Accidents happen. You might feel confident that you know when to slap a small adhesive bandage on a paper cut and when you need to call an ambulance, but in between there is a gray area where you can treat yourself at home or delay going to the doctor until you can assess the situation further. We spoke to two doctors who gave us their heuristics for evaluating how they would deal with an at-home scrape or burn.
If you have a cut, the first test whether you can stanch the bleeding. Hold a thin piece of gauze over the wound and press down tightly; thicker bandages will lessen the pressure of your grip, so use only one or two layers. If the blood doesn’t stop seeping out after a minute, “call 911, end of story,” says Jonathan S. Jones, emergency medicine doctor and former president of the American Academy of Emergency Medicine. Continue holding the gauze down until the paramedics arrive, even if it doesn’t seem like it’s affecting the wound.
Even if you can control the bleeding, there are still some circumstances in which a doctor should examine your injury, such as if you were cut by dirty or rusty material. For cuts that cover a joint or wrap around a limb or digit, you should see a doctor regardless. The same applies if you can see anything other than cut skin, such as muscles or tendons, or if the cut is longer than a half inch.
Burns don’t bleed, so you generally have a little more time to think about the situation, although you should still move quickly. If the burn doesn’t blister, you likely have a first-degree burn and probably don’t need medical treatment. If a blister does appear, you have a second-degree burn, and the situation begins to escalate. If a second-degree burn of any size crosses one of your joints—your wrist or elbow, for example—you should visit a doctor. Skin shrinks slightly while it heals from a burn, which can impede your movement if you don’t have it treated properly. The same principle applies to a burn that wraps around a body part, such as a finger or arm, as the shrinking can cause the skin to constrict the blood vessels underneath, limiting circulation.
Paradoxically, a less painful burn might be a bad sign, as your nerves could be damaged. If you can’t feel anything, and your skin appears dry, leathery, white, bright red, or charred black, you might have a third-degree burn. If you have a third-degree burn, you should seek medical attention. “Unless it’s a very, very small third-degree burn, that healing process can take a long time, and there’s a risk of infection and really bad scarring,” says Rabia Nizamani, a burn surgeon, the interim medical director at the UMC Lions Burn Center, and an assistant professor in the department of surgery at the University of Nevada Las Vegas.
The last question you face: How prompt do you need to be about getting care? Should you call an ambulance—expensive!—or could you book an appointment with your primary care physician and not spend a night in the hospital? Jones says he wouldn’t be stressed about getting emergency care if he wasn’t actively bleeding—within 24 hours would probably be fine.
The doctors we consulted differed slightly on when to call an ambulance after a burn. Nizamani says that she would call the paramedics if the injury covered more than 10% of someone’s body, about the size of an arm or the front of a leg. According to Jones, you generally don’t need to call an ambulance for a burn unless you can’t move or are in unbearable discomfort. Ultimately, those two pieces of advice might not be that different, since burns are notoriously painful.
If you’ve decided to treat your wound at home, you probably already have the required supplies. Once you’ve gathered them, the steps should be relatively simple—or at least as simple as they can be while you deal with the distraction of an injury.
