When Things Heat Up: Burn Care Basics for the Outdoors
SOLO Manager Barrett Wood, WEMT, answers frequently asked questions about burn care in the backcountry. Read on for practical advice and trail-tested know-how to help you handle burns outdoors and stay prepared on your next adventure.
Types of Burns
Burns can happen anywhere. While they’re most common in the kitchen, they also frequently occur outdoors from campfires, sun exposure, hot liquids, and camp stoves.
We can categorize burns by their type (cause) and their depth. There are four types of burns:
- Thermal
- Electrical
- Chemical
- Radiation
All cause cellular damage, but through slightly different mechanisms. This article focuses on thermal burns, which occur when the skin comes into contact with an external heat source.
Burn Depth
The preferred terminology to describe burn depth is superficial, partial-thickness, and full-thickness, though the traditional first/second/third degree system is also used. Superficial burns only affect the epidermis, while the damage from partial-thickness burns extends through the epidermis and into the dermis. Full-thickness burns fully penetrate the skin and cause damage below the skin, harming muscles, blood vessels, tendons, bones, organs, and other body tissue (Hubbell, 2022).
Knowing how to respond to burns is essential when recreating outdoors. That’s why burn assessment and treatment are covered through both hands-on scenarios and classroom instruction in all of our Wilderness First Aid and Wilderness First Responder courses. Explore our wilderness medicine courses here to learn more!
FAQ: Backcountry Burn Care
Should I use ice to cool off a burn?
While cooling burns is appropriate and beneficial during the first hour after a burn occurs, please don’t use ice or snow. Cool water is preferred as ice delays the healing process (Bitter et al., 2025). We want to halt tissue damage, but running water will achieve the same result as ice without any downsides.
Can I cool it off too much?
Yes! Your skin is a very important insulator for your body. Large and/or deep burns significantly reduce the body’s ability to retain heat. This means excessive cooling can cause the patient to become hypothermic. Be cautious when cooling the burn itself and make sure you monitor the patient for signs of hypothermia during and after the immediate care (Szymanski & Tannan, 2023).
Should I put butter on a burn?
Please don’t do that. Butter has two negative effects on burns. First, butter is a mixture of fat and water and fats (lipids). Lipid molecules are good at trapping heat rather than dispersing it. This means that applying butter to the surface of the burn can slow the cooling process. While the outermost layer of tissue gets some cooling effect, the deeper areas become insulated by the butter. Secondly, the butter can contaminate the injury and will need to be cleaned off to prevent infection. These issues are most severe in full-thickness burns.
For superficial and partial thickness burns, you can use water, burn gels, aloe, Betadine, or Silvadene to keep the area moist and clean. Generally, full-thickness burns are treated with dry, occlusive dressings (Hubbell, 2022).
Can burns make you dehydrated?
Yes, they can, for the same reason that we worry about hypothermia: damaged skin doesn’t function well. A large superficial burn (whole torso sunburn) can cause mild dehydration, but a partial or full-thickness burn can cause hypovolemic shock and usually requires IV fluids. At the ALS (Advanced Life Support) level of care, the Parkland Formula is used to determine the exact fluid volume needed (Szymanski & Tannan, 2023). North Carolina Office of EMS considers partial and/or full-thickness burns greater than 5% of total body surface area to be “serious burns” and greater than 15% to be “critical burns”. Treatment for both includes IV fluids. The Rule of Nines, or the palmar rule, can be used to assess body surface area.
Sources
Hubbell, F. (2022). Wildcare. Stonehearth Open Learning Opportunities Inc.
North Carolina Office of EMS 2025 Thermal Burn Protocols (TB 9).
Szymanski, K. & Tanna,n S. (2023). Thermal Burns. StatPearls
Looking to expand your wilderness medicine knowledge?
No matter where your next adventure leads, be prepared for anything by learning essential wilderness medicine skills. SOLO Southeast provides courses for all experience levels and schedules, making it easy to include safety training in your next outdoor trip. Browse our wilderness medicine courses or call us at 828-366-7517 to learn more.