Thermal Injuries in the Field

What are the different types of burns?

Burns are classified by mechanism. Thermal burns come from contact with hot objects, liquids, and flames. Electrical burns come from current — exposed wires or lightning. Chemical burns come from acids, solvents, detergents, or anything that disrupts the skin on contact. Radiation burns come from energy transmitted at the cellular level — various wavelengths of light, or ionizing radiation such as gamma rays. This article focuses on thermal burns.

Some statistics

Outdoor burns — particularly from campfires and recreational fires — account for a large number of injuries each year. Some studies put burns at 2–8% of wilderness trauma cases, primarily scalds from hot or boiling liquids and direct contact with hot objects (campfires, stoves, and the like). Military trauma registries cite burns as 5–20% of combat casualties, mostly from IED blast injuries.

How to prevent burns

• Dress for the environment and the work. Long pants, long sleeves, gloves, and boots protect you. The material need not be fire-retardant, but if you anticipate open flames or blasts, consider the extra cost to protect yourself.
• Campfire safety. Keep at least three feet from your fire or cooking apparatus. Keep sand, water, dirt, or a flame-resistant blanket handy to smother flames, and bury hot embers. Learn to set up a Dakota fire hole.
• Cooking stoves. A common injury is scalding of the thighs and groin from boiling water spilling onto a table and the person sitting closest. Always secure your stove and fuel on a stable surface, away from where you eat. If you're overlanding, keep a fire extinguisher handy, and consider a dedicated personal fire-suppression device for your vehicle, ruck, or first aid kit.
• Avoid hot surfaces. In direct sun, a car hood can reach ~130°F, a picnic bench ~100°F, and pavement ~180°F. Stay conscious of contact-burn hazards around you.
• Suppressors. If you shoot suppressed for hearing protection, understand that a suppressor can reach 300–500°F after a few magazines and up to 1000°F during sustained fire. Wear gloves — we like Outdoor Research Firemark sensor gloves, or go retro with USMC Nomex.

I suffered a burn — what do I do?

Step 1: Stop the burn

Remove the heat source immediately. If clothing is on fire, stop, drop, and roll. If hot liquid caused the burn, remove soaked clothing. Take off jewelry and piercings, and expose the entire burn by removing or cutting away clothing. Do not peel off fabric stuck to the skin.

Step 2: Cool the burn

Cool as soon as possible to reduce tissue damage and pain. Use reliable US tap water or properly purified, potable field water, running cool (not ice-cold) water over the burn for at least 10–15 minutes. Room-temperature water is acceptable but cools more slowly. If no running water is available, apply a clean, damp cloth. Do not use ice — it can cause further damage. Do not use grease, butter, or other home remedies; they significantly increase infection risk. Commercial burn products with cooling properties may also be applied.

Step 3: Assess the severity

We list the traditional class first, then the modern medical term.

First-degree / superficial: red and painful, no blisters; involves only the epidermis; usually heals within 6–7 days as the damaged epithelium peels away.

Second-degree, superficial partial thickness: red, swollen, painful; blisters form between epidermis and dermis after about 24 hours; usually heals in 7–21 days with some weeping that may become infected; may cause pigment changes but generally no functional impairment or hypertrophic scarring.

Second-degree, deep partial thickness: red, swollen, painful only to pressure; damage to deeper structures like hair follicles and glands; almost always blisters, often immediately, and may appear pale white to red; if infection is prevented and it heals without surgery, expect 2–9 weeks; expect a hypertrophic scar, and joint dysfunction if a joint is involved; can be hard to distinguish from third-degree.

Third-degree / full thickness: leathery, pale-white to charred, generally painless; destroys all layers of the dermis and subcutaneous tissue; an eschar forms and, left alone, sloughs off with massive scarring; will not heal without surgery.

Fourth-degree / deep tissue: life-threatening wounds involving deep tissue including muscle and bone.

Step 4: Assess the extent

Look at your palm. A burn the size of your palm without fingers/thumb is about 0.5% of total body surface area (BSA); with fingers/thumb, about 1%. Do not count first-degree burns in this estimate.

Why it matters: the more skin involved, the more serious the injury. As skin is lost, the body can't regulate temperature and loses substantial water through the burned area. Stay hydrated after any burn. If a burn is larger than 1% of BSA, seek immediate medical attention.

Step 5: Dress the burn

• Wash your hands with soap and purified water before touching the burn.
• Gently clean the area with mild soap and water — do not scrub. Dawn dish soap or a wilderness wash work well in the field.
• Cover the wound. Do not pop blisters. Use a non-stick bandage secured with gauze or an elastic wrap, or a commercial burn dressing with gel/cooling agent. Don't compress with an overly tight bandage — just secure enough to stay on and keep out debris.
• Rule of opposites. Give moisture to a dry burn (first- or second-degree that hasn't blistered) — medicinal honey, commercial burn gel, an adhesive film dressing, or a purpose-made burn dressing. Conversely, a "wet" burn with disrupted blisters or weeping should get a non-stick absorbent dressing — hydrocolloid, foam, alginate, or a commercial burn dressing.
• Treat pain and hydrate. Use acetaminophen or ibuprofen. Do not take anything stronger if you are conducting self-rescue, so as not to impair your ability to do so. Drink plenty of water.
• Change the dressing daily, or sooner if it becomes soiled or soaked through, cleaning the wound at each change.

Conclusion

Treating minor burns in an austere setting takes basic knowledge, calm thinking, and quick action. By cooling the burn, cleaning gently, and protecting the wound, you can prevent complications and support healing even in resource-limited environments. Always watch for signs of infection or deeper injury — and when in doubt, evacuate. Stay safe out there, and stay clinical.