Going to an Emergency Room for Severe Burn Treatment

About 500,000 people are treated for burn injuries every year, with many of those being severe enough to require immediate medical attention. But how do you know when a burn needs medical, and even emergency, care?

We’re here to explain the different types of burns — not all are caused by hot liquid — and when you should go to your nearest AdventHealth emergency room for severe burn treatment. The more you know about burns, the better prepared you’ll be to get care quickly for yourself or a loved one.

When Should You Go to the Emergency Room for Burns?

In most cases, the types of burns that are the most severe are third-degree burns. These burns are also called full-thickness burns because the burn impacts all layers of the skin in one area and can also destroy nerve endings.

Other signs of a severe burn that require immediate medical attention in an emergency room include:

• Confusion
• Dizziness
• Dry or leathery skin in the burn area
• Skin in the burn area looks white or black
• Large surface area (larger than 3 inches in diameter on an adult or 2 to 3 inches on children)
• Located in any area of the face, including the mouth, nose or eyes, as well as genitals, buttocks, hands, feet or major joints like elbows and knees
• Loss of sensation
• Respiratory problems or smoke inhalation
• Severe pain
• Shock
• Signs of infection
• Swelling

Any burns from electricity or chemicals, including from household cleaning products, should always be treated as an emergency, as they may have different needs than other types of burns.

Types of Burns to Know

Burns are normally classified into one of three classes or degrees: first, second and third, from least to most severe.

First-Degree Burns

First-degree burns are also called superficial burns as they only impact the top layer of skin, called the epidermis. In most cases, they’ll heal completely in a week to 10 days.

Some common examples of first-degree minor burns are:

• Mild electrical shock from an outlet
• Skin rubbing against another surface for too long, known as a friction burn
• Spilling a small amount of hot liquid on the skin
• Sunburn
• Touching a hot object, such as the stove or an iron

Because they’re superficial, the symptoms of first-degree burns are generally mild and may include:

• Dry to the touch
• Flaky or peeling skin as it heals
• No permanent scarring
• Redness
• Slight pain that can be managed with over-the-counter medications

Second-Degree Burns

Second-degree burns are more serious than first-degree burns. They affect the outermost layer of the skin and the one below it, called the dermis. For this reason, second-degree burns take a bit longer to heal, usually a few weeks. Depending on its size and severity, a second-degree burn can sometimes be an emergency.

Examples of how you might get a second-degree burn include:

• Burn caused by an open flame, also known as a thermal burn
• Chemical burns from acid or another corrosive chemical
• Electrical burns from an electric current
• Intense friction burn
• Scalding your hand by accidentally pouring boiling water on it
• Serious burns from touching a hot stove or other appliance
• Severe sunburn from UV exposure or a tanning bed

As second-degree burns are partial-thickness burns, their symptoms will be a bit more severe, such as:

• Blisters
• Burned skin may look wet or discolored
• Confusion
• Extreme sensitivity
• Fever
• Nausea or vomiting
• Redness
• Severe pain
• Swelling
• Warm to the touch

Third-Degree Burns

Third-degree burns are the most severe burns and should always be treated as an emergency. This is because they can impact all layers of your skin, as well as the bone and muscle underneath. In many cases, a third-degree burn may require a skin graft, where a piece of healthy skin from another area of your body is surgically placed where the burn is. Depending on the burn severity, these deep burns can take a few months to even a few years to heal completely.

Some examples of third-degree burns are:

• Burns from a fire
• Extended exposure to chemicals
• Extreme sunburn
• Intense exposure to electricity, such as an electrical wire or a lightning strike
• Spilling burning water on yourself
• Touching an extremely hot object for an extended period of time
• Touching dry ice or something extremely cold without wearing gloves

Third-degree burn symptoms may include:

• Breathing issues
• The burn area looks dry or leathery
• Discolored skin that may look black or white
• No pain or sensation in the burn area due to nerve damage
• Shock
• Swelling

If you think that you or someone else might have a third-degree burn, always go to your nearest ER.

What Happens During Burn Treatment in the ER?

If you have a severe burn, it's important to either call 911 or get yourself or a loved one to the nearest emergency room. The first thing our paramedics or ER teams will do is stabilize you and take some immediate actions, such as:

• Addressing any airway or inhalation issues, such as a hoarse voice or signs of smoke inhalation
• Beginning intravenous fluids
• Cooling down the burn as quickly as possible
• Offering pain management for your burn as necessary
• Removing any items touching or near the burn wound, such as clothing or jewelry
• Stopping the burn (for example, if your burn is from chemicals, they will remove any remaining chemicals from your burn area as quickly as possible)

Once in the emergency department, your doctors will assess how severe your burn is, which will inform your treatment. This may include:

• Cleaning the wound with a disinfectant
• Debridement of the burn to remove any dead skin or other materials to ward off infection
• Dressing the wound with healing ointments and sterile bandages
• Monitoring of your condition by doctors and nurses during your stay in the ER

If your care team deems it necessary, they may guide your transfer to a burn center or burn unit if you need a skin graft or more extensive treatment for a severe burn.

How to Care for Burns Before Arriving at the ER

If you or a loved one has a major burn, there are a few steps you can take before you get to the hospital that can help in your treatment. These include:

• Cooling the burn down by running cool — never cold — water over the affected area for five to 10 minutes
• Elevating the burned area above the heart, if possible
• Gently and loosely covering the burn with a sterile bandage or clean cloth
• Getting yourself or a loved one away from the burn source
• Removing anything in the way of the burn, such as clothing or jewelry (do not try to remove anything that is stuck to the burned area)
• Taking an over-the-counter pain medication as needed

A few things you should never do with a severe burn are:

• Breaking any blisters that form
• Trying to remove anything stuck to the burn, such as clothing
• Using cold running water or ice for the burn
• Using home remedies like butter or oils on the burn

Plus, if you suspect someone with a severe burn has inhalation issues, don't give them anything to swallow or take by mouth.

Debunking Common Myths About Burn Treatment

There are several common misconceptions when it comes to the treatment of burns. Following any of these myths might make the burn worse and increase the risk of infection, especially if it’s a very serious burn. Let’s debunk some of the most common burn treatment misunderstandings.

Myth: I should always apply very cold water or ice directly to a burn.

Fact: You should be applying cool water, as water that is too cold can cause the burn to freeze or cause further skin damage.

Myth: If my burn develops blisters, I should pop them.

Fact: Popping blisters can lead to infection. Even though they’re uncomfortable, leave the blisters alone so they can heal on their own.

Myth: It’s OK to put lotion, butter or other cooking oils on a burn.

Fact: Applying any of these substances to a burn can trap in heat, making it worse.

Myth: I should apply a disinfectant like rubbing alcohol or vinegar to a burn.

Fact: These substances can be way too harsh on your burned skin and can make your injury worse.

Myth: I should let my burn breathe and not place a bandage on it so it heals faster.

Fact: The opposite is true. Keeping a sterile bandage with healing ointments on your burn helps it heal faster and stops it from drying out.

Your Trusted Team for Severe Burn Care

You can’t predict when you’ll need severe burn treatment, but you can rest assured that our medical care will always be ready for you, anytime you need it.

Our emergency rooms are here to provide you with the compassionate and effective burn care you need when dealing with a serious burn. Find your nearest AdventHealth ER today to know where to go at a moment’s notice.