chemical burns Flashcards

1
Q

Chemical Burns most common

A

Alkalis, acids, organic compounds (petroleum products)

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2
Q

tx of burns from white phosphorous?

A

neutralization w/ 1% copper sulfate solution and administration of calcium gluconate gel to address the concomitant hypocalcemia

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3
Q

Alkalis

A

hydroxides, carbonates, caustic sodas of Na, K, ammonium, Li, Ba, Ca (oven cleaners, drain cleaners, fertilizers, industrial cleaners)

structural bond for cement

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4
Q

CF of alkali burn

A

worse than acid!! tissue damage by liquefaction necrosis and protein denaturation

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5
Q

Acids

A

HCl in bathroom cleaners, oxallic and HFl (rust removers) pool cleaners, sulfuric acid in drain cleaners,

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6
Q

Acid CF

A

tissue damage by coagulation necrosis and protein precipitation

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7
Q

Hydrofluoric Acid

A
Industrial use: 
o	Etch glass
o	Teflon
o	Clean semiconductors
o	Home use – rust removers

*weak acid, but F- is very toci

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8
Q

CF of hydrofluoric acid

A

severe pain for 6-8 hours, tissue necrosis, hypocalcemia bc F binds to free serum calcium

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9
Q

Tx of hydoflouric acid

A
  • Flood wound with water – require copious lavage for at least 30 minutes
  • Neutralize with topical calcium gel
    o 1 amp calcium gluconate in 100 gm lubricating jelly
  • Apply with gloved hand
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10
Q

what do you need to monitor in a hydroflouric acid poisoning?

A

HEART!
IV line to tx hypocalcemia, wound excision, burn center consult
some pts: intra-arterial calcium infusion or subeschar dilute calcium gluconate

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11
Q

Organic solvents

A

Phenols (chemical disinfectants), Petroleum (creosote, gasoline, kerosene)

  • cutaneous damage due to fat solvent action (cell membrane solvent action)
  • toxic effects on kidneys and liver
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12
Q

tx of chemical burns

A

removal of staruated clothing, brush off powder agents, continuoulsy irrigate w/ lots of water

use litmus pater to get pH to 7 (esp. in eyes

wounds may look superficiatl, but can develop to full thickness in 2-3 days

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13
Q

what is contraindicated for treatment of chemical burns?

A

neutralizeing chemical!!!–think heat generation

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14
Q

Ocular Burns tx

A

*** early irrigation is CRUC. USE 1-2 L OF SALINE OR WATER W/ MORGAN LENS UNTIL PH IS NEUTRAL

-can use topical anesthetic to aid in pain management!

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15
Q

Electrical injury

A

“tip of the Iceberg” the Grand Masquerader

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16
Q

types of electrical injury

A

high voltage= +/= 1000

low V= < 1000 V

17
Q

Alternating Current Burn clinical feature

A

contact sites, but no true entrace/exit sites. causes flexion contraction-sticks to the source

**more dangerous=tetany, death from cardiace fibrillation, respiratory muscle paralysis

18
Q

Direct Current burn clinical feature

A

sudden contractio of muscles, and then thrown off

will se entrance and exit sites

19
Q

extent of electrical injury is dependent on?

A

type, pathway of flow, local tissue resistance, duration

Current =V/R

20
Q

what in the body has high resistance?

A

Skin, bones, and fat!

current flows along bone surface-generated heat damages adjacent muscle

21
Q

complications of electrical injury?

A

higher the R, the more heat is generated leading to heat damage of the muscle groups –> paralysis, LOC, dysrhythmias, Vfib, pulmonary arrest

22
Q

management of electrical burn

A

fasiotomy of extensive muscle damage

Cardiac monitoring for the first 24 hours
1/3 of pts w/ significant electrical injury will require amputation

23
Q

what if you see red pigment urine in a pt w/ an electrical burn?

A

muscle break down! myoglobinuria

tx by increaseing fluid to obtain an urine output of 100 ml/hr

alkalinize uring w/ NaCO2 50 mgEq/L

24
Q

lightning strikes

A

riks is 1/ 280000

kills 80-100 ppl in US annually and associated with 30 % mortality

70% of survivors=serious complications

25
Q

lightning strike chemical features

A

DC, not associated with deep burns, cardiac and neruological damage

26
Q

lichtenberg?

A

fern like dendritic pattern on skin