Burns and Scalds: First Aid, Which Burns Need a Hospital, and Getting Through Diwali Safely

A sparkler held a second too long. A spark from a cracker landing on a sleeve. A pan of hot oil during the festival cooking, or a pressure cooker opened too soon. The weeks around Diwali are when most families in Delhi deal with a burn.

Most household burns are small and heal well at home with the right first aid. What you do in the first twenty minutes matters more than anything a doctor does afterwards. And a few burns need a hospital, not a clinic, from the start. This page covers all three.

First aid: what to do in the first 20 minutes

1. Move away from the heat. Put out any flames on clothing by getting the person to stop, drop to the ground and roll, or smother the flames with a thick cotton blanket. Do not let them run.

2. Cool the burn under cool running tap water for 20 minutes. Start as soon as you can. Ordinary tap water is right; it should be cool, not icy. If there is no tap, pour cool bottled water over it, or keep re-soaking a clean cloth. Cooling still helps if you start late, up to about three hours after the burn.

3. Take off rings, bangles, watches and clothing near the burn while you cool it, before swelling starts. Leave anything that is stuck to the skin. Pulling it off tears the burn.

4. Keep the rest of the person warm, especially a child. You are cooling the burn, not the person.

5. Cover it loosely. Lay a sheet of kitchen cling wrap over the burn without wrapping it round tightly, or use a clean plastic bag over a burnt hand. A clean, non-fluffy cloth will do if you have nothing else. Do not use cotton wool, which sticks.

A large study of children's burns found that those who had 20 minutes of cool running water within three hours of the injury were less likely to need a skin graft or an admission to hospital. It is the one piece of first aid with real evidence behind it.

What not to put on a burn

Every Delhi household has a remedy for burns. These are the ones that make things worse:

- No ice or iced water. Extreme cold damages skin that is already injured.

- No toothpaste, ghee, butter, oil, turmeric, ink, flour or coffee powder. They trap heat in the skin, make the burn harder to clean, and can introduce infection. A doctor then has to scrub them off a raw wound.

- No creams or ointments in the first hours, unless a doctor has told you to use one.

- Do not burst blisters. The blister is the body's own dressing over new skin.

- No sticky plasters or tight bandages directly on the burn.

How to tell how bad a burn is

Burns are graded by how deep they go, not only by how big they are.

- Surface burns. Red, sore, dry skin with no blisters, like bad sunburn. These usually heal on their own with simple care.

- Blistering burns. Red, very painful, with blisters or wet-looking skin underneath. Small ones should heal within about two weeks with good care, but they need a doctor to check the depth and need watching for infection.

- Deep burns. The skin looks white, grey, waxy, leathery, brown or charred. These can hurt less than a smaller burn, because the nerves in the skin are damaged. Do not be reassured by that. A deep burn of any size needs a hospital.

A useful measure of size is the burnt person's own hand. An area the size of their palm and fingers together is about 1% of their body.

🔴 Go to a hospital emergency department, not a clinic, if

- The burn is larger than the burnt person's own hand

- Any part of the skin is white, grey, leathery or charred, whatever the size

- There are blisters on the face, hands, arms, feet, legs, genitals or over a joint

- It is an electrical burn, however small it looks on the skin. Electricity can damage what is underneath. Switch off the power at the mains before you touch the person

- It is a chemical burn, from acid, bleach, cement or a cleaning product. Brush off any powder, take off soaked clothing, and rinse with running water for much longer, while someone arranges transport

- They were in a smoke-filled room, or have a hoarse voice, a cough, trouble breathing, or soot around the nose and mouth. Smoke can injure the airway and the signs can appear hours later

- A cracker burst in or near someone's hand, or the skin looks blackened and torn rather than simply red. These injuries are often deeper than they look

- The person burnt is a young child, pregnant, older, or has diabetes, and the burn has blistered. Burns are more serious in these groups

- The burn goes all the way round an arm, leg or finger

Call 112 or have someone drive you. Do not drive yourself, and keep cooling the burn on the way if you can.

If a cracker has injured an eye

Do not rub it, press on it, or try to wash or pull anything out of it. Do not put drops or ointment in it. Hold a clean paper cup or a folded card over the eye without touching it, and go straight to an eye hospital or a hospital emergency department. We do not have an eye doctor on our panel, and an eye injury should not wait for a clinic visit first.

## What a small burn at home needs over the next two weeks

Once a small burn has been cooled and covered, it needs a clean dressing and to be looked at. Keep it clean and dry, keep it covered, and take your usual painkiller if you need one, following the dose on the box.

Get it seen again if:

- it becomes more painful, more red or swollen, or starts to smell

- the dressing is soaked through with fluid

- you develop a fever of 38°C or more

- it has not healed after two weeks

Those can mean infection, or a burn that was deeper than it first looked.

Check the tetanus. If you are not sure when you or your child last had a tetanus injection, ask the doctor. Whether you need a booster depends on the wound and on your vaccination history.

How to keep the festival free of burns

- Keep a bucket of water nearby wherever crackers or diyas are lit, and put finished sparklers straight into it. A sparkler wire stays hot long after the light goes out.

- Light crackers at arm's length and stand well back. Never go back to one that did not go off.

- No sparklers for children under five. Older children hold them only with an adult beside them, arm stretched out, away from their face and clothes.

- Wear close-fitting cotton. Synthetic fabric catches fire and melts onto the skin. Tuck in dupattas and loose sleeves near diyas and the stove.

- In the kitchen, keep children out while frying, turn pan handles inwards, and let the pressure cooker cool before you open it.

What we will not do

- We will not treat a burn that needs a hospital. We do not have a burns unit. If yours is large, deep, on the face, hands or genitals, electrical, chemical, or involved smoke, we will tell you to go to a hospital emergency department, and we would rather you went there first.

- We do not treat eye injuries. There is no eye doctor on our panel.

- We will not dress a burn without a doctor looking at how deep it is. A deep burn hidden under a neat dressing is a deep burn found late.

- We will not burst blisters as a routine, or send you home with a cream for every burn. Each step is decided on the burn in front of us.

What a doctor does here, and what it costs

For a small burn, a doctor will look at how deep and how large it is, clean it, put on a proper burn dressing, check your tetanus cover, and tell you when it needs changing.

| | Fee |

|---|---|

| General physician consultation | from ₹800 |

| Dressing at the clinic, single site | ₹500 |

| Dressing at the clinic, several sites or a larger burn | ₹1,000 |

| Dressing change at home by our nurse, single site | ₹700 |

| Dressing change at home, several sites or complex | ₹1,400 |

| Tetanus injection (TT) at the clinic, vaccine included | ₹300 |

These are a guide. We tell you the figure before anything is done. Any medicine you take home is charged separately. Fees are for booking directly with us; fees for appointments booked through third-party platforms are set on those platforms and may differ.

Who you will see

Dr. Waquar Yunus (MBBS), our general physician, is in the clinic for the full clinic day, Monday to Saturday, 8:00 AM to 9:00 PM. Dr. Sushma Vikirna (MBBS, PGDMCH), general physician with 40 years' experience, consults Monday to Saturday, 2:00 to 5:30 PM. Both dress wounds, and our page on stitches and wound care covers cuts as well as burns.

Once a doctor has seen the burn, later dressing changes can be done at home. Our nursing at home service runs 6 AM to midnight, seven days a week, including Sunday, when the clinic itself is closed.

Frequently asked questions

Should I put toothpaste or ghee on a burn?

No. Cool running water for 20 minutes is the first aid that works. Toothpaste, ghee, butter, oil and turmeric trap heat in the skin and have to be cleaned off the wound later.

Should I burst a blister?

No. The blister protects the healing skin underneath. If it is large, in the way or has burst on its own, a doctor can deal with it properly.

It happened an hour ago. Is it too late to cool it?

No. Cool it under running water for 20 minutes now. Cooling still helps when it is started up to about three hours after the burn.

Does every burn need a tetanus injection?

Not always. It depends on the burn and on when you last had a tetanus injection. If you are not sure, ask the doctor. A tetanus injection at the clinic is ₹300, vaccine included.

How long does a small burn take to heal?

A red burn with no blisters usually heals on its own; a small blistering burn should heal within about two weeks. If it has not healed after two weeks, or is getting more painful, get it looked at.

Can I come straight to the clinic with a burn?

Cool the burn for 20 minutes first, then call 8800844793 and we will tell you whether to come in or go to a hospital. If the burn has any of the hospital signs above, go to a hospital emergency department instead.

All Is Well Medical Centre

Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

Clinic hours: Monday to Saturday, 8:00 AM – 9:00 PM. Closed Sunday.

Home nursing: 6:00 AM – midnight, seven days a week, including Sunday.

Phone: 8800844793 · WhatsApp: https://wa.me/918800844793 · Book an appointment: https://alliswellmedicalcentre.com/doctors-appointments

Rated 4.9★ by patients on Google.

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Medically reviewed by Dr. Sushma Vikirna, MBBS, PGDMCH — general physician, All Is Well Medical Centre.

This article is general information and is not a substitute for a consultation with a doctor. If you are worried about a burn, please see a doctor. In an emergency, call 112 or go to the nearest hospital.

Contact

Call 8800844793. Home nursing 6 am to midnight

Phone

8800844793

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Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

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All is well medical centre

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