Cool running water is best immediate treatment for burns

Contemporary PEDS JournalVol 37 No 4
Volume 37
Issue 4

Burns are a common injury in childhood, and parents have a number of folk remedies available to use to treat them. A new study confirms that cool running water is still the best treatment.

Burns can be a common injury in childhood and the number of so-called remedies is myriad, ranging from putting butter on the burn to using aloe vera. A new Australian study in the Annals of Emergency Medicine looked at the effectiveness of cool running water as an early management tool in treating burns.

The researchers used a prospectively collected registry of patients who received care at a tertiary children’s hospital. They evaluated the relationship between using first aid and the need for skin grafting. The secondary outcomes included operating room interventions, wound depth, time to re-epithelialization, and hospital admission and length of stay. Application of 20 minutes of cool running water within 3 hours of receiving the injury was defined as adequate first aid.

Cool running water is effective when applied for an adequate amount of time

The cohort included 2495 children with 2259 being given first aid that included running water. Unfortunately, only 1780 of those children had first aid of adequate duration of running water. Additionally, 236 children needed skin grafts. Investigators found that the odds of requiring skin grafts were decreased in children who received adequate first aid (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4-0.8). Furthermore, adequate first aid was linked to reductions in hospital admission (OR, 0.7; 95% CI, 0.3-0.9); the need for operating room interventions (OR, 0.7; 95% CI, 0.5-0.9); and full-thickness depth (OR, 0.4; 95% CI, 0.2-0.6). Adequate first aid was not associated with a reduction in the length of stay at a hospital (hazard ratio=0.9; 95% CI, 0.7-1.2; P=0.48).


Investigators confirmed that cool running water was an important way to reduce burn severity and improve outcomes, but the duration needed had to be at least 20 minutes. They further said that out-of-hospital and emergency medical services need to prioritize applying cool running water for an adequate amount of time during the preliminary management of burns in children.



1. Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM. Cool running water first aid decreases skin grafting requirements in pediatric burns: a cohort study of two thousand four hundred ninety-five children. Ann Emerg Med. 2020;75(1):75-85.

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