Chemical burn


Chemical burn

Description, Causes and Risk Factors:

A chemical burn is irritation and destruction of human tissue caused by exposure to a chemical, usually by direct contact with the chemical or its fumes. Chemical burn can occur in the home, at work or school, or as a result of accident or assault.

Chemical burn

The depth or degree of burn depends on which layers of skin are damaged or destroyed. The epidermis is the outer layer that forms the protective covering. The thicker or inner layer of the dermis contains blood vessels, hair follicles, nerve endings, sweat and sebaceous glands. When the dermis is destroyed, so are the nerve endings that allow a person to feel pain, temperature, and tactile sensation.

Types:

    Superficial. Very painful, dry, red burns which blanch with pressure. They usually take 3 to 7 days to heal without scarring. Also known as first-degree burns. The most common type of first-degree burn is sunburn. First-degree burns are limited to the epidermis, or upper layers of skin.

  • Superficial partial-thickness. Very painful burns sensitive to temperature change and air exposure. More commonly referred to as second-degree burns. Typically, they blister and are moist, red, weeping burns which blanch with pressure. They heal in 7 to 21 days. Scarring is usually confined to changes in skin pigment.

  • Deep partial-thickness. Blistering or easily unroofed burns which are wet or waxy dry, and are painful to pressure. Their color may range from patchy, cheesy white to red, and they do not blanch with pressure. They take over 21 days to heal and scarring may be severe. It is sometimes difficult to differentiate these burns from full-thickness burns.

  • Full-thickness. Burns which cause the skin to be waxy white to a charred black and tend to be painless. Healing is very slow, if at all, and may require skin grafting. Severe scarring usually occurs.

Tissue damage determined by:

    Strength/concentration.

  • Manner of contact.

  • Quantity of agent.

  • Phase (liquid/solid).

  • Duration of contact.

  • Mechanism of action.

  • Extent of penetration.

Many chemical burns occur accidentally through misuse of products such as those for hair, skin, and nail care. Although injuries do occur at home, the risk of sustaining a chemical burn is much greater in the workplace, especially in businesses and manufacturing plants that use large quantities of chemicals.

Most chemical burns are caused by either strong acids or strong bases. Acids damage and kill cells by coagulating cells while bases liquefy cells. Prolonged exposure can severely damage human tissues and, if the patient survives, leads to scarring and disability. Other chemicals like oxidants and certain metals may also produce similar chemical burns. Limiting the time of exposure to any of these chemicals can greatly reduce their damaging effects.

A variety of common household products that may cause chemical burns are as follows:

    Bleach.

  • Concrete mix.

  • Drain or toilet bowl cleaners.

  • Metal cleaners.

  • Pool chlorinators.

Symptoms:

Signs and symptoms of chemical burns include the following:

    Redness, irritation, or burning at the site of contact.

  • Pain or numbness at the site of contact.

  • Formation of blisters or black dead skin at the contact site.

  • Vision changes if the chemical gets into the eyes.

  • Cough or shortness of breath.

  • Vomiting.

Diagnosis:

In the emergency department, a person can expect the following:

    Initial evaluation and stabilization.

  • Rapid evaluation of the chemical's ability to damage tissue.

  • Determination of the extent of injury.

  • Blood tests and other studies to determine if the patient should be admitted to the hospital.

  • Determination of additional injuries and treatment.

Treatment:

Most people with minor chemical burns do not need to be admitted. Most can go home after arranging follow-up care with a doctor. Patients with major chemical burns however, need to be admitted to a hospital. Ingestion or inhalation of chemical burns may need to be admitted for observation, depending on the potential severity of tissue damage.

Other treatment options include:

    Irrigation.

  • Debridement of devitalized tissue/particles.

  • Topical antimicrobials.

  • Tetanus Td.

  • Aggressive IVF replacement.

  • Analgesics.

  • Allergic RXN (reaction): antihistamines, steroids, epinephrine.

  • Surgical excision: if ongoing tissue destruction.

  • Grafts: full thickness.

  • Hyperbaric oxygen.

Preventive measures:

    Secure all chemicals, in and out of the home, in locked cabinets or out of the reach of children.

  • People should always follow directions and safety precautions on the label provided by the manufacturer when using any chemicals.

  • Wear safety gloves clothing and eye protection when using most chemicals, and remember - safety first!

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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