Which sequence best reflects the standard field care steps for severe sunburn?

• A. Hydration, analgesia, cool skin, protect from sun exposure
• B. Cool the skin, analgesia, hydration, protect from sun exposure
• C. Cool the skin, hydrate, analgesia, protect from sun exposure
• D. Analgesia, hydrate, cool skin, protect from sun exposure

Answer: (B)

In field care for severe sunburn, the first priority is to limit tissue damage and relieve pain, which is best achieved by cooling the skin. Cooling helps reduce ongoing heat injury, swelling, and discomfort, so start with cool running water or cool compresses on the burned areas for about 10–20 minutes, being careful not to apply ice directly to the skin.

After cooling, providing analgesia is the next step. Pain control makes the patient more comfortable, which in turn helps reduce stress and the risk of dehydration from pain and heat exposure. After the patient is more comfortable, address fluids.

Hydration comes next because sunburns cause fluid loss through damaged skin and from heat exposure. Offer fluids the patient can tolerate to support circulation and healing; in a higher-level setting, IV fluids may be considered if needed. Finally, protect from sun exposure to prevent further injury and promote healing—keep the affected areas shaded, loosely covered with clean dressings or clothing, and avoid additional UV exposure.

Other sequences skip or delay cooling or pain control, which can allow further tissue damage and prolong discomfort, making the overall injury harder to manage. The order that places cooling first, followed by analgesia, hydration, and then protection from sun exposure best supports immediate symptom relief and the healing process.