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After a scald, run cool water over it right away for 20 minutes, and don't put on toothpaste or soy sauce

  • Top value
  • Evidence A
  • Buys life
  • Free
  • Takes minutes
  • No willpower

In a real emergency, call 911 first, then read this.

In plain words

Running cool water over it for a full 20 minutes within 3 hours of the injury cuts the chance of later needing a skin graft to about 60% of what it is without rinsing. Use cool water, not ice water, because ice makes the injury worse. If clothing is stuck to the wound, don't tear it off. After rinsing, cover it with a clean cloth and go to the hospital. Don't put on toothpaste, soy sauce, sesame oil or flour. If you only remember after a while, rinsing within 3 hours still helps.

Cost

Free. It takes 20 minutes.

What you get

Australia followed 2,495 children with burns and scalds. For children who ran cool water over the injury for 20 minutes within 3 hours, the odds ratio for later needing a skin graft was 0.6, 95% CI 0.4–0.8 (confidence interval, the range the true value likely falls in), about 60% of that of children who did not. A combined analysis of 7 studies likewise found that "20 minutes of cool running water within three hours of injury significantly lowered the chance of needing a skin graft and surgical wound care"

Notes

Use cool water, not ice water, because ice makes the injury worse. If clothing is stuck to the wound, don't tear it off; after rinsing, cover it with a clean cloth and go to the hospital. Don't put on toothpaste, soy sauce, sesame oil or flour, which interfere with the doctor judging the depth and also invite infection. Rinsing within three hours still helps

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM (2020). Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children. Annals of Emergency Medicine, 75(1), 75-85. https://doi.org/10.1016/j.annemergmed.2019.06.028
  2. Griffin B, Cabilan CJ, Ayoub B, et al. (2022). The effect of 20 minutes of cool running water first aid within three hours of thermal burn injury on patient outcomes: A systematic review and meta-analysis. Australasian Emergency Care, 25(4), 367-376. https://doi.org/10.1016/j.auec.2022.05.004

Mentioned in

Translated from the Chinese original. Original book, section 13, tip 14. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer