This leaflet is created from first aid advice provided by St John Ambulance, the nation's leading first aid charity. This advice is no substitute for first aid training - find a training course near you.
Burns and scalds
Severe burns and scalds
- Start cooling the burn or scald immediately under running water for at least 10 minutes.
- Dial 999/112/911 for an ambulance.
- Make the person as comfortable as possible; lay them down.
- Continue to pour copious amounts of cold water over the burn or scald for at least 10 minutes or until the pain is relieved.
- Whilst wearing disposable gloves, remove jewellery, watch or clothing from the affected area - unless it is sticking to the skin.
- Cover the burn or scald with clean, non-fluffy material to protect from infection. Cloth, a clean plastic bag or kitchen film all make good dressings.
- Treat for shock.
- Hold the affected area under cold water for at least 10 minutes or until the pain subsides.
- Remove jewellery, etc and cover the burn or scald as detailed above.
If a minor burn or scald is larger than a postage stamp it requires medical attention. All deep burns or scalds of any size require urgent hospital treatment.
Clothing on fire
- Stop the person panicking or running - any movement or breeze will fan the flames.
- Drop the person to the ground.
- If possible, wrap the person tightly in a coat, curtain or blanket (not the nylon or cellular type), rug or other heavy-duty fabric. The best fabric is wool.
- Roll the person along the ground until the flames have been smothered.
- Do not use lotions, ointments and creams.
- Do not use adhesive dressings.
- Do not break blisters.
Prickly heat is a highly irritating prickly red rash, hence the name, and it most commonly occurs in hot weather.
It is caused by bacteria or dead skin cells blocking sweat glands. The rash particularly affects areas where sweat is trapped and cannot evaporate, such as the feet for instance. People who often have prickly heat also tend to be susceptible to heatstroke.
You can recognise prickly heat by a prickling or burning sensation over the effected area; there will also be a rash of tiny red spots or blisters.
Your main aim is to relieve any discomfort and pain, so you should encourage the person to stay in cool conditions as much as possible, and cool the skin by gently sponging with cold water.
Sunburn can be caused by overexposure to the sun or even a sunlamp. At high altitudes sunburn can occur even on an overcast summer day. Some medicines can trigger severe sensitivity to sunlight and, rarely, it can be caused by exposure to radioactivity.
Most sunburn is superficial. In severe cases, the skin is a lobster red in colour and blistered - the person may also be suffering from heatstroke.
- Reddened skin.
- Pain in the area of the burn.
- Later there may be blistering to the affected skin.
Your aims when dealing with somebody with sunburn are to move the person out of the sun or away from the source of the sunburn and to relieve any discomfort and pain.
Caution though: if there is extensive blistering or any other skin damage you need to seek medical advice.
- With minor sunburn cover the person's skin with light clothing or a towel.
- Move them into the shade or preferably indoors.
- Cool the skin by sponging it with cool water or by soaking the affected area in a cold bath or a cool shower for 10 minutes.
- Encourage the person to have frequent sips of cold water.
- If the burns are mild, calamine lotion or an after-sun preparation may soothe them.
- For severe sunburn obtain medical aid.
Heatstroke is caused by a failure in the thermostat in the brain. This regulates body temperature. The body then becomes dangerously overheated usually due to a high fever or prolonged exposure to heat.
Heatstroke can also result form the use of drugs such as ecstasy.
In some cases heatstroke follows heat exhaustion, when sweating ceases and the body then cannot be cooled by the evaporation of sweat. Heatstroke can develop with very little warning, causing unconsciousness within minutes of the person feeling unwell.
- Dizziness and discomfort.
- Restlessness and confusion.
- Hot, flushed and dry skin.
- A rapid deterioration in the level of response.
- A full bounding pulse.
- A body temperature above 40°C (104°F).
Your aims are to lower the person's body temperature as quickly as possible and arrange urgent removal to hospital.
- You need to quickly move the person to a cool place and remove as much of the outer clothing as possible.
- Dial 999/112/911 for an ambulance.
- Wrap the person in a cold wet sheet and keep the sheet wet until the temperature falls to 38°C (100.4°F), under the tongue or under the armpit.
- If no sheet is available, fan the person or sponge them down with cold water. Once the person's temperature appears to have returned to normal replace the wet sheet with a dry one.
- Always monitor and record the vital signs, the level of response, pulse and breathing rate until help arrives.
- If the temperature starts to rise again repeat the cooling process.
- Caution though: if the person becomes unconscious open the airway and check breathing and be prepared to give rescue breaths and chest compressions if necessary, or if the person is unconscious but breathing normally place them into the recovery position. Please refer to the relevant tips.
Heat exhaustion is caused by a loss of salt and water from the body, usually through excessive sweating.
It develops gradually and it usually happens to people who are not acclimatised to hot humid conditions or to people who are unwell, especially those with illnesses that cause vomiting and diarrhoea. They are more susceptible than others to developing heat exhaustion.
A dangerous and common cause of heat exhaustion is the excessively high body temperature and other physical changes that result from certain drugs taken for pleasure, such as ecstasy. The user sweats profusely, due to prolonged overactivity, then dehydration develops leading to heat exhaustion. These effects coupled with the drug's effect on the temperature regulating centre of the brain can lead to heatstroke and even cause death.
- Dizziness and confusion.
- Loss of appetite.
- Sweating with pale clammy skin.
- Cramps in the arms, legs and the abdominal wall.
- Rapid, weakening pulse.
- Rapid, shallow breathing.
Your aims are to replace any lost body fluids and salt; to cool the person down, if necessary, and to obtain medical help.
- Help the person to a cool place.
- Get them to lie down with their legs raised.
- Give them plenty of water.
- Follow if possible with a weak salt solution - one teaspoon of salt per litre of water; assist the person to drink it.
- Even if the person recovers quickly, ensure that they see a doctor.
- If the person's responses deteriorate, place them into the recovery position and dial 999/112/911 for an ambulance.
- Monitor and record any vital signs - the level of response, the pulse and breathing rate.
- Be prepared to give rescue breaths and chest compressions if necessary.
Note: these hints are no substitute for thorough knowledge of first aid. St John Ambulance holds first aid courses throughout the country.
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St John Ambulance