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Burns and Scalds: Australian First Aid That Actually Works
Most Australians think burns and scalds are a summer problem. The data says otherwise. According to AIHW 2023-24 figures, burn hospitalisations peak in September (514 cases) and May (495), with kitchens, heaters, and hot water bottles doing more damage than BBQs and beach mishaps combined. Children under five are the highest-risk group, and the bad advice keeps showing up in the same forms it has for fifty years.
We've been selling burn treatment and clinical wound care for over a decade. I've been a theatre nurse for more than thirty years. This is the version of burns and scalds first aid we want every Australian household to have, with the parts that matter most up the front.
The three steps that matter: cool, cover, call
A scald is a burn caused by hot liquid or steam. The first aid is identical to any other burn. For any burn that isn't a tiny pinprick, do these three things in order.
Cool the burn with cool running water for 20 minutes. Not iced water. Not the tap-on, tap-off approach. Twenty unbroken minutes, ideally within three hours of the injury. This is the most evidence-backed step in burns first aid, and the one most people skip.
Cover the cooled burn with cling wrap, layered loosely, or a clean non-stick dressing. Cling wrap is in the Australian guideline for a reason. It is clean, transparent so the hospital can see the burn without removing the cover, and easy to find in a kitchen.
Call 000 for any burn covering more than 10% of an adult's body, or more than 5% of a child's body. Also call for any burn in an infant or very young child, any burn to the face, hands, feet, genitals, or across a joint, any electrical burn, any chemical burn, any burn that looks deeper than the top layer of skin, or any burn you simply aren't sure about.
Australia's first aid sequence for burns is set by ANZCOR Guideline 9.1.3. A 2022 systematic review in Australasian Emergency Care (Griffin et al.) confirmed 20 minutes of cool running water as the clinical standard.
What "20 minutes of cool running water" actually means
People don't believe it is really 20 minutes. They get to two or three minutes, the kid is yelling, the burn looks better, someone says "that should do it." It isn't enough.
The 20-minute target is what reduces scarring, depth of tissue damage, and the need for skin grafts later. The benefit window stretches to three hours after the injury. So if you didn't get a clean 20 minutes at the time, cooling the burn two hours later is still worth doing.
Cool running water only. Not iced. Not a wet towel. Ice constricts the small blood vessels under the burn and can extend the damage. A wet towel warms up against the skin and stops cooling within a couple of minutes.
If a tap and sink aren't available, a shower works. A hose works. A clean bucket with a steady refill works. Whatever delivers cool water to the burn for the full time.
How to tell a minor burn from one that needs an ambulance
Three things drive the decision: how big it is, how deep it is, and where it is.
Size. Use the patient's own palm as a rough measure. The palm is about 1% of body surface area. A burn larger than the patient's palm warrants a doctor's review. A burn covering more than 10% of an adult's body, or more than 5% of a child's body, is a 000 call. The threshold is lower for children because their smaller body surface area makes the same burn more dangerous.
Depth. Superficial burns affect the top skin layer only. They are red and painful but the skin is not broken. Partial-thickness burns blister and weep clear or yellow fluid. Full-thickness burns look pale, charred, or leathery, and may not hurt at the burn site because the nerves have been destroyed. Anything beyond a superficial burn needs medical assessment.
Location. Burns to the face, hands, feet, genitals, or across a major joint always need a doctor, regardless of size. So do electrical burns, where the visible damage often understates the internal damage, and any chemical burn.
When in doubt, get it looked at. Burns are one of the few injuries where the consequence of getting it wrong is permanent scarring, and the cost of being cautious is a few hours in an emergency department.
The myths that still hurt people
Surveys have found Australians regularly put toothpaste on burns. It contains abrasives and detergents that irritate the wound, trap heat, and increase infection risk. Butter does the same thing. Egg whites, cooking oil, raw aloe vera, and undiluted tea tree oil all fall in the same category.
None of these are evidence-based, and several actively make burns worse. Faoagali and colleagues (Burns journal, 1997) found tea tree oil was toxic to human skin cells and recommended against its use on burns.
Cool running water. Cling wrap. A doctor's review for anything beyond trivial. That is the whole kit of best-practice burns first aid.
Where burns actually happen in Australia
Winter, kitchens, and children under five do more damage than any other combination.
Burns Awareness Month is June, run by Kidsafe Australia and the Australian and New Zealand Burns Association, because June is when the data spikes. Hot water bottles, electric heaters, oil heaters, and reheated drinks from the microwave drive the winter peak. Kids aged 0 to 4 account for a disproportionate share of the 5,400 to 5,800 burns hospitalisations every year in Australia.
If you have young children at home, the highest-impact change you can make is hot water bottles out of reach and heater barriers in place by April.
What to keep at home for burns and scalds
A small burn kit is one of the most useful things to have in a kitchen drawer or family first aid kit. The basics are:
- A burn gel or burn spray for use after the 20-minute cooling
- Cling wrap, or a non-stick burn dressing for cover
- Sunscreen for the burns most likely to happen on your January week away
- A clean source of cool running water, which you already have
For workplaces, school camps, or businesses that need more, a dedicated burn first aid kit is purpose-built. The full home and family essentials list sits inside what should I include in my first aid kit.
Once cooled and covered, the next decision is about ongoing dressing care. The wound care guide covers dressing choice, healing stages, and signs of infection. For broader kit and supply decisions across the household, see the home and family first aid hub.
When in doubt, ring us
We sell to families, schools, workplaces, and clinicians. Burns advice doesn't change much across those groups. Cool, cover, call.
If you have a question about which burn product is right, or you aren't sure whether to send someone to a doctor, ring the shop on 03 5443 2239 during business hours. We've been doing this a long time, and you'll get a straight answer from someone who knows what they're talking about.
Or grab a burn gel and stash it in the kitchen drawer before the next time you need it.