Burn injuries are often seen as a challenge to clinicians due to their complexity. Healing is dependent on the quality of the initial management of the wound. Best practice involves cooling the wound with water for 20 minutes within three hours of the initial injury and yet this is not widely known. This simple action can prevent the wound from increasing in size and can offer a better psychological, social, physical and functional outcome for the patient. National educational strategies and awareness campaigns to promote a standardised approach to first aid for burns and scalds are needed. This article looks at what happens to the burn wound following injury and discusses the importance of timely and appropriate first aid.