chemical burns Flashcards
Chemical Burns most common
Alkalis, acids, organic compounds (petroleum products)
tx of burns from white phosphorous?
neutralization w/ 1% copper sulfate solution and administration of calcium gluconate gel to address the concomitant hypocalcemia
Alkalis
hydroxides, carbonates, caustic sodas of Na, K, ammonium, Li, Ba, Ca (oven cleaners, drain cleaners, fertilizers, industrial cleaners)
structural bond for cement
CF of alkali burn
worse than acid!! tissue damage by liquefaction necrosis and protein denaturation
Acids
HCl in bathroom cleaners, oxallic and HFl (rust removers) pool cleaners, sulfuric acid in drain cleaners,
Acid CF
tissue damage by coagulation necrosis and protein precipitation
Hydrofluoric Acid
Industrial use: o Etch glass o Teflon o Clean semiconductors o Home use – rust removers
*weak acid, but F- is very toci
CF of hydrofluoric acid
severe pain for 6-8 hours, tissue necrosis, hypocalcemia bc F binds to free serum calcium
Tx of hydoflouric acid
- 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
what do you need to monitor in a hydroflouric acid poisoning?
HEART!
IV line to tx hypocalcemia, wound excision, burn center consult
some pts: intra-arterial calcium infusion or subeschar dilute calcium gluconate
Organic solvents
Phenols (chemical disinfectants), Petroleum (creosote, gasoline, kerosene)
- cutaneous damage due to fat solvent action (cell membrane solvent action)
- toxic effects on kidneys and liver
tx of chemical burns
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
what is contraindicated for treatment of chemical burns?
neutralizeing chemical!!!–think heat generation
Ocular Burns tx
*** 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!
Electrical injury
“tip of the Iceberg” the Grand Masquerader