Burn First Aid for Thermal and Chemical Burns on the Job

For a heat burn, cool it under cool, not cold, running water right away: the Mayo Clinic says about 10 minutes, and the WHO says about 20 minutes for smaller burns. Then take off rings and tight gear and cover it loosely with a clean dressing (Mayo Clinic; World Health Organization). For a chemical burn, brush off any dry chemical, pull off contaminated clothing, and flush with water for at least 15 to 20 minutes, unless the safety data sheet calls for something different (Texas Department of Insurance). Don't put ice, butter, oil or toothpaste on any burn, and get emergency care for any large, deep, electrical or strong chemical burn, or a burn to the face, hands, feet or genitals.

Thermal burns: the first minutes

Thermal burns on a lease come from hot lines, steam, exhaust, welding, and flash fires. The steps are the same either way (from Mayo Clinic and World Health Organization):

1. Stop the burning. Get the person away from the heat source. If clothing is on fire, stop, drop and roll, or smother the flames.
2. Cool it with water. Run cool, not cold, water over the burn for about 10 to 20 minutes. Starting early matters more than getting the exact time.
3. Take off rings, watches, belts and tight items near the burn before it swells. Don't pull off clothing that's stuck to the skin. Cut around it.
4. Cover it loosely with a clean, dry cloth or sterile gauze, and raise a burned arm or leg above heart level if you can.
5. Keep the person warm. The WHO warns that cooling a big burn can bring on hypothermia, so cool the burn, not the whole body, and cover the rest of them with a blanket or jacket.

What not to do, per Mayo Clinic: no cold water or ice, which can make the injury worse; no butter, oil or toothpaste, which can trap heat; and don't pop blisters, since they protect against infection.

Chemical burns: flush first, then read the SDS

Oilfield crews handle acids, caustics, biocides and other treating chemicals, and a chemical keeps burning until it's gone. Texas Department of Insurance lists the order: remove the source, brush off dry chemical before adding water, take off contaminated clothing and jewelry, and flush the skin with cool running water for at least 15 to 20 minutes. Wear gloves so you don't burn yourself while helping.

The right flush time depends on the chemical. The University of Minnesota lab safety plan calls for 30 minutes for most corrosives and 60 minutes for strong alkalis such as sodium hydroxide, since alkali burns go deeper. Some chemicals have special first aid. Hydrofluoric acid, for example, needs calcium gluconate gel and immediate medical care on top of flushing. That's why the first aid instructions in Section 4 of the safety data sheet, or the entry in the NIOSH Pocket Guide, should be read before a job starts, not after.

For a splash to the eyes, CCOHS cites American Heart Association and Red Cross guidance to rinse right away with plenty of tap water for at least 15 minutes or until advanced medical care arrives. CCOHS also says the most important thing is that flushing starts immediately.

Eyewash and safety showers on site

OSHA's first aid standard says that where a worker's eyes or body may be exposed to corrosive materials, "suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use" (29 CFR 1910.151). CCOHS notes that the ANSI Z358.1 standard for emergency eyewash and showers expects equipment that can supply flushing fluid for at least 15 minutes. A small squeeze bottle is fine for a first rinse on the way to a plumbed or self-contained station, but it can't give a full flush by itself. Check our guide to OSHA first aid requirements on remote sites for what else belongs in the truck.

Flash fires and FR clothing

A gas release that finds an ignition source can turn into a flash fire. In a 2010 letter, OSHA described hydrocarbon flash fires as reaching roughly 1,000°F to 1,900°F and lasting up to about 5 seconds, and said employers in oil and gas drilling, servicing and production must assess that hazard and provide flame-resistant clothing where it exists under 29 CFR 1910.132(a). The FR clothing standards the industry uses are NFPA 2112 (the garment) and NFPA 2113 (selection, care and use). Everyday cotton or synthetic shirts worn under FR, or synthetic layers that melt, can make a burn worse, so keep layering in mind on cold mornings too.

When a burn needs emergency care

Call for emergency help, or take the person straight to an emergency room, for any of these (from Mayo Clinic and World Health Organization):

• Deep burns that go through all layers of skin, or skin that looks dry, leathery, charred, or has white, brown or black patches.
• Burns larger than 3 inches across, burns that wrap around an arm or leg, or burns that swell very fast.
• Burns to the face, hands, feet, genitals, buttocks or a major joint such as a knee, shoulder or elbow.
• Any burn from electricity or lightning. Make sure the power is off before you touch the person.
• Any burn from a strong chemical, and any chemical in the eyes.
• Any burn that happens along with smoke inhalation, which the WHO also flags as needing urgent care.

Keep flushing a chemical burn on the way if you can, and send the SDS or product name with the patient. Watch for shock, which the Mayo Clinic describes as cool, pale skin, a weak pulse or fast breathing. Lay the person down and cover them with a clean, dry sheet or light blanket. If the person stops breathing, start CPR (Mayo Clinic).

Small burns afterward

A minor burn can usually be cared for on site after cooling. The Mayo Clinic suggests a clean, loose bandage, an over-the-counter pain reliever if needed, and a lotion with aloe vera once the burn has cooled and starts to heal. If a blister breaks, clean it gently with water and use an antibiotic ointment. A deep burn may need a tetanus booster if the person hasn't had one in five years (Mayo Clinic). Report every burn, however small, so the cause gets fixed.

Chemical in the eye is a different first-aid path than a skin burn: continuous irrigation with the lids held open, then emergency eye care. See chemical eye splash first aid for flush times and eyewash rules.