Chemical injuries

Chemical injuries

There are over 70 /uni00A0 000 di ff erent chemicals in regular use within industry . Occasionally , these cause burns. Ultimately , there destruction of the skin and the second is any poisoning caused by systemic absorption. The initial management of chemical burns is to ascertain whether it is in a solid powder or liquid state. Water irrigation should not be used for solid powders as this will result in further reaction, these substances require removal with forceps. Exam ples include phosphorous, a component of military devices and elemental sodium, which is occasionally present in laboratory explosions. It is rare that a medical practitioner will encounter these bur ns. The more common injuries are caused by either acids or alkalis. Alkalis are usually the more destructive and are especially dangerous if they have come into contact with the eyes. After copious lavage, the next step in the management of any chemical injury is to identify the chemical and its concen tration and to elucidate whether there is any underlying threat to the patient’s life if absorbed systemically . Summary box 46.20 Chemical burns /uni25CF /uni25CF /uni25CF One acid that is a common cause of acid burns is hydro fluoric acid, although generally a weak acid, it chelates cal cium and magnesium in tissues. Burns a ff ecting the fingers and caused by dilute acid are relatively common. The initial management is with calcium gluconate gel topically; how ever, severe b urns or burns to large areas of the hand can be subsequently treated with Bier’s blocks containing calcium gluconate 10% gel. If the patient has been burnt with a con centration greater than 50%, the threat of hypocalcaemia and subsequent arrhythmias then becomes high, and this is an indication for acute early excision. It is best not to split-skin graft these hydrofluoric acid wounds initially , b ut to do this at a delayed stage.

Damage is from corrosion and poisoning Copious lavage with water helps in most cases Then identify the chemical and assess the risks of absorption

Chemical injuries

There are over 70 /uni00A0 000 di ff erent chemicals in regular use within industry . Occasionally , these cause burns. Ultimately , there destruction of the skin and the second is any poisoning caused by systemic absorption. The initial management of chemical burns is to ascertain whether it is in a solid powder or liquid state. Water irrigation should not be used for solid powders as this will result in further reaction, these substances require removal with forceps. Exam ples include phosphorous, a component of military devices and elemental sodium, which is occasionally present in laboratory explosions. It is rare that a medical practitioner will encounter these bur ns. The more common injuries are caused by either acids or alkalis. Alkalis are usually the more destructive and are especially dangerous if they have come into contact with the eyes. After copious lavage, the next step in the management of any chemical injury is to identify the chemical and its concen tration and to elucidate whether there is any underlying threat to the patient’s life if absorbed systemically . Summary box 46.20 Chemical burns /uni25CF /uni25CF /uni25CF One acid that is a common cause of acid burns is hydro fluoric acid, although generally a weak acid, it chelates cal cium and magnesium in tissues. Burns a ff ecting the fingers and caused by dilute acid are relatively common. The initial management is with calcium gluconate gel topically; how ever, severe b urns or burns to large areas of the hand can be subsequently treated with Bier’s blocks containing calcium gluconate 10% gel. If the patient has been burnt with a con centration greater than 50%, the threat of hypocalcaemia and subsequent arrhythmias then becomes high, and this is an indication for acute early excision. It is best not to split-skin graft these hydrofluoric acid wounds initially , b ut to do this at a delayed stage.

Damage is from corrosion and poisoning Copious lavage with water helps in most cases Then identify the chemical and assess the risks of absorption

Chemical injuries

There are over 70 /uni00A0 000 di ff erent chemicals in regular use within industry . Occasionally , these cause burns. Ultimately , there destruction of the skin and the second is any poisoning caused by systemic absorption. The initial management of chemical burns is to ascertain whether it is in a solid powder or liquid state. Water irrigation should not be used for solid powders as this will result in further reaction, these substances require removal with forceps. Exam ples include phosphorous, a component of military devices and elemental sodium, which is occasionally present in laboratory explosions. It is rare that a medical practitioner will encounter these bur ns. The more common injuries are caused by either acids or alkalis. Alkalis are usually the more destructive and are especially dangerous if they have come into contact with the eyes. After copious lavage, the next step in the management of any chemical injury is to identify the chemical and its concen tration and to elucidate whether there is any underlying threat to the patient’s life if absorbed systemically . Summary box 46.20 Chemical burns /uni25CF /uni25CF /uni25CF One acid that is a common cause of acid burns is hydro fluoric acid, although generally a weak acid, it chelates cal cium and magnesium in tissues. Burns a ff ecting the fingers and caused by dilute acid are relatively common. The initial management is with calcium gluconate gel topically; how ever, severe b urns or burns to large areas of the hand can be subsequently treated with Bier’s blocks containing calcium gluconate 10% gel. If the patient has been burnt with a con centration greater than 50%, the threat of hypocalcaemia and subsequent arrhythmias then becomes high, and this is an indication for acute early excision. It is best not to split-skin graft these hydrofluoric acid wounds initially , b ut to do this at a delayed stage.

Damage is from corrosion and poisoning Copious lavage with water helps in most cases Then identify the chemical and assess the risks of absorption