Light chemical burn: Chemical burns: First aid – Mayo Clinic
Chemical burns: First aid – Mayo Clinic
Chemical burns can be caused by many substances, such as strong acids, drain cleaners (lye), paint thinner and gasoline. Usually, you are aware of the burn and its cause. But sometimes you may not immediately recognize a burn caused by a milder chemical. As with some sunburns, the pain and redness may develop hours after the exposure.
When to seek emergency care
Call 911 or seek immediate care for a chemical burn in which the burn:
- Is deep
- Covers an area larger than 3 inches (about 8 centimeters) in diameter
- Covers the hands, feet, face, groin, buttocks or a major joint
If you’re unsure whether a substance is toxic, call Poison Help at 800-222-1222 in the United States. If you seek emergency medical help, take the chemical container or the name of the chemical with you to the emergency department.
Treating chemical burns
If you think you have a chemical burn, take these steps immediately:
- Remove the cause of the burn. Flush the chemical off the skin with cool running water for at least 10 minutes. For dry chemicals, brush off any remaining material before flushing. Wear gloves or use a towel or other suitable object, such as a brush.
- Remove clothing or jewelry that has been contaminated by the chemical.
- Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton) or a clean cloth. Wrap it loosely to avoid putting pressure on burned skin.
- Flush again if needed. If you experience increased burning after the initial flushing, flush the burn area with water again for several more minutes.
Make sure that your tetanus booster is up to date.
Feb. 08, 2018
- What to do in a medical emergency. American College of Emergency Physicians. http://www.emergencycareforyou.org/Emergency-101/Emergencies-A-Z/Burns/. Accessed Nov. 24, 2017.
- Kermott CA, et al. , eds. Emergencies and urgent care. In: Mayo Clinic Guide to Self-Care. 7th ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Burns. Merck Manual Professional Version. http://www.merckmanuals.com/professional/injuries_poisoning/burns/burns.html?qt=burns&alt=sh#v1112914. Accessed Nov. 24, 2017.
- Walls RM, et al. Chemical injuries. In: Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Nov. 24, 2017.
Causes, Symptoms, Treatment, Prevention, Care
What Are Chemical Burns?
Chemical burns are injuries to the skin, eyes, mouth, or internal organs caused by contact with a corrosive substance. They may also be called caustic burns.
Chemical burns can happen in the home, at work, or at school. They can result from an accident or an assault. Although few people in the United States die after contact with chemicals in the home, many substances common in living areas and in storage areas can do serious harm.
Many chemical burns happen accidentally through misuse of products such as those for hair, skin, and nail care. Although injuries do happen 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.
Types of Chemical Burns
Chemical burns are classified like other burns based on the amount of damage done:
- Superficial or first-degree burns only affect the outer layer of skin, called the epidermis. The area will be red and painful, but there usually is no permanent damage.
- Partial thickness or second-degree burns extend into the second layer of skin called the dermis. You may have blisters and swelling, and it may leave scars.
- Full thickness or third-degree burns go through the skin and may damage tissue underneath. The area may look black or white. Because nerves are destroyed, you may not feel pain.
Chemical Burn Causes and Risk Factors
Most chemicals that cause burns are either strong acids or bases. A glance at the medical information on the labels of dangerous chemicals confirms the expected toxicity. Commonsense precautions and consumer education can reduce your family’s risk of injury. A variety of household products can cause chemical burns, including:
- Battery acid
- Concrete mix
- Drain or toilet bowl cleaners
- Metal cleaners
- Pool chlorinators
- Tooth-whitening products
Infants and older people are most at risk for burns. Chemical burns tend to happen to:
- Young children exploring their environments who get their hands on something dangerous
- People whose jobs put them in contact with chemicals
Chemical Burn Symptoms
Chemical burn of the skin.
Chemical burn of the eye.
All chemical burns should be considered medical emergencies. If you have a chemical burn of the mouth or throat, call 911 and seek immediate medical attention.
Most chemical burns happen on the face, eyes, arms, and legs. Usually a chemical burn will be relatively small and will require only outpatient treatment. Chemical burns can be deceiving, however. Some agents can cause deep tissue damage not readily apparent when you first look at it.
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 your eyes
- Cough or shortness of breath
Tissue damage from chemical burns depends on several things, including:
- The strength or concentration of the chemical
- The site of contact (eye, skin, mucous membrane)
- Whether it’s swallowed or inhaled
- Whether or not skin is intact
- How much of the chemical you came into contact with
- Duration of exposure
- How the chemical works
In serious cases, you may develop any of the following:
Emergency Medical Care for Chemical Burns
Any chemical burn can be a legitimate reason to get emergency medical help. Always call 911 if you don’t know how severe the injury is or whether or not the person is medically stable. Also call 911 if you have any concerns about a chemical injury.
Emergency personnel are trained to assess the extent of a chemical burn, begin treatment, and take patients to the hospital.
Emergency workers also may determine the need for more involved decontamination of both you and the accident site prior to going to the hospital. When you contact 911, tell the dispatcher as much of the following information as possible:
- How many people are injured and the location where they are
- How the injury happened
- Whether emergency personnel can reach the victims or whether the victims are trapped
- Name, strength, and volume or quantity of the chemical causing the burn (Give a container of the chemical to emergency personnel, if possible.)
- Length of time of contact with the chemical
Always seek emergency care for any burn that is larger than 3 inches in diameter or is very deep. Also seek emergency care for any chemical burns involving the face, eyes, groin, hands, feet, or buttocks or if it is over a joint.
Even if the exposure was very small and you have completed basic first aid, call your doctor to review the injury and the chemical involved and to make sure no further emergency treatment is needed. The doctor can arrange appropriate treatment or will direct you to go to a hospital’s emergency room. If you’re the person with the burn, ask your doctor if you need a tetanus shot.
Chemical Burn Diagnosis
In the emergency room, you can expect the following:
- Initial evaluation and stabilization
- Rapid evaluation of the chemical
- Determination of the extent of injury
- Blood tests and other studies to determine if you should be admitted to the hospital
Most people with chemical burns do not need to be admitted. Most can go home after arranging follow-up care with their doctor. In severe cases, however, they may need to be admitted to a hospital.
Chemical Burn Treatment
As soon as you or your child have contact with a dangerous chemical, begin basic first aid. Call Poison Control at 800-222-1222 if you do not know whether the chemical is toxic.
Immediately call 911 if you have a severe injury, any shortness of breath, chest pain, dizziness, or other symptoms throughout your body. If you are aiding an injured person with these symptoms, lay the person down and immediately call 911.
- Remove yourself or the person with the burn from the accident area.
- Remove any contaminated clothing.
- Wash the injured area to dilute or remove the substance, using large volumes of water. Wash for at least 20 minutes, taking care not to allow runoff to contact unaffected parts of your body. Gently brush away any solid materials, again avoiding unaffected body surfaces.
- Especially wash away any chemical in your or the person’s eye. Sometimes the best way to get large amounts of water to your eye is to step into the shower.
- IV fluids may be needed to normalize blood pressure and heart rate.
- The IV access may also be used for any medications needed to treat pain or protect against infection.
- Decontamination will begin (likely water irrigation).
- You will be given any antidote to counteract the chemical, if appropriate.
- Antibiotics often are not needed for minor chemical burns.
- Wounds will be cleaned and bandaged with medicated creams and sterile wraps as needed.
- Consultation with other medical specialists may be done.
- Pain from a burn can often be severe. Adequate pain control will be addressed by your doctor.
- If there is any indication of breathing problems, a breathing tube may be placed in your airway to help.
- If needed, a tetanus booster will be given.
- Itching as a burn heals can be a serious problem. You may need special medication to soothe it.
- For severe burns, you may need surgery. In a process called skin grafting, a piece of healthy skin from somewhere else on your body or from a donor can be transplanted to replace the damaged skin.
- Cosmetic or reconstructive surgery may be needed to deal with scarring.
- Physical and occupational therapy can keep scars from limiting your range of motion.
- Counseling and support groups can help with emotional issues caused by trauma from the injury or disfigurement.
Chemical Burn Follow-Up
After leaving the emergency department, call your doctor within 24 hours to arrange follow-up care. Call sooner if any new problems or concerns arise.
Chemical Burn Complications
Serious chemical burns can cause long-term complications:
- Many people have pain and scarring.
- Burns in the eye can lead to blindness.
- Swallowing harmful chemicals can lead to problems in your gastrointestinal tract, potentially leading to permanent disability.
- Some acid burns can cause the loss of fingers or toes.
- Burns can cause emotional issues including anxiety, depression, and insomnia.
Chemical Burn Prevention
- Secure all chemicals in and out of the home in locked cabinets or out of the reach of children.
- Store chemicals in their original containers.
- Try to use chemicals as little as possible, and don’t let them touch your skin.
- When using chemicals, always follow directions and safety precautions on the label provided by the manufacturer.
- Make sure your work area is well ventilated.
- Wear safety clothing and eye protection, and remember, safety first!
Chemical Burn Outlook
Most chemical burns are minor and can be treated without causing long-term problems. Some burns, however, cause significant scarring or other medical complications.
First Aid for Chemical Burns
Note: If a chemical has beenswallowed that may be a poison or may cause burning in the throat and esophagus, call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. When you call the Poison Control Center, have the chemical container with you, so you can read the content label to the Poison Control staff member. The Poison Control Center can help determine what steps to take next.
Most chemical burns of the skin are treated first by rinsing (flushing) the chemical off your body with a large amount of room temperature water, but not all chemicals are treated this way. It is important to treat the burn correctly to avoid further complications.
Chemical burns rinsed with water
- Flush the area for at least 20 minutes.
- Do not use a hard spray of water, because it can damage the burned area.
- Have the person with the burn remove the chemical substance if he or she is able.
- Put on gloves to protect yourself from the chemical, if you need to remove it.
- As you flush the area, take off any clothing or jewelry that has the chemical on it.
- If the area still has a burning sensation after 20 minutes, flush the area again with flowing water for 10 to 15 minutes.
Hydrofluoric acid is flushed with a large amount of water and treated with calcium gluconate. You need immediate medical care.
Chemical burns not rinsed with water
Some chemical burns are made worse if rinsed (flushed) with water.
- Carbolic acid or phenol does not mix with water, so use isopropyl (rubbing) alcohol first to flush the chemical off the skin and then flush with water. If alcohol is not available, flush with a large amount of water. Do not flush the eye with alcohol.
- Sulfuric acid is flushed with a mild, soapy solution if the burns are not severe. Sulfuric acid feels hot when water is added to the acid, but it is better to flush the area and not leave the acid on the skin.
- Dry powders, such as dry lime, are brushed away first, because adding water can make a liquid that burns. After the powder is brushed away, flush with water for 20 minutes.
- Metal compounds are covered with mineral oil.
The most important first aid for a chemical in the eye is to immediately flush the substance out with large amounts of water to reduce the chance of serious eye damage. For any chemical burn to the eye, see the topic Burns to the Eye.
If evaluation by your doctor is necessary, take the chemical container with you.
Current as of:
February 26, 2020
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP – Emergency Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
H. Michael O’Connor MD – Emergency Medicine
Martin J. Gabica MD – Family Medicine
Current as of: February 26, 2020
Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & H. Michael O’Connor MD – Emergency Medicine & Martin J. Gabica MD – Family Medicine
How to Treat a Chemical Burn| Banner Health
Chemical burns are one of the most common burn hazards in the workplace, but they can also happen at any place, at any time. You might not realize how many chemicals you come in contact with on a regular basis that could pose a potential risk as well.
A chemical burn occurs when your skin or eyes come in contact with acidic or alkaline chemicals. Burns can also occur when someone inhales or eats these substances.
To better understand chemical burns, we sought the expertise of Lyndsay Deeter, MD, a burn surgeon and the director of the Western States Burn Center at North Colorado Medical Center.
Common Causes of Chemical Burns
Some of the most common products you might come in contact with at home, work and outside of the home may include:
- chlorine and swimming pool products
- oven cleaner
- paint thinners
- dental cleaners and teeth whitening products
Symptoms of a Chemical Burn
Typically, you’ll be aware of the burn and what caused it, but some of the effects might not be apparent until later.
In general, common symptoms associated with chemical burns include:
- Irritation, redness or burning
- Changes or loss of vision if your eyes came in contact with the chemical
- Pain and numbness
- Skin appears white and pale (seen with alkalotic burns)
Treating a Chemical Burn
If someone experiences a chemical burn, Dr. Deeter recommended the following first-aid steps:
- Check and ensure the area is safe and remove any contaminated clothing and jewelry.
- Brush dry chemicals off the skin with a glove or towel first before flushing.
- Rinse the exposed area right away with running water for at least 20 minutes. This removes the chemical and stops the burning process, which hopefully leads to a less significant injury.
- Cover with a clean, dry dressing that is not too tight. Tight wraps can cause a tourniquet effect as the injury area swells.
- Seek medical attention immediately.
If a chemical splashes in someone’s eyes, rinse their eyes right away and call 911. Continue rinsing until medical help arrives. If they wear contacts, make sure those are removed.
Preventing Chemical Burns at Home
“While many of these types of burns occur in a work-setting, they can definitely occur at home as well,” Dr. Deeter said. “Make sure to follow safety protocols and practices at work and take special care at home to follow safety procedures and take precautions.”
Some of these precautions include:
- Wear appropriate protective equipment
- Keeping chemicals out of reach of children and away from food and drinks
- Storing chemicals properly and safely
- Wear protective gear at all times
- Use chemicals in a well-ventilated area
- Avoid mixing chemicals with other chemicals
- Leave chemicals in their original containers
- Acquaint yourself with the chemicals you’ll be working with at work and at home by reading the labels
- Call the poison control center at 1-800-222-1222 if you are unsure whether a certain substance is toxic
Seek Immediate Medical Attention
If you’ve suffered a chemical burn, don’t wait.
“All burns should be considered a potential medical emergency,” Dr. Deeter said. “Although the burn may not be readily apparent, it could have caused deep tissue damage.”
To locate a Banner Health urgent care or emergency care or medical provider near you, visit bannerhealth.com.
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Acid and chemical burns – NHS
Recovering from a chemical burn
Minor burns affecting the outer layer of skin and some of the underlying layer of tissue normally heal with good ongoing burn care, leaving minimal scarring.
Your dressing will need to be checked and changed regularly until the burn has completely healed to help prevent infection.
If the burn is severe, you may be referred to a specialist burns unit, which may be in a different hospital. You may stay in hospital for a number of days.
You may need surgery to remove the burnt area of skin and replace it with a section of skin (a graft) taken from another part of your body. See plastic surgery techniques for more information.
More severe and deeper burns can take months or even years to fully heal and usually leave some visible scarring. In some cases, the depth and location of the burn may also lead to problems such as sight loss or restricted use of limbs or muscles.
Specialist burns teams include occupational therapists, physiotherapists and mental health professionals who can support your recovery. For chemical burns affecting the eyes, you’re also likely to be urgently assessed by an eye specialist to help minimise the risk of lasting vision loss.
If you’ve been the victim of an attack and continue to feel upset, anxious or afraid several days after the incident, you can ask to be referred to the hospital’s mental health liaison team for support and treatment. Anyone with an existing mental health problem who has suffered an attack should also be referred to this team.
Burns support groups also provide practical and emotional support to victims and their families. Your care team should be able to signpost you to local groups, and the following national organisations can also help:
- Changing Faces provides support for people whose condition or injury affects their appearance
- Victim Support provides help and advice to victims and witnesses of crimes
- Katie Piper Foundation provides specific help for victims and families of acid attacks and other burns
Chemical burn | DermNet NZ
Author: Vanessa Ngan, Staff Writer, 2007.
What is a chemical burn?
Chemical burn is a burn to internal or external organs of the body caused by a corrosive or caustic chemical substance that is a strong acid or base (also known as alkali). Chemical burns are usually the result of an accident and can occur in the home, at school or more commonly, at work, particularly in manufacturing plants that use large quantities of chemicals.
Very mild chemical burns result in irritant contact dermatitis. Chemical burn from a strong acid or alkali is also known as a caustic burn.
What causes a chemical burn?
The main cause of chemical burn is contact with strong acids or bases.
- The strength of acids and bases is defined by the pH scale, which ranges from 1–14.
- A very strong acid has a pH of 1 and may cause a severe burn.
- A very strong base has a pH of 14 and may also cause a severe burn.
- A substance with a pH of 7 is considered neutral and does not burn.
Sulphuric acid – concentration ranges from 8% to almost pure acid
- Toilet bowl cleaners
- Drain cleaners
- Metal cleaners
- Car battery fluid
- Fertiliser manufacturing
- Used in engraving, metal refining, electroplating and fertiliser manufacturing
Hydrofluoric acid – a weak acid and in a dilute form does not burn or cause pain on contact
- Rust removers
- Tyre cleaners
- Tile cleaners
- Glass etching
- Dental work
Hydrochloric acid – concentrations range from 5–44%
- Toilet bowl cleaners
- Metal cleaners
- Swimming pool cleaners
- Dye manufacturing
- Metal refining
- Metal cleaners
- Disinfectants, detergents
- Fertiliser manufacturing
Sodium hydroxide and potassium hydroxide — depending on the concentration — may be very corrosive
- Drain cleaners
- Oven cleaners
- Denture cleaners
Sodium and calcium hypochlorite
- Household bleach
- Pool chlorinating solution
- Cleaners and detergents used in dilute form are not highly corrosive
- Gaseous anhydrous ammonia used in fertilising manufacturing can cause severe burns
- Many household detergents and cleaners
What are the signs and symptoms of chemical burn?
The signs and symptoms of a chemical burn depend on several factors, including:
- pH of the agent
- Concentration of the agent
- Length of contact time
- Amount of agent involved
- Physical form of the agent (ie: solid, liquid, gas)
- Site of contact (e.g. eye, skin, mucous membrane)
- Whether swallowed or inhaled
- Whether or not skin is intact.
Swallowing a solid pellet of an alkaline substance highlights the importance of these factors. The solid pellet sits in the stomach for a longer period, thus more severe burns sustained. Another important factor is concentrated forms of some acids and bases generate a large amount of heat when diluted; this results in a thermal burn as well as a chemical burn.
Some signs and symptoms of chemical burns include:
- Redness, irritation, or burning at the site of contact
- Pain or numbness at the site of contact
- Formation of black dead skin (eschar) — this occurs particularly with acid chemical burns as they produce a coagulation necrosis by denaturing proteins
- Deep tissue injury to the skin is caused by alkali chemical burns, as they produce a liquefaction necrosis that involves denaturing of proteins as well as saponification of fats
- Vision changes or complete loss of vision if chemicals get into the eyes.
In severe chemical burns where the agent has been swallowed, inhaled or absorbed into the bloodstream, the following systemic symptoms may occur.
- Cough or shortness of breath
- Low blood pressure
- Faintness, weakness, dizziness
- Muscle twitching or seizures
- Cardiac arrest or irregular heartbeat
What is the management of a chemical burn?
Basic first aid should be administered as soon as a chemical burn has occurred.
- Remove contaminated clothing
- Irrigate the affected area with copious amounts of water. Wash for at least 20 minutes, taking care not to allow runoff to contact unaffected areas. It has been shown that irrigation received within 10 minutes of the burn reduces the severity of the wound and time of stay in hospital.
Chemical burns involving elemental metals (lithium, potassium, sodium and magnesium) should not be irrigated with water as this can result in a chemical reaction that causes burns to worsen. These types of chemical burn should be soaked with mineral oil while waiting for medical attention.
People with minor chemical burns do not require hospitalisation. For more severe burns, patients should receive treatment as for a typical thermal burn patient. In some situations an antidote may be given to counteract the offending chemical agent. For example, hydrofluoric acid burns should be promptly treated with calcium gluconate gel applied every 15 minutes, so the gel should be kept at relevant work sites.
The main treatment aims of burn wound management are:
- Carefully monitor wound
- Keep wounds clean
- Prevent the wound drying out
- Manage secondary infection.
Commonly used topical antibacterials include 1% silver sulfadiazine cream, 0.5% silver nitrate solution and mafenide acetate 10% cream.
Treating chemical burns | 2017-02-26
Are chemicals used in your workplace? Mayo Clinic notes that chemical burns can be caused by a variety of substances, including strong acids, drain cleaners, paint thinners and gasoline.
A worker who receives a severe chemical burn may go into shock – a life-threatening condition that requires emergency medical care. Signs of shock include fainting, a pale complexion and very shallow breathing.
Source: National Safety Council’s “First Aid, CPR & AED” course. Learn more about NSC first aid and CPR training – including online and classroom training for learners, and courses and materials for instructors. © 2015 National Safety Council
According to Mayo Clinic, other reasons to seek medical care for a chemical burn include the following:
- The burn penetrated the first layer of skin.
- The burn area is more than 3 inches in diameter.
- The burn “encircles a limb or involves the eyes, hands, feet, face, groin or buttocks, or a major joint.”
If you determine that medical attention is needed, bring the name of the chemical or its container with you.
Chemical burns can be tricky. Sometimes you may not realize what caused a burn because symptoms develop hours after exposure. However, if you immediately recognize that you have suffered a mild chemical burn, Mayo Clinic recommends you take the following steps:
- Get the chemical off of you. For dry chemicals, put on gloves and brush off any material with a towel or similar item.
- Take off any contaminated clothing or jewelry to help prevent further injury.
- Immediately rinse the burn area by running a gentle but steady stream of cool water over the affected area for at least 10 minutes. As you clean yourself, be sure to protect your eyes.
- Apply a loose gauze or bandage to the affected area.
- Take a pain reliever as needed, such as ibuprofen, acetaminophen or naproxen.
- Check with your health care provider to see if you should receive a tetanus shot or booster. Medical experts recommend getting a tetanus shot every 10 years.
Chemical burns of the esophagus in children
Chemical burns of the esophagus in children
Burns of the esophagus with chemical compounds in children are the most common type of traumatic injury to the esophagus. Burns occur after swallowing concentrated solutions of alkalis and acids. The most frequently affected are children between the ages of 1 and 3, who, due to an oversight of adults, taste everything.
The depth and severity of the burn depends on the concentration and chemical nature of the substance, as well as its amount and time of contact with the mucous membrane.
Degrees of chemical damage
There are three degrees of chemical damage to the esophagus:
- Grade 1 – the mildest, manifested by edema and redness of the surface layers of the esophagus. The edema goes away within three days from the moment of injury, and the complete restoration of the epithelium occurs after 7 days;
- 2 degree – more severe, manifested by necrosis of the mucous membrane and the appearance after 3 weeks of tender scars at the site of injury, which do not narrow the lumen of the esophagus;
- Grade 3 – the most severe, characterized by complete damage to the mucous and submucous layer of the esophagus, up to damage to its muscular apparatus.Most often, after 4 weeks from the moment of injury, coarse scar tissue appears, which deforms the esophagus and narrows its lumen.
Why are chemical burns of the esophagus dangerous?
After swallowing a chemical, the child becomes restless, cries, vomits, sometimes with blood.
In case of damage to the upper respiratory tract in children, shortness of breath and impaired breathing occurs.
The most severe damage is observed due to the absorption of a chemical into the bloodstream, with a disruption in the functioning of the liver and kidneys, which is manifested by the clinic of acute renal or hepatic failure.
After injury, all children must be examined by a doctor, followed by gastric lavage!
In almost all children, on the 5-6th day, the condition improves, they begin to swallow food, salivation and vomiting stop.
With burns of 1 and 2 degrees, the esophagus is completely restored. With grade 3 burns, the improvement is temporary. At 4 weeks after injury, there is a clinic of obstruction of the esophagus – difficulty in swallowing, vomiting, salivation.At first, children can only take liquid food, and after a while they do not swallow saliva. Exhaustion develops gradually.
How to treat a chemical burn of the esophagus?
In order to prevent narrowing of the esophagus in the early post-burn period, bougienage is performed . For bougie use bougie of a certain size, depending on the age of the child. The number and frequency of bougienage is determined after control endoscopy 3 weeks after injury.With deep burns, bougienage is first performed once a week for 3 months, then 2 times a month, and then once a month for six months. All bougienage sessions are performed under the control of an endoscope. With the correct bougienage, the outcome is most often favorable.
However, after burns resulting from the swallowing of concentrated solutions of acids and alkalis, the formation of an extended esophageal stenosis most often occurs, which requires surgical intervention.
Laser recanalization is used for dense scars, which practically cannot be stretched during bougienage.The scar is dissected in several radial directions. After the action of the laser on the scar tissue, they undergo qualitative changes – they become more pliable and elastic, which allows you to continue bougienage and get good results.
Stenting is an endoscopic prosthetics of the esophagus using special stents that have a mesh structure. This method of treating esophageal burns helps to consolidate the result after balloon dilations and laser recanalization.The duration of a stent in the body can be months or years. The procedure is performed under general anesthesia. During endoscopy, the stent is inserted into the esophagus in a folded state using a special guidewire. After removing the conductor, it expands and expands the narrowed esophagus to physiological dimensions.
Surgical treatment for chemical burns of the esophagus is performed if it is impossible to perform stenting of the esophagus or continue prophylactic bougienage due to complete obliteration of the esophagus, the appearance of fistulas, as well as due to the occurrence of multiple diverticula or damage to the esophagus during endoscopic procedures.In these cases, intestinal plastic is performed using a large intestine or small intestinal transplant.
Treatment in Belarus is the guarantor of recovery
The leading center for pediatric surgery provides medical care to children with burns of the esophagus at a high professional level. Here you will find not only high-quality medical care, but also a responsive, attentive attitude to your problem.
In order to be able to come for treatment at the Republican Scientific and Practical Center for Pediatric Surgery, contact us through the consultation form or by phone – we will answer all questions, help calculate the cost of treatment and book a place in the clinic.
90,000 What you need to know about throat burns
26 August 2016
In the event of a burn (chemical or thermal), difficulty in swallowing, belching, and sometimes vomiting occur. There may be pain behind the sternum along the esophagus, especially after eating. In the oral cavity, esophagus, pharynx, redness, necrotic plaques appear, which bleed easily when eating. Life-threatening complications are possible: perforation of the esophagus and stomach wall, mediastinitis, peritonitis, laryngeal edema. After a while (if there are no complications – about 2 weeks), these signs subside, and a period of apparent improvement begins (more often on the 8-12th day).The patient’s condition improves, he can eat not only liquid, but also solid food. However, after 2-4 months, narrowing of the esophagus develops.
To prevent complications, much depends on the urgency and correctly carried out first aid measures, which consists, first of all, in eliminating the cause of the burn, stopping the action of thermal or chemical factors, preventing complications – cicatricial changes in the esophagus leading to its narrowing. At the first moment after a chemical burn of the esophagus, it is necessary to drink abundantly (in particular, milk), swallow pieces of ice, a solution of novocaine, vegetable oil, consume raw egg protein, gargle with antiseptic agents.
Immediately flush the stomach with a neutralizing liquid (through a tube). In case of acid poisoning, an alkali is used, for example, a 10% solution of magnesium oxide (burnt magnesia), milk of lime. Alkalis are neutralized with acids, for example, a 0.1% solution of acetic or hydrochloric acid. At the same time, a good result is noted in cases where neutralization was performed in the first hours after the burn.
In case of shock, prescribe cardiovascular drugs (korglikon, camphor, cardiamin), pain relievers.The patient is given humidified oxygen, an ice pack is placed on the epigastric region, while it is necessary to warm the patient, give him a warm drink.
To prevent irritation of the mucous membrane of the pharynx and esophagus in the first time after the burn, the food should be liquid, slightly salted, then salt is gradually added to it. Fresh tea leaf juice, tea extract or powdered dry tea are effective.
What should be done to prevent burns of the esophagus? For the prevention of a burn, and subsequently – narrowing of the esophagus and heavy operations to create an artificial esophagus from the intestine or the patient’s skin, care must be taken in storing hazardous substances that cause burns.This especially applies to vinegar essence, caustic soda, various acids. If these potent substances really need to be kept at home, then the vinegar essence can be replaced with a weak solution of acetic acid, and caustic soda – with washing powders. When a large amount of poison is drunk, there can be not only complications, but also severe poisoning, leading to inevitable death, especially when help is belated. All these substances should be stored where children are not, since they are more likely to have severe poisoning and burns of the esophagus, leading to disability. You cannot treat esophageal burns at home!
90,000 Animal burns: treatment and types of burns
Animals are inherently very curious creatures. They love to explore everything – literally every corner of the apartment. And also many pets, also out of curiosity, can eat something. Sometimes it happens that, for example, a cat, jumping onto a kitchen cabinet or stove, can burn the pads of its paws, or overturn a hot pot. Also, substances absorbed by animals without the knowledge of their owners can burn the animal’s mouth, esophagus, and stomach.This problem has always been, is and will be, since the animal’s curiosity cannot be taken away. Therefore, one must always be vigilant and be able to quickly provide assistance to an animal.
Burn – damage to body tissues caused by high temperatures or the action of certain chemicals (alkalis, acids, salts of heavy metals and others).
There are 4 degrees of burn:
- skin redness,
- necrosis of the entire thickness of the skin,
- tissue carbonization.
The severity of the burn is determined by the size of the area and the depth of tissue damage. The larger the area and the deeper the tissue damage, the more severe the course of the burn injury. First aid for burns consists in stopping the influence of external factors and treating the wound.
Contents of the article
Causes of burns
Burns can be caused by a variety of reasons, which are characterized by their manifestations and signs of damage. Burns can be provoked by:
- thermal factors;
- electric current;
- radiation exposure;
- bacteria (so-called fire blight).
All of these factors can affect to varying degrees, so the burn will have its own manifestations and require an individual approach to treatment.
Varieties of burns
- The most common are thermal burns , that is, those resulting from exposure to:
- Fire. The upper respiratory tract and muzzle are very often damaged.
- Boiling water. The area may be small, but the depth is significant.
- Pair. Such defeat usually does not cause many problems.
Incandescent Objects: These tend to leave clear boundaries and deep lesions.
In case of thermal burn, the degree of injury depends on several factors:
- duration of exposure;
- degree of thermal conductivity;
- general health and skin of the victim.
- Chemical burn is damage to the skin or mucous membranes as a result of exposure to various aggressive substances, for example: acids (after such exposure, the lesion is usually shallow), alkalis; heavy metal salts such as silver nitrate, zinc chloride, which most often cause superficial skin burns.
- Electrical burns can occur from contact with conductive materials. The current quickly spreads through muscles, blood, cerebrospinal fluid. A distinctive feature of electric shock is the presence of an entry and exit point. This is the so-called current label. The affected area is usually small but deep.
Radiation burns can be associated with:
- With ultraviolet radiation. Such burns can easily be earned by lovers of sunbathing at noon.The area of the lesion is usually large, but most often it is possible to cope with the help of home remedies.
- With exposure to ionizing radiation. In this case, not only the skin is affected, but also the neighboring organs and tissues.
- With infrared radiation. It often causes burns to the cornea, retina, and skin. The defeat depends on the duration of the impact of this negative factor.
And another type of burn is bacterial burn , which can be caused by some types of microorganisms.The severity also ranges from small nodular lesions to a condition that can even threaten a person’s life, such as the development of staphylococcal scalded skin syndrome.
By localization, they are distinguished:
- External – skin lesions, including burns on the paw pads of a cat.
- Internal – damage to the esophagus, tongue, stomach, upper respiratory tract, lungs.
- Lesions of mucous membranes – eyes, nose, genitals and all types of internal burns.It is necessary to be able to distinguish between a burn of the mucous membrane, from irritation or an allergic reaction. The most common causes of mucosal burns are feeding hot food or inhaling smoke in a fire. External burns, most often, are classified according to the degree of damage: I, II and III degree.
Burns of the first degree
In an animal, on the affected area of the body, there is: swelling, redness, soreness, local fever. Possible reasons: cat burns with boiling water or water with a temperature above 60C °, short-term contact with fire or a hot surface, sunburn.
Second degree burns
First degree, complicated by watery blisters, which eventually burst and turn into crusts. With a large area of the lesion, general weakness, an increase in base body temperature, severe soreness, and refusal to eat are observed. Possible causes: hot oil or grease, prolonged contact with fire, fur fire, chemical burns in a cat with alkali or acid, walking on hot days on asphalt.
Burns of III degree
The wounds are covered with charred crusts, within a few hours necrosis begins – rejection of dead tissue, there is an increase in body temperature, refusal to eat and drink, internal intoxication, acute pain – a critical condition.
Treatment depends on the location, origin and severity of the burns. For more successful treatment, it is recommended to immediately contact a veterinary clinic.
Treatment of burns of the respiratory tract in St. Petersburg
If you have a question to our doctor about the treatment of diseases, you can call 8 (812) 748-23-48 or ask a question to the surgeon online.
Thermochemical damage to the respiratory tract occurs in 12 – 16% of those hospitalized with burns.The factors leading to its occurrence can be the presence of the victim in a burning room and inhalation of combustion products, hot air, and flames. This type of damage can occur, both isolated and in combination with skin burns, carbon monoxide poisoning.
Thermal inhalation trauma significantly aggravates the course of burn disease. It is possible to suspect inhalation trauma after collecting an anamnesis, when the circumstances of the injury, the duration of stay in a smoky room are being clarified.
Indirect diagnostic criteria for inhalation trauma can be clinical examination data. Localization of burns on the face, neck, anterior surface of the chest, as well as scorched hairs in the nasal passages, traces of soot in the nasopharynx, on the tongue may indicate damage to the respiratory tract.
Of the complaints presented, attention is drawn to: change in voice (dysphonia, aphonia), cough with sputum containing soot, shortness of breath, choking.
The most objective way to diagnose and assess the severity of airway damage is fibrobronchoscopy.When visually assessing the state of the mucous membrane of the respiratory tract, the severity and prevalence of hyperemia and edema are taken into account; hemorrhages and erosion, the presence of combustion products and fibrin in the lumen and on the walls of the trachea and bronchi, impaired bronchial patency due to edema, obturation with secretions, combustion products.
Depending on the localization of the lesion (upper, lower respiratory tract), the predominance of one or another damaging factor (thermal, toxic-chemical, or their combination), the type of laryngotracheobronchitis (catarrhal, erosive, necrotic), 3 degrees of inhalation injury severity are distinguished: mild, moderate and heavy.
Views on the pathogenesis of airway injury in inhalation trauma have undergone significant changes over the past decades. For a long time, there was an opinion about local damage to the upper respiratory tract, since the vocal cords reflexively close under the influence of hot air. However, after the widespread introduction of fibrobronchoscopy into the clinic, reports appeared about the leading role of combustion products that cause severe widespread lesions of the upper respiratory tract.
It is believed that the solid-dispersed smoke fraction performs a transport function in relation to gaseous toxic substances.Penetrating deep into the respiratory tract, when interacting with endogenous water, they form acids and alkalis, which cause chemical burns of the mucous membrane of the respiratory tract with the development of aseptic inflammatory reactions. In severe thermochemical lesions of the respiratory tract, the mechanisms of localization of inflammation are disrupted. The result of starting a cascade of reactions of the systemic inflammatory response is damage to the alveolar-capillary membrane and, as an outcome, the development of respiratory distress syndrome.
A complication of thermal inhalation trauma can be the development of bronchitis and bronchopneumonia, purulent tracheobronchitis, impaired airway patency, the development of a syndrome of acute lung injury and respiratory failure.
If the severity of the injury is mild and there are no complications, additional treatment is usually not required. In case of severe damage to the respiratory tract, especially in combination with extensive burns, impaired consciousness, gas exchange, respiratory support in the form of artificial ventilation of the lungs in various modes, sanitation and diagnostic fibrobronchoscopy, nebulizer therapy, the use of surfactant preparations, as well as an innovative method of extracorporeal membrane oxygenation (ECMO).
We provide treatment for burns and their consequences
First aid, degree of burn and treatment
In this article we will tell you:
When we hear about thermal burns, cases most often come to mind when contact of a red-hot object or substance – boiling water, frying pan handle, oil, iron surface, etc. occurred with the skin. Each of us has faced similar situations at least once in our life and is approximately aware of the consequences – pain, redness, blistering and wounds that do not heal for a long time.
However, not only the skin can suffer from thermal burns. It happens that the damaging agent comes into direct contact with the eye shell: for example, when a jet of steam, flame, molten wax or other substance, spark or boiling liquid enters this area. Then experts talk about a thermal burn of the eyes.
Thermal eye burn – damage to the tissues of the eyeball, which occurred as a result of exposure to high temperatures.Of all types of burns (which are also chemical and radiation), thermal ones are considered the least dangerous: when exposed to temperatures, we reflexively blink, squint, thereby protecting the most delicate tissues. Most often, with a thermal burn of the eye, nearby tissues also suffer: eyelids, eyelashes, etc.
Thermal burns are usually distinguished from chemical burns by the degree of damage. Acids, alkalis and other substances that cause chemical burns of the mucous membrane of the eye penetrate much deeper into the structure of the organ.The consequences of such exposure are more dangerous for eyesight, the treatment is complex and lengthy. Radiation burns of the cornea of the eyes also differ from thermal ones: when exposed to ultraviolet radiation, symptoms most often appear delayed, some time after exposure, while with thermal burns – immediately.
Degree of eye burn
|I degree||II degree||III degree||IV degree|
|Signs of eye burn||The upper layer of the cornea is damaged||Several layers of the cornea are damaged||Damaged deep layers of the cornea, conjunctiva||Irreversible lesions of all departments|
|Eye burn symptoms||
– hyperemia of the skin of the eyelids and around the eyes;
– redness of the conjunctiva due to dilated blood vessels;
– superficial erosion on the cornea;
– swelling of the mucous membrane;
– pain, itching, burning;
– blisters on the skin of the eyelids;
– clouding of the cornea;
– edema, whiteness of the conjunctiva;
– increased tearing, pain, burning, itching;
– inflammatory processes of the vessels of the eye;
– violation of pressure;
– necrosis of the surface tissues of the organ.
– the appearance of a dark crust on the affected areas;
– deepening of necrotic lesions of the epidermis, cornea, conjunctiva;
– the cornea dries up, changes color to gray-yellow;
– development of cataracts, iridocyclitis.
– necrosis of the eyelids and nearby tissues;
– complete destruction, perforation of the cornea;
– secondary glaucoma;
– deep vascular lesions;
– loss of vision;
– often – loss of an eye.
First aid for thermal burns
The sooner you provide first aid for eye burns, the more superficial the lesions will be.
What to do in case of thermal eye burn
- Eliminate the source of injury, the damaging factor.
- Rinse out the eye.
For this, clean running water with a temperature of 12 to 18 degrees is used. The procedure time is at least 20 minutes. Rinsing is carried out from the outer edge to the inner one simply under the tap (the victim must bend over) or with the help of improvised containers – a large-volume syringe, a plastic bottle, a rubber bulb, etc.
If you can’t find anything suitable, put cool water in a clean pot, ask the victim to dip their face in it and blink as often as possible.
- To drip pain relievers, anti-inflammatory, antiseptic drops for eye burns.
- Lubricate the damaged tissue around the eye with an antiseptic ointment.
- Apply a bandage (or cover your eye with a clean handkerchief).
- Take the victim to a medical facility where they will receive further assistance.
Thermal eye burn: treatment
It is imperative to treat such injuries in a hospital, under the supervision of specialists.The attending physician selects adequate therapy depending on the degree of injury. With a mild degree of damage, it is possible that treatment will cost with conservative approaches: medications, physiotherapy, a course of massage. Severe cases may require staged surgery.
90,000 Testimonials from a patient with esophageal burn
When Nye was only six years old, her life changed. Having played enough on a summer evening, the baby asked in one institution for a glass of water, where she was accidentally given a glass of dishwasher rinse aid .Naya immediately felt unwell, there was severe burning in her throat and non-stop vomiting began: she got burns of the esophagus as a result of swallowing caustic liquid.
On the same day, Naya received emergency treatment at a nearby hospital, and then was admitted to Hospital Sant Joao de Deu Barcelona , where she stayed for more than two weeks until her condition stabilized. A few days after being discharged from the hospital, the girl reappeared with symptoms, including dysphagia (difficulty swallowing), and difficulty breathing .Intoxication, already eliminated, caused esophageal stenosis : the tract that leads from the mouth to the stomach narrowed in response to the injury, and this led to difficulty swallowing, and also to the fact that Naya had a terrible feeling of suffocation .
Primary treatment for esophageal stenosis
Over the next months, the solution to Nyei’s problem was to carry out esophageal dilatation procedure which had to be done to the baby every two to three weeks in the Department of Gastroenterology.This enlargement of the esophagus would alleviate the symptoms and was considered the optimal treatment option to initially avoid surgery , which was very difficult and entailed risks. But stenoses as a result of chemical burns are difficult to eliminate, and each time the problem returned more and more often.
During one of the frequently performed enlargements of the esophagus, the girl developed a perforation of the esophagus, and therefore had to urgently change the method of treatment.For this treatment, gastrostomy (insertion of a feeding tube) was performed, so that the patient did not lose weight due to the perforation of the esophagus. In addition, Naya needed to gain weight before the operation, because due to stenosis and problems with food intake, the girl at her 8 years old weighed only 17 kilograms.
“The worst part was that due to the treatment I could not go on field trips and school holidays. I was also upset that on my friends’ birthdays I could not eat , ”Naya tells about the period of treatment with the expansion method and subsequent gastrostomy while having breakfast with a sandwich.Susana, the patient’s mother, says that during the treatment, she was very nervous and worried, because she was afraid that the feeling of suffocation that had arisen before would be repeated.
Esophageal replacement as a final solution
Finally, Dr.Xavier Tarrado, Head of the Surgical Department of the Hospital Sant Joan de Deu Barcelona, announced to the family the decision that was considered the most appropriate and permanent for Naya: esophageal replacement .This technique involves using a portion of the patient’s colon to replace a previously excised portion of the esophagus. This is a complex surgical procedure that entails many risks. “Although we were scared, the best solution in this case was to operate on Naya. Either decide to do this, or she would have to live with a gastrostomy until the end of her days, ”says the patient’s mother.
The main difficulty was that the colon fragment implanted into the esophagus was of a different size and width, and had to be adapted to this anatomical region of the patient.The operation was successful and, despite some complications in the postoperative period, Naya successfully recovered thanks to the participation of the staff of the Intensive Care Unit and subsequent respiratory physiotherapy.
Naya is now 12 years old, attending school, and most of her 90,016 hospital visits now involve control endoscopy and single esophageal dilations. Despite the fact that until the onset of adulthood the girl will have to be under constant supervision, Naya does not lose her optimism. “Now I feel good, all the bad things are behind me, and I am sure that in the future I will be fine too,” the patient says.
Chemical burns of eyes and skin
Chemical burns result from damage by substances that can quickly cause tissue necrosis as a result of the interaction of damaging agents with substances that make up the cells.
In case of chemical burns, the skin is affected
Burns of the skin in the modern world are a frequent type of injuries both at home and at work, reaching 5–12% of all known injuries.
Causes of chemical burns
Chemical burns occur due to damage by substances that can quickly cause tissue necrosis as a result of the interaction of damaging agents with substances that make up cells. Among the chemical burning substances, concentrated acids (nitric, sulfuric, hydrochloric, acetic and others), alkalis (caustic soda, potassium, caustic soda, quicklime, ammonia), heavy metal salts, phosphorus and some toxic substances (such as mustard gas) are distinguished.Zoochemical burns are extremely rare and, as a rule, in hot countries in contact with jellyfish, toad-yeah. Receiving chemical burns, as a rule, is the result of non-observance of the safety rules provided for working with the specified reagents, as well as the result of domestic accidents and injuries in production conditions.
Grades of chemical burns
Burns most often affect the skin of the face, hands, esophagus and stomach. The main substances that cause burns are acids (sulfuric, hydrochloric, nitric, hydrofluoric, etc.), alkalis (caustic soda, caustic potash, etc.), gasoline, kerosene, heavy metal salts (zinc chloride, silver nitrate, etc.), some volatile oils, phosphorus, bitumen.
The severity of damage to the skin and mucous membranes in a chemical burn depends on the concentration of the substance and the duration of its action on the tissue. In total, it is customary to distinguish 4 degrees of severity of a burn with chemicals:
4 degree. All tissues are affected, including the skin, muscles, and tendons.
3rd degree.Those layers of the skin that are located near the adipose subcutaneous tissue are affected. The characteristic features inherent in a burn of this degree are the appearance of bubbles with a cloudy liquid or mixed with blood. In the area of the lesion, sensitivity is disturbed, that is, the victim does not feel pain within it.
2nd degree. In this case, the lesion affects, in addition to the upper layer of the skin, its deeper layers. A burn of this degree is characterized by manifestations in the form of puffiness and redness, in addition, bubbles filled with transparent liquid also appear.
1 degree. Only the upper layer of the skin is affected. Among the main manifestations that accompany this type of burn, there is a slight swelling and redness of the skin. In addition, mild painful sensations also occur in the affected area.
Chemical burns of the skin on the hand
First aid for chemical burns
When providing assistance, immediately remove the scraps of clothing soaked in the chemical and neutralize the remains on the body.The skin is washed abundantly with a stream of running water for 10 to 15 minutes. If help is provided with some delay, the duration of flushing should be increased to 30-40 minutes. It is unacceptable to get rid of the affecting chemical with napkins or cotton swabs moistened with water! If the burning sensation intensifies after washing the affected area, it should be rinsed again for 5 to 10 minutes. The effectiveness of first aid is assessed by the disappearance of the characteristic smell of a chemical or by a change in the color of litmus paper.Used as neutralizers: for burns with caustic alkalis – 2% solution of acetic or citric acid, acids – 5-10% solution of baking soda (2.5 cups of water + 1 teaspoon of soda) or soapy water, cyanide compounds – solution of permanganate potassium, hydrogen fluoride – magnesium sulfate in large quantities. Finally, a loose (non-compressive) dressing made of dry, clean cloth or bandage is applied to the area of the chemical lesion. In case of burns with phosphorus, you must first extinguish the flame, then remove its particles with tweezers and treat with a 5% solution of copper sulfate.Ointments should not be used because of the likelihood of fixation and absorption of phosphorus. The victim should take a pain reliever and seek qualified medical attention immediately. Often there is a need for hospitalization in a surgical or burn department, and in case of general poisoning – in a toxicology department.
Chemical eye burn
Chemical eye burn
Chemical eye burn is always considered a difficult situation from the point of view of treatment in ophthalmology.It all depends on the degree of damage, on the agent, on the depth of penetration. Such a burn can sometimes lead not only to a weakening of vision, but even to its complete loss.
Chemical eye burn with acid is the easiest to treat in comparison with other types of agents.
Chemical eye burn with alkali is difficult to treat because it causes hydrolysis of the protein structure itself, which destroys cells and can quickly lead to wet necrosis. This can affect the intraocular fluid and significantly increase the intraocular pressure.
After a chemical enters the eye, the first step is to immediately rinse the eyes with water within a few seconds. In production, special devices for washing the eyes should be provided. If an accident occurs at home, start rinsing the eye immediately and prepare to transport the victim to the nearest clinic, eye hospital or trauma center.
A convenient way to wash your eyes at home is as follows.The patient holds his head over the sink with the washed eye upward, and the person helping him pours cold tap water from a glass or mug.