risk, requiring an ambulance. They also cover signs that the injury may not heal without long-term damage unless you go to A & E or seek other medical treatment. You can still call an ambulance in these situations if you don’t feel well enough to travel to hospital.

We recognise that many people may be concerned about the potential consequences of going to hospital after self-harming. This resource is intended to help you judge when the risks of not getting medical help may outweigh the risks of doing so.

If you are supporting another person to treat their injuries, it’s also important to remember the risks of disease transmission, and wear gloves while handling any bodily fluids.

This is not a substitute for first aid training and does not qualify anyone to describe themself as a ‘first aider’.

Burns

How to treat

Cool the burn with water, remove any tight jewellery or clothing, leave blisters intact, and dress with clingfilm or a specialist burn dressing. Chemical burns require special treatment.

1. Cooling
   • To reduce the damage, hold the burned area under cold running water for at least 10 minutes.
   • Don’t use ice, as this may stick to the skin and cause further damage.
2. Removing constricting items
   • If you have burned a large area, remove any jewellery (e.g. rings) or tight clothing from the limb, in case it swells.
   • Don’t pull away any clothing stuck to the burn itself - this will need to be removed in hospital.
3. Blisters
   • Try not to pop or damage blisters, as this will increase the infection risk.
   • If you can’t avoid damaging a blister, rinse the burn under running water again to clean it before dressing,. If you can't manage this, use an alcohol-free saline wipe
4. Dressing
   • Don’t use standard plasters, as they may stick to the burn. If you don’t have a specialist burn dressing, you can dress it with clingfilm.
     • Unroll and discard a couple of rounds before cutting your piece, to make sure that it’s clean.
     • Cut a square to cover the burn and tape it at the edges. Don’t wrap it all the way around the limb - this might affect your circulation if the burned area swells up.
   • Alternatively, you can dress the burn with a clean, unused plastic bag.
5. Aftercare
   • Large burns which break the skin can be a high infection risk, so it's a good idea to clean them every time you change the dressing.
   • Don't scrub the injury, as this may interfere with healing - just gently rinse.
   • You can use tap water, bottled water, or a saline solution.

Chemical burns

Chemical burns are particularly risky and need special treatment.

• Rinse them under running water for at least 20 minutes, tilting the burned area so that the contaminated water does not drip onto other parts of your body.
• Don’t try to ‘neutralise’ them with another substance - if one chemical reacts with another, this is likely to cause further damage.
• Don’t try to dress them at home: they will need hospital treatment.

Call an ambulance if...

• You have burns on your face or throat which are affecting your ability to breathe.

• You have burned a large area and notice any of the following symptoms
  • You feel weak, dizzy, sick or confused.
  • Your skin feels cold, but clammy and sweaty.
  • Your skin looks paler than usual (lighter skin) or has a greyish tone (darker skin).
  • This is called ‘shock’, and indicates that there is not enough fluid in your body to allow proper blood circulation. (Though burns don’t bleed red blood, they ooze fluid, which can have the same effect as blood loss.) Call 999 urgently and lie down with your feet propped up on a chair.

Go to A & E/get urgent medical help if...

• The burn was caused by a chemical
  • You might not be able to remove all traces of the chemical, so it may continue to cause damage.

• You have burned yourself with electricity
  • Even if the burn on your skin looks small, the electricity may have damaged your internal tissues and organs.

• The burn is larger than the palm of your hand.
  • Large areas of burn present a high risk of infection.

• Part of the burned area looks either white, brown or charred black. (This may be surrounded by a larger area of less severe burn).
  • This means you have burned through all the layers of skin - it’s unlikely to heal without specialist treatment and may need a skin graft.

• The burn goes all the way around your arm, leg, finger or toe.
  • If the burn swells, it could affect the blood circulation to the limb.

• The burn is on a hand, foot or joint (e.g. an elbow)
  • If left to heal on its own, the burnt skin is likely to contract, which may leave you with restricted movement.

Infected wounds

Cuts and burns may both become infected, in which case they will require treatment with antibiotics.

Call an ambulance if...

• The wound looks infected and you start to feel seriously ill in any way, including but not limited to:
  • Feeling feverishly hot or extremely cold
  • Feeling confused or sleepy
  • Shivering or muscle pain
  • Fast breathing or breathlessness

• These are possible signs of sepsis, a rare but life threatening condition when your body responds to infection by attacking its own tissues and organs.

Go to A & E/get urgent medical help, if...

• You see any of the following signs of infection, but aren’t otherwise feeling ill
  • bad smell from the wound
  • skin around the wound feels hot
  • increased pain around the wound
  • increased swelling around the wound
  • on lighter skin, visible redness spreading out from the injured area
  • dark yellow or green pus

If you are using clingfilm or a specialist burn dressing, you will see that the burn does not form a scab underneath the dressing, but remains wet and raw-looking. This may look alarming, but it's a normal part of the healing process when you are using this kind of dressing.

• You might see some clear or pale yellow fluid on the surface of the wound, which will leave a yellow stain on dressings. If it doesn't smell bad, this is not a sign of infection.