What is the appropriate initial management for a thermal burn?

• A. Remove all clothing including stock clothing and apply ice
• B. Do nothing until EMS arrives
• C. Stop burning with water or saline and remove smoldering clothing and jewelry; DO NOT remove stock clothing; cover burned area with dry sterile dressing
• D. Apply lotion and cover with bandage

Answer: (C)

Cooling the burn to stop ongoing tissue damage is the first priority. Using cool running water or saline for about 10 to 20 minutes helps limit depth and pain. If possible, remove smoldering clothing and jewelry because heat and swelling can trap or spread injury; do not forcibly remove clothing that is stuck to the skin to avoid tearing tissue. After cooling, cover the area with a clean, dry sterile dressing to protect against contamination and further injury. Do not apply ice or any lotion/ointment, as these can worsen tissue damage. This sequence—cooling, careful removal of heat sources, and protective covering—best addresses immediate injury control and reduces complications while awaiting further care.