Advice given to people at risk by fire control personnel should support them in taking action to reduce the severity of the burn injury until either the call is redirected to ambulance control, or emergency responders arrive.
Stop – Drop – Roll
In situations where a person or an item of their clothing is on fire, the burning process should be stopped as quickly as possible. Fire control personnel should tell the person on fire to:
- Stop – Prevent the person from running around as this may fan the flames and make them burn faster
- Drop – Try to get the person to the floor and lie down as this will make it harder for the fire to spread and reduce the effect of flames on the face and head
- Roll – Get the person to roll around to smother the flames. A fire blanket, heavy cloth blanket, coat or rug can also be used to smother the flames
The casualty may need help dropping to the floor. If all options have been explored and the casualty is still not on the ground another person can use their leg to sweep the casualties’ legs from under them so they drop to the ground. This may cause additional injury to the person on fire or to the third party so should only be considered as a last resort.
A fire extinguisher can be used to extinguish the flames if there is one available.
Cool the burn
A burn injury will continue to burn until heat has been taken away. The burn should be cooled immediately with cool or lukewarm water for 20 minutes or until operational personnel or a medical response arrives. Any water source that is available can be used as the benefits of the cooling process outweigh the risk of contamination. Ice, iced water, creams or greasy substances such as butter must not be used.
Remove burnt clothing
Attempts should not be made to remove clothing that is stuck to the skin. Clothing or jewellery that is near the burnt area of skin, including babies’ nappies should be removed. Jewellery retains heat and continues tissue damage if left in place.
Keep warm
The cooling of burns may cause hypothermia, especially in the very young or elderly casualties. The casualty should be kept warm taking care to avoid rubbing blankets or other materials against burnt skin.
Cover the burn
After cooling the burn should be covered loosely with a layer of cling film to aid wound hygiene. Cling film should not be wrapped around the burn due to the possibility of swelling. If cling film is not available the wound may be loosely covered with clean, damp cloth.
Covering the burn wound:
- Minimises contamination by shielding the burn wound from secondary infection
- Reduces pain produced by the exposure of the damaged nerve endings (in partial thickness burns) to the air currents
- Provides protection during transport
Sit up
If the face or eyes are burnt the casualty should try to sit up to help reduce swelling.
Watch for shock
If the person is uncommunicative, delirious, or the caller indicates that the casualty looks pale, they may be in shock. The casualty should be sat up or propped up and kept warm.
Chemical burns
The principles of ‘REMOVE REMOVE REMOVE’ will help if someone has a chemical burn.
People helping the casualty should avoid getting the chemical on themselves.
The following actions will help people to limit the effects of the chemical until Category 1 emergency responders arrive:
- Remove themselves from the contaminated area to avoid further exposure to the substance
- Remove contaminated clothing, cutting off with scissors to avoid pulling over the head.
- Remove the substance from the skin using a dry absorbent material to either soak it up or brush it off
- Do not pull off clothing that is stuck to the skin
- Do not smoke, eat or drink
- Rinse the burn or contaminated area with copious amounts of water
- For facial burns, lean the casualty forward and pour water over the back of the head
- Wash eyes out directly
- Continue irrigation with copious amounts of water if there is any irritation of the skin or eyes such as burning, itching or pain