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Why should a third-degree burn not be immersed in cool water?

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Cross-section diagram of human skin showing burn depth by degree, with arrows indicating that first-degree burns affect only the epidermis, second-degree burns reach the dermis, third-degree burns extend into subcutaneous tissue, and fourth-degree burns penetrate to muscle. — burn This diagram shows how burn injuries are classified by severity. First-degree burns damage the outer skin, known as the epidermis. First-degree burns are the least severe form of burn injury. Second-degree burns damage the outer skin and some of the underlying skin, known as the dermis, which also includes some connective tissue. Third-degree burns damage all the layers of skin, including subcutaneous tissue. Fourth-degree burns, which are the most severe, destroy every layer of skin and also damage muscle, tendons, and bones.

Third-degree burns, also known as full-thickness burns, are serious medical emergencies that require immediate professional attention. Unlike minor burns, these injuries should not be immersed in cool water because doing so can intensify the circulatory shock that often accompanies such severe trauma.12

Instead of immersion, the recommended first-aid approach for a third-degree burn is to cover the injury with a bulky, sterile dressing or freshly laundered bed linens to protect the area. It is critical to avoid applying any ointments, salves, or sprays, and clothing that is stuck to the wound should never be removed. Because these burns involve the destruction of the entire thickness of the skin and underlying structures, they carry a high risk of grave fluid loss and metabolic disturbances, making rapid access to professional medical care the highest priority.132