Chemical burn: treatment and first aid
Trauma caused to the tissues of the body by aggressive substances is called a chemical burn.
All chemical damage is classified according to the type of reagent, the area and volume of the affected parts of the body, and a number of other criteria, depending on which the severity of the condition of the victim is assessed and a treatment plan is drawn up.
All chemical injuries are divided into domestic and industrial. The latter are associated with the ingestion of harmful substances in the workplace or in chemical laboratories, where a variety of reagents with high concentrations are often used. Household burns do not usually cause significant damage to human health.
An assessment of the severity of chemical burns is made according to two main criteria - the area and depth of the lesion. The area of skin lesions is determined approximately based on the rule of the palm or the "principle of nine".The human palm area is estimated as 1.2% of the total skin surface area. The area of the skin surface of the head and neck is taken in 1/9 part, the surface of the chest - 2/9, etc.
So acid leads to coagulation of proteins, therefore, to the appearance of a dense scab that slows the penetration of the reagent into the underlying tissues of the body. Alkalis, on the contrary, soften the scab when saponifying fats and dissolving proteins, which contributes to a more intensive penetration of the reagent and an increase in the severity of the lesion.
The color of affected tissues depends on the type of the damaging reagent. So a white scab that turns into brown or black is a sign of sulfuric acid, and the yellow color is formed from the action of hydrochloric acid.
Less frequent burns can be caused by compounds of fluoride, phosphorus, phenol and many other substances. A separate group should designate a group of chemical warfare agents for blistering operations( mustard gas, etc.).
A somewhat excellent clinical picture gives the skin of oil products( gasoline, kerosene, etc.), as well as juice and etheric vapors of some poisonous plants( ash, cow, etc.).In case of a burn, a stratification of the surface layers of the skin occurs, with the formation of bubbles filled with liquid. Around such lesions, the skin often becomes pigmented, such a "tan" can last for many months.
The following types of chemical burns are distinguished at the place of contact of an aggressive substance:
The success of treatment of a chemical burn, and often the life of a victim, directly depends on the speed and quality of emergency first aid. Therefore, it is so important: as soon as possible to eliminate the effects of aggressive substances.
The contaminated clothing should be carefully removed, taking care not to cause additional injury to the damaged skin. The reagent should be removed from the skin by rinsing or shaking. Most often washed with water, except for the defeat of substances, giving a moist reaction in a humid environment with the release of heat( quicklime, concentrated sulfuric acid, etc.).
Treatment with means preventing the growth of the affected area and inactivating the reagent. So, if acids get into the treatment, use a slightly alkaline solution( baking soda, etc.), and against alkalis - acid solutions of low concentration( acetic, citric, etc.).
Some reagents are bound and / or inactivated by specific drugs. For example, when exposed to lime, wash it with 20% sugar syrup, carbolic acid neutralized with glycerin, and white phosphorus does not like 5% solution of potassium permanganate.
As many chemical reagents quickly penetrate into the tissues of the body, their action does not stop from rapid washing of the skin surface. Therefore, in a number of cases, the wound should be washed continuously for several hours. Even if this does not lead to a complete washout of the reagent, its concentration decreases, hence, the damaging ability decreases.
Treatment should be carried out in specialized medical institutions( burn centers or departments), in their absence - in surgical departments or others, taking into account the site of the lesion. For example, a patient with a chemical face burn can be cured in the department of maxillofacial surgery.
The therapy to be carried out should be carried out in a complex way:
But no matter what successes the specialists in the treatment of burns achieve, always it is necessary in advance to take care of the prevention of chemical lesions. See also, treatment of sunburn.
All chemical damage is classified according to the type of reagent, the area and volume of the affected parts of the body, and a number of other criteria, depending on which the severity of the condition of the victim is assessed and a treatment plan is drawn up.
All chemical injuries are divided into domestic and industrial. The latter are associated with the ingestion of harmful substances in the workplace or in chemical laboratories, where a variety of reagents with high concentrations are often used. Household burns do not usually cause significant damage to human health.
An assessment of the severity of chemical burns is made according to two main criteria - the area and depth of the lesion. The area of skin lesions is determined approximately based on the rule of the palm or the "principle of nine".The human palm area is estimated as 1.2% of the total skin surface area. The area of the skin surface of the head and neck is taken in 1/9 part, the surface of the chest - 2/9, etc.
In depth, chemical burns are divided into 4 degrees:
- 1) The first is a superficial burn. Affects the uppermost layer of the skin without deep penetration. External manifestations are similar to an easy degree of thermal burn: small reddening and edema. Recovery takes place in several in full, without any consequences.
- 2) The second - the destruction of the epithelial layer of the skin and partial damage to the upper layers of the dermis. The boundary of necrosis passes at different depths, the areas of superficial lesion alternate with deeper ones. Unlike thermal burns, the appearance of bubbles is extremely rare. First, a necrotic superficial scab is formed, which is often destroyed several days after the injury by a purulent exudate. As a result, a purulent wound is formed against a background of mild edema.
- 3) The third - the defeat of all layers of the skin. The healing usually ends with the formation of persistent scars, the restoration of the skin is possible only at the edges of the burned area.
- 4) Fourth - the destruction of the skin and underlying tissues( fatty tissue, bones, muscles, etc.).Occurs rarely, a distinctive feature is the alternation of dead and not damaged tissues.
So acid leads to coagulation of proteins, therefore, to the appearance of a dense scab that slows the penetration of the reagent into the underlying tissues of the body. Alkalis, on the contrary, soften the scab when saponifying fats and dissolving proteins, which contributes to a more intensive penetration of the reagent and an increase in the severity of the lesion.
The color of affected tissues depends on the type of the damaging reagent. So a white scab that turns into brown or black is a sign of sulfuric acid, and the yellow color is formed from the action of hydrochloric acid.
Less frequent burns can be caused by compounds of fluoride, phosphorus, phenol and many other substances. A separate group should designate a group of chemical warfare agents for blistering operations( mustard gas, etc.).
A somewhat excellent clinical picture gives the skin of oil products( gasoline, kerosene, etc.), as well as juice and etheric vapors of some poisonous plants( ash, cow, etc.).In case of a burn, a stratification of the surface layers of the skin occurs, with the formation of bubbles filled with liquid. Around such lesions, the skin often becomes pigmented, such a "tan" can last for many months.
The following types of chemical burns are distinguished at the place of contact of an aggressive substance:
- skin lesion.
- burns the oropharynx, esophagus and stomach. Burns of the upper respiratory tract
- .
- chemical eye damage, etc.
- clear and understandable labeling of all hazardous to health reagents.
- prohibition on food intake, including the use of drinks in chemical laboratories.
- use of systematically verified personal protective equipment when working with aggressive substances.
- availability in the laboratory and in harmful production of manned first-aid kits for first aid.
- conducting regular classes to provide first aid to victims of chemical burns.
Treatment and first aid for chemical burns
The success of treatment of a chemical burn, and often the life of a victim, directly depends on the speed and quality of emergency first aid. Therefore, it is so important: as soon as possible to eliminate the effects of aggressive substances.
For this, it is necessary to remove the reagent from the place of contact quickly and as completely as possible. The assisting person must be careful not to become a victim himself.
The contaminated clothing should be carefully removed, taking care not to cause additional injury to the damaged skin. The reagent should be removed from the skin by rinsing or shaking. Most often washed with water, except for the defeat of substances, giving a moist reaction in a humid environment with the release of heat( quicklime, concentrated sulfuric acid, etc.).
Treatment with means preventing the growth of the affected area and inactivating the reagent. So, if acids get into the treatment, use a slightly alkaline solution( baking soda, etc.), and against alkalis - acid solutions of low concentration( acetic, citric, etc.).
Some reagents are bound and / or inactivated by specific drugs. For example, when exposed to lime, wash it with 20% sugar syrup, carbolic acid neutralized with glycerin, and white phosphorus does not like 5% solution of potassium permanganate.
As many chemical reagents quickly penetrate into the tissues of the body, their action does not stop from rapid washing of the skin surface. Therefore, in a number of cases, the wound should be washed continuously for several hours. Even if this does not lead to a complete washout of the reagent, its concentration decreases, hence, the damaging ability decreases.
Treatment should be carried out in specialized medical institutions( burn centers or departments), in their absence - in surgical departments or others, taking into account the site of the lesion. For example, a patient with a chemical face burn can be cured in the department of maxillofacial surgery.
The therapy to be carried out should be carried out in a complex way:
- 1) Elimination of the local chemical effect and retardation of the absorption of the reagent and the decomposition products of the affected tissues.
- 2) Reduction of the general toxic effect on the body( detoxification, combating possible complications - disruption of the kidneys, liver, etc.).
- 3) Combating infection in the lesion and eliminating the consequences of already occurring suppuration.
- 4) General restorative therapy.
- 5) Rehabilitation of the patient after completion of the main treatment.
But no matter what successes the specialists in the treatment of burns achieve, always it is necessary in advance to take care of the prevention of chemical lesions. See also, treatment of sunburn.