Chemical Burn (eyes Or Esophagus) - First Aid For Chemical Burns And Their Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

First aid for chemical burns and their treatment

Content:

• First aid for chemical burns
• Chemical eye burn
• Chemical burn of the esophagus
• Chemical burn treatment

A chemical burn is a type of traumatic injury to the skin and mucous membranes of organs caused by exposure to aggressive chemical environments and compounds, accompanied by a violation of their integrity and structure. The rapid introduction of chemical production technologies into everyday life leads to an increase in the number of this type of damage. The most common cases of household chemical burns, characterized by a relatively low severity. Such incidents in production are more dangerous. Sometimes they are the result of a suicide attempt.

Various chemical reagents can be traumatic factors:

1. Acids: hydrochloric, sulfuric, nitric, acetic, hydrofluoric and many others;
2. Alkalis: caustic potassium, sodium and barium;
3. Heavy metal salts: silver nitrate, zinc chloride;
4. Volatile oils: bitumen, phosphorus;
5. Compounds of various chemical nature: pesticides, pesticides, gasoline;
6. Household chemicals: various cleaning powders and liquids, especially for the care of plumbing fixtures.

Regardless of the reason for a chemical burn, its severity will depend on certain factors. They determine the degree of violation of the structure of the affected area and affect the prognosis of the disease. These include:

1. The concentration and nature of the chemical agent, its aggressiveness towards the tissues of the human body;
2. The number and strength with which causal factors act;
3. Exposure (duration of contact) of an aggressive agent on the skin or mucous membranes;
4. The structure and condition of tissues susceptible to traumatic effects;

Naturally, the more aggressive the environment and the duration of its effect on tissues (especially delicate and sensitive ones), the more severe the damage will be.

With regard to the classification of chemical burns by area and degree, it is identical with that of thermal burns. It is based on the possibility of independent reversibility of changes in the area of burnt tissues. It depends on whether or not the growth layer of the skin, which is responsible for the restoration of the structure, is affected, and the extent of the burn. Most often, chemical burns are small in area, but severe in terms of the depth of the lesion. There are such degrees:

1. I - damage to the upper layer (epidermis). It is functionally insignificant, therefore it does not cause severe manifestations and clinically looks like redness of the burned surface with slight swelling and soreness;
2. II - the epidermis and dermis are destroyed up to the papillary layer. This suggests that the vascular and nerve structures of the affected area remain intact. When viewed from such a burn, it looks like bubbles filled with a transparent liquid;
3. III a - damage to the dermis, including the papillary layer, in which microcirculatory elements pass. On examination, such a burn looks like a blister filled with bloody fluid or a bleeding burn wound;
4. III b - destruction of the skin in the entire thickness to the subcutaneous tissue;
5. IV - damage to the skin and deep tissues (adipose, muscle-tendon, bone).

It should be noted about some of the features of chemical burns, consisting in the severity and subtleties of the course, as well as the global differences between acid and alkaline burns. It is the damage by these compounds that is often very deep. Burns by other chemical compounds are in most cases superficial.

Getting on healthy skin, acids lead to its destruction and dehydration, gradually spreading deeper. The result of such processes is the formation of a relatively dense and dry scab from necrotic tissue. Alkaline compounds, on the contrary, causing rapid splitting and saponification of the protein-fat components of the skin, due to which they very quickly penetrate into the deep layers. Such a burn looks like a soft, loose stupa without clear boundaries. These facts determine the long and persistent course of the pathological process, which requires long and active measures to eliminate the problem only in a specialized medical institution.

First aid for chemical burns

The most important thing in this regard is timeliness. The sooner elementary measures are taken, the less the skin will suffer. This is especially important for burns with concentrated substances. The first thing to do is to stop contact of an aggressive environment with the burned surface. All further activities are carried out in a specific sequence.

1. Clean damaged skin from clothing or other items that may also be saturated with chemical compounds.
2. Wash off remaining reagent from burnt areas. For these purposes, cold water is suitable. Important points that must be observed - it must fall on the burn under pressure, or at least drain from it. In no case should it be immersed in a bathtub or wiped off with a towel, napkins or other devices. The duration of the washing procedure should be about half an hour. It depends on how quickly from the moment of receiving the burn, they began to carry it out. If the period exceeds the 15-minute line, and the chemical is quite aggressive, then the duration of the flush should be increased, especially with alkaline burns.
3. If a burning sensation appears some time after rinsing, it is worth repeating the procedure. The criterion for its effectiveness is the absence of discomfort in the absence of deep wounds.
4. Neutralization of aggressive components of a chemical compound in the area of the burn. It should only be carried out if the nature of the substance is known. In case of exposure to acids, the surface is treated with a weak alkali (solution of baking soda in 2% concentration - 300 ml of water with 1 tsp. Of its powder). With alkaline burns, the same solution of acetic or citric acid can act as a neutralizer. If the origin of the compound is not known, the best neutralizer will be water, which is equally effective for any composition of an aggressive environment.
5. Limitation of the burn surface from the environment. Dry dressings are best suited for these purposes. If possible, they can be impregnated with a solution of novocaine, which, upon contact with tissues, will have an analgesic effect. You should not immediately try to expose surfaces to various antiseptics and ointments. Several hours should pass, which will show the degree of the burn and determine further tactics.

Chemical eye burn

It occurs when exposed to aggressive chemical compounds that get on the surface of the cornea or in the conjunctival sac. Since these tissues are delicate and sensitive, any of their chemical burns are considered severe damage and require only specialized treatment. Their danger is the possibility of penetration of chemical particles into the deep layers of the eye and irreversible loss of vision. In other cases, a widespread burn of the cornea is possible, which will not be able to restore its structure.

The clinical manifestations are so vivid that they do not make you hesitate for a long time in providing assistance with such burns. The more aggressive the substance, the more pronounced burning sensation, pain, cramps, lacrimation, photophobia, inability to open the eyes. Even an instant loss of vision or a decrease in its acuity is possible.

First aid measures must be instant. Much will depend on this. As with chemical burns of the skin, it is necessary to wash out and remove the remnants of the chemical compound from the surface of the cornea and conjunctiva. To do this, wash the eyes with a stream of water for at least 15 minutes. It is not necessary to neutralize substances, even in the case of a known nature of the chemical compound. It can only hurt. It is enough to rinse with water, after which a dry bandage and gauze bandage is applied to the eye. All victims, without exception, should be examined by an ophthalmologist.

Chemical burn of the esophagus

This type of injury is severe and requires only specialized treatment. You can get it by accidentally or deliberately drinking a liquid with an aggressive chemical compound. The mucous membrane of the esophagus is very vulnerable and sensitive. Considering the fact that its lumen is in a practically collapsed state, even a small portion of acid or alkali can burn the mucous membrane throughout.

Clinical manifestations of chemical burns of the esophagus are distinguished by a particular severity and progressive development. Immediately after the substance is drunk, there is a burning sensation and pain in the chest, accompanied by vomiting, salivation, difficulty in swallowing and breathing. The victims are rushing about, cannot find a place for themselves because of the pain. Very early signs of intoxication begin to appear in the form of tachycardia (heart palpitations), rapid breathing and a drop in blood pressure up to a state of shock.

The urgency of measures in such conditions is beyond doubt. Therefore, immediately after receiving a burn, it is necessary to rinse the esophagus and stomach with plenty of cold water. If the chemical nature of the damaging agent is known, appropriate neutralizing solutions of weak acids and alkalis can be used immediately for washing. The victim should drink about a liter of water, which, after inducing vomiting, is removed back from the stomach. The total amount of liquid is about 10 liters. After washing for the purpose of anesthesia, you can drink 20-30 ml of a 1% solution of novocaine, a raw egg or Almagel (Almagel A). After that, the patient should be taken to the nearest medical facility.

Chemical burn treatment

All therapeutic measures for the treatment of chemical burns are carried out after establishing its degree, area and localization. Superficial injuries, which include grade 1-2-3A burns, are treated conservatively under ointment or wet-drying dressings. For limited minor burns, general intervention is not required. In case of extensive damage or deep wounds of any prevalence, infusion, detoxification and antibiotic therapy is indicated only in a specialized burn department. All other cases can be treated on an outpatient basis under the supervision of a specialist.

Local surface treatment for chemical burns pursues the following goals: antibiotic prophylaxis, creating an optimal environment for healing, accelerating regenerative and reparative processes in the wound. For burns of the skin in the early stages, ointments are used on a water-soluble basis (levomekol, oflokain, syntomycin, levosin), which contribute to the rejection of necrotic tissues and cleanse the wound. At the first degree of a burn, you can lubricate the affected areas with ointments rescuer, agrosulfan, betadine, bepanten, panthenol. In the case of deeper damage, they are connected at the stage of wound regeneration. From antiseptics, neutral agents with good antimicrobial properties are shown (chlorhexidine, dioxidine, dekasan).

See also the article: How to get rid of a burn at home?

Deep burns of the skin and underlying tissues are subject to surgical treatment. Surgical interventions are carried out in the long term, after a clear limitation of the burn. They include necrectomy (removal of non-viable tissue within healthy tissue) and plastic replacement of the resulting wound defects. For these purposes, donor skin of the patient from healthy areas or various types of xenocarbon are used.

In the treatment of chemical burns of the esophagus, the most important value belongs to early anti-shock infusion therapy and bougienage. The last event is aimed at preventing stenosis (narrowing) and obstruction of the esophagus, and begins a week after receiving a burn.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.