Vivid Ready

Twenty minutes of cool running water, and it still helps up to three hours later. Nothing else you can put on a burn does as much, and several traditional remedies actively make it worse.

Burns are one of the commonest injuries in a household running on fire, candles, stoves and boiling water instead of mains services, which is precisely the situation this app is written for. They are also the injury where good first aid makes the largest measurable difference to the eventual outcome.

The one thing that matters

Twenty minutes is much longer than it feels, and people routinely stop at two or three. Time it. This single intervention reduces the depth of the burn, reduces pain, and measurably reduces scarring. Nothing else you can apply comes close.

Cooling works by taking heat out of tissue that is still cooking after the source is removed. That is why it keeps helping for hours: the damage is ongoing, not instantaneous.

The full sequence

Stop the burning. Remove the person from the source, or the source from the person. Smother flames, turn off the heat, move away from the fire.
Remove clothing and jewellery from the area, quickly, before swelling starts. But do not pull off anything stuck to the burn. Cut around it and leave what is adhered.
Cool with running cool water for at least 20 minutes. A tap, a shower, or poured from a jug over a bowl if water is limited. Reuse is acceptable if supply is short; running is better.
Keep the rest of the person warm. This matters more than it sounds, see the warning below.
Cover loosely with cling film, laid on in strips rather than wrapped round. Not on the face. A clean non-fluffy cloth or a clean plastic bag works if you have no film.
Elevate the burned part if you can, which reduces swelling.
Pain relief: paracetamol or ibuprofen at normal doses.
Reassess against the "needs more than you" list below.

Cling film specifics: lay it in overlapping strips rather than wrapping circumferentially, because a wrapped limb that then swells can have its circulation cut off. Discard the first turn off the roll. Do not use it on the face; use a clean damp cloth there instead.

What never goes on a burn

DANGER

Do not use any of these. Several are traditional and all of them cause harm:

Ice or iced water. Causes further tissue damage by freezing injury on top of the burn, and worsens the depth.
Butter, margarine, oil, lard. Traps heat in the tissue, keeps it cooking, and introduces infection.
Toothpaste. Common folk remedy, causes chemical irritation and has to be scrubbed off later.
Egg white, flour, honey on a fresh burn, or any food.
Creams, ointments, antiseptic pastes or anything greasy on a fresh burn. They hold heat in and they have to be removed before the burn can be assessed, which is painful and delays care.
Bursting blisters. The blister is a sterile biological dressing. Leave it.
Fluffy or adhesive dressings directly on the burn. Cotton wool sheds fibres into it.
Adhesive tape on the burned skin itself.

The general principle: water, then a clean loose cover, then nothing. Everything else is either useless or actively obstructive, and the traditional remedies are the worst offenders because they feel like doing something.

Judging depth

Depth	Looks like	Feels like	Heals
Superficial	Red, dry, no blisters. Like sunburn	Painful	3 to 7 days, no scar
Superficial partial thickness	Red, wet, blisters	Very painful	1 to 3 weeks, usually no scar
Deep partial thickness	Blotchy red and white, may blister	Reduced sensation	3+ weeks, scars
Full thickness	White, waxy, leathery, brown or charred	Painless, because the nerves are destroyed	Will not heal alone. Needs surgery

Judging size

Size drives fluid loss and shock risk, which is why it matters as much as depth. A large superficial burn can be more dangerous than a small deep one.

When it needs more than you

DANGER

Get emergency help for any of these. Ring 999 for the serious ones, 111 or a GP for the rest, and in a no-services situation treat these as the threshold at which you should be trying hard to reach someone.

Ring 999:

Burns to the face, neck, hands, feet, genitals, or across any joint, whatever the size. These scar in ways that cost function.
Any burn that is white, leathery, charred or painless, however small.
Burns larger than the palm of the casualty's hand, roughly 1% of body surface.
Any burn to a child under 5, or to an elderly person, beyond the very smallest.
Chemical burns. Irrigate continuously with water for far longer, at least 20 minutes and often much more, and identify the chemical if you safely can.
Electrical burns. Always, even if the skin looks fine, because the damage runs deep along the path of the current and the heart may be affected. Isolate the supply before touching the person.
Any suspicion of inhalation injury: burns around the mouth or nose, singed nasal hair, soot in the mouth, hoarseness, coughing, stridor, or a burn sustained in an enclosed smoky space. The airway can swell shut over hours. This is the burn complication that kills soonest.
Circumferential burns, going all the way round a limb, finger or the chest, because swelling then constricts.

Burns to a joint, the hands or the face are function-critical, not cosmetic. In a household that will need to work, a badly healed hand is a long-term disaster.

Aftercare

Leave blisters intact. If one bursts on its own, leave the loose skin over the wound as a cover.
Redress daily, or when soiled or wet, with a non-adherent dressing. A silicone or paraffin gauze dressing is the right thing to have in the kit; this is a genuinely worthwhile item to stock.
Keep it clean and dry between dressings.
Watch for infection: increasing pain after the first day or two, spreading redness, heat, swelling, pus, smell, or fever. A burn is a large open wound and infection is the main complication once the immediate danger has passed. Read recognising sepsis, because burns are a recognised route into it.
Keep new skin out of the sun for at least a year. It burns very readily and pigments permanently.
Once healed, moisturise and massage the area daily, which genuinely improves the eventual scar.
Push fluids. Burns lose fluid steadily. See oral rehydration in this domain.