Burns and Electric Shock | Michigan Medicine

Have you been burned, had an electrical shock, or inhaled smoke or fumes?

Yes

Burn, electrical shock, or smoke inhalation

No

Burn, electrical shock, or smoke inhalation

How old are you?

Less than 12 years

Less than 12 years

12 to 50 years

12 to 50 years

51 years or older

51 years or older

Are you male or female?

Why do we ask this question?

• If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
• If your symptoms aren’t related to those organs, you can choose the gender you identify with.
• If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Are you having trouble breathing (more than a stuffy nose)?

Yes

Difficulty breathing more than a stuffy nose

No

Difficulty breathing more than a stuffy nose

Would you describe the breathing problem as severe, moderate, or mild?

Severe

Severe difficulty breathing

Moderate

Moderate difficulty breathing

Mild

Mild difficulty breathing

Would you describe the problem as severe, moderate, or mild?

Severe

Severe difficulty breathing

Moderate

Moderate difficulty breathing

Mild

Mild difficulty breathing

Is there a burn you can see?

Fourth degree

Fourth-degree burn

Third degree

Third-degree burn

Second degree

Second-degree burn

First degree

First-degree burn

Is the burn on the face, eyelids, or ears?

Yes

Burn is on the face, eyelids, or ears

No

Burn is on the face, eyelids or ears

Is the burn on the hands or feet, in the groin area, or over a joint?

Yes

Burn to hands, feet, groin area, or skin over a joint

No

Burn to hands, feet, groin area, or skin over a joint

Does the burn go completely around an arm, hand, leg, or foot?

Yes

Burn encircles arm, hand, leg, or foot

No

Burn encircles arm, hand, leg, or foot

Were you struck by lightning?

Did you get an electrical shock?

Have you noticed any irregular heartbeats or are you dizzy after the electrical shock?

Your heart rate may have changed right when the shock happened (it probably sped up), but it should have returned to normal very soon after.

Yes

Change in heart rate after electrical shock

No

Change in heart rate after electrical shock

Did the shock cause numbness and tingling?

Yes

Electrical shock caused numbness and tingling

No

Electrical shock caused numbness and tingling

Were you shot by a stun gun or Taser?

Yes

Shot by a stun gun or Taser

No

Shot by a stun gun or Taser

Do you think that the burn may have been caused by abuse?

Yes

Burn may have been caused by abuse

No

Burn may have been caused by abuse

After breathing in smoke, are you having any problems with your throat, such as throat pain, hoarseness, cough, or trouble talking?

Yes

Throat problems after smoke inhalation

No

Throat problems after smoke inhalation

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Do you think you may have a fever?

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

No

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Were you able to clean the wound well?

You may not be able to clean the wound if it is deep, hurts too much, or has an object stuck in it.

Yes

Able to adequately clean wound

No

Unable to adequately clean wound

As the burn heals, is it pulling the skin tight or making it hard to move the area?

Yes

Healing burn is pulling the skin tight or preventing normal movement

No

Healing burn is pulling the skin tight or preventing normal movement

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

• Try home treatment to relieve the symptoms.
• Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

It can be hard to tell how deep a burn is.

• A fourth-degree burn goes through the skin and fatty tissue to injure muscle, nerves, blood vessels, and bones.
• A third-degree burn goes through all the skin layers to the fatty tissue beneath. The skin is dry and swollen and may be pale white or charred black. This kind of burn destroys the nerves, so it may not hurt except on the edges.
• A second-degree burn involves several layers of skin. The skin may be swollen, puffy, moist, or blistered.
• A first-degree burn affects only the outer layer of skin. The skin is dry and hurts when you touch it. A mild sunburn is a first-degree burn.

Some common burn patterns and common areas for burns that result from abuse include:

• Circular burns that are the size and shape of the end of a cigarette or cigar.
• Burns on the bottom of the feet.
• Burns that look like gloves (on the hands), socks (on the feet), or a large circle on the buttocks. These come from putting someone’s hands, feet, or buttocks in a sink or tub of scalding-hot water.

With burns caused by abuse, the explanation for the burn may not match the size, shape, or location of the burn. But it still can be hard to tell whether a burn was caused on purpose. A burn caused by throwing hot liquid on someone may look just like a burn caused by an accidental spill.

Symptoms of difficulty breathing can range from mild to severe. For example:

• You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
• It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

• The child cannot eat or talk because he or she is breathing so hard.
• The child’s nostrils are flaring and the belly is moving in and out with every breath.
• The child seems to be tiring out.
• The child seems very sleepy or confused.

Moderate trouble breathing means:

• The child is breathing a lot faster than usual.
• The child has to take breaks from eating or talking to breathe.
• The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

• The child is breathing a little faster than usual.
• The child seems a little out of breath but can still eat or talk.

Severe trouble breathing means:

• You cannot talk at all.
• You have to work very hard to breathe.
• You feel like you can’t get enough air.
• You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

• It’s hard to talk in full sentences.
• It’s hard to breathe with activity.

Mild trouble breathing means:

• You feel a little out of breath but can still talk.
• It’s becoming hard to breathe with activity.

Heartbeat changes can include:

• A faster or slower heartbeat than is normal for you. This would include a pulse rate of more than 120 beats per minute (when you are not exercising) or less than 50 beats per minute (unless that is normal for you).
• A heart rate that does not have a steady pattern.
• Skipped beats.
• Extra beats.

Pain in adults and older children

• Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
• Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
• Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

• Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
• Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
• Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Here are some ways to estimate how much of the body is burned in an adult or older child.

• The palm of the person’s hand equals 1% of the body’s surface area. Using the person’s palm is a good way to estimate the size of a small burn.
• The total surface of the head plus the neck is 9% of the body’s surface area.
• The total surface of one arm and hand is 9%.
• The chest is 9%.
• The belly is 9%.
• The upper back is 9%.
• The lower back is 9%.
• The total surface of one leg and foot is 18%.
• The groin area is 1%.

Here are some ways to estimate how much of the body is burned in a baby or young child.

• The palm of the child’s hand equals 1% of the body’s surface area. Using the child’s palm is a good way to estimate the size of a small burn.
• The total surface of the head plus the neck is 21% of the body’s surface area.
• The total surface of one arm and hand is 10%.
• The total surface of the chest plus the belly is 13%.
• The back is 13%.
• The buttocks are 5%.
• The total surface of one leg and foot is 13.5%.
• The groin area is 1%.

Symptoms of infection may include:

• Increased pain, swelling, warmth, or redness in or around the area.
• Red streaks leading from the area.
• Pus draining from the area.
• A fever.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

• Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
• Long-term alcohol and drug problems.
• Steroid medicines, which may be used to treat a variety of conditions.
• Chemotherapy and radiation therapy for cancer.
• Other medicines used to treat autoimmune disease.
• Medicines taken after organ transplant.
• Not having a spleen.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

• Passing out (losing consciousness).
• Feeling very dizzy or lightheaded, like you may pass out.
• Feeling very weak or having trouble standing.
• Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

• Passing out (losing consciousness).
• Being very sleepy or hard to wake up.
• Not responding when being touched or talked to.
• Breathing much faster than usual.
• Acting confused. The child may not know where he or she is.

To clean a wound well:

• Wash your hands first.
• Remove large pieces of dirt or debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
• Hold the wound under cool running water. If you have a sprayer in your sink, you can use it to help remove dirt and other debris from the wound.
• Scrub gently with water, a mild soap, and a washcloth.
• If some dirt or other debris is still in the wound, clean it again.
• If the wound starts to bleed, put direct, steady pressure on it.

If a chemical has caused a wound or burn, follow the instructions on the chemical’s container or call Poison Control (1-800-222-1222) to find out what to do. Most chemicals should be rinsed off with lots of water, but with some chemicals, water may make the burn worse.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

• For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
  • You haven’t had a tetanus shot in the past 5 years.
  • You don’t know when your last shot was.
• For a clean wound, you may need a shot if:
  • You have not had a tetanus shot in the past 10 years.
  • You don’t know when your last shot was.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

• Call your doctor today to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care today.
• If it is evening, watch the symptoms and seek care in the morning.
• If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

• Call your doctor now to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care in the next hour.
• You do not need to call an ambulance unless:
  • You cannot travel safely either by driving yourself or by having someone else drive you.
  • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

• Make an appointment to see your doctor in the next 1 to 2 weeks.
• If appropriate, try home treatment while you are waiting for the appointment.
• If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Rare chemical burns: first response, early hospitalization and first t

Introduction

Burn is a trauma causing physiological changes in the tissue creating impairments of form, organ loss and death. Burn care and treatment is extremely difficult and includes complex procedures.¹

Chemical burns result from exposure to various chemical substances commonly found in the home, workplace or external surroundings, because of carelessness or neglect. Chemical substances are knowingly used by people in many areas, primarily in domestic and work environments. Approximately 6 million variations of chemical substances are used by people. Chemical burns constitute 3% of all burns, and 30% of chemical burns result in death. ¹

The most common causes of chemical burns are acids such as sulfuric, hydrofluoric, hydrochloric and acetic acid, bases such as sodium and potassium hydroxide and calcium hydroxide, oxidants used in the home such as chlorides and peroxides, and various other substances such as hair dyes and airbag injuries. Acidic agents cause coagulation necrosis leading to cytotoxicity. Alkaline substances are more toxic than acidic agents due to the irreversible changes in protein and lipid tissue damage.^2,3

The prognosis of a chemical burn depends on the type of chemical and the degree of injury. Most small lesions heal well but larger wounds do not generally heal and may become scars. The most common complications are pain and scarring after a burn. Most patients require consultation from more than one physician, and skin grafts may be necessary to reduce the scarring in many patients.¹

The aim of this study was to present the demographic data of patients with common and rarely seen chemical burns treated in our clinic, the type of chemical substance that caused the burn, the burn area and depth, the location of the accident, the first intervention made, the time to first admittance to hospital and to discuss these data in the light of information in literature.

Materials and methods

Patient selection

Approval for the study was granted by Diyarbakır Gazi Yaşargil Training and Research Hospital (6/7/2018-127) ethics committee; patient and guardian written informed consents were obtained in strict accordance with the principles set by Helsinki declaration. A retrospective evaluation was made of 19 patients (12 males, 7 females, mean age: 29.44 years) who were admitted for treatment of chemical burns in the Burns Unit of Healthcare Sciences University Diyarbakir Gazi Yaşargil Training and Research Hospital between 2014 and 2018. Initially, the records of 20 patients with chemical burns were examined but 1 case was excluded due to incomplete information. Thus, final evaluation in the study was made of 19 cases of chemical burns. All patients or their legal guardians provided informed consent for the use of their photographs and data. Samples of the chemical burns are shown in Figure 1.

Exclusion criteria

Of the 20 cases retrieved from the archives, 1 case was excluded from the study because of incomplete records.

Data collection

Data were retrieved from the hospital patient files and recorded on a data form for evaluation in this study. Demographic data included age and gender and clinical data included; the cause of the burn (type of chemical), burn percentage, burn degree, burn localization, length of hospital stay, type of first intervention performed, time from trauma to presentation at hospital, VAS score, type of anesthesia applied, ASA score, culture taken and the agent if there was production, laboratory values, the presence of additional pathology, and treatments applied.

Statistical analysis

Data obtained in the study were analyzed statistically using the hospital database Windows program. Descriptive statistical methods (mean, standard deviation, median, interquartile range values) were used in the data evaluation.

Results

The patients comprised 12 males and 7 females with a mean age of 29.44 years. The burns were evaluated as 2nd degree in 9 patients, 3rd degree in 5 patients and mixed 2nd–3rd degree in 5 patients (Table 1). The total body surface area (TBSA) affected was mean 7.55±6.59% (range, 2–30%). The localization of the burns was the lower extremity in 12 patients, upper extremity in 6, mixed in 2, the genital region in 1, the chest in 3 and the area around the eyes in 2 patients (Table 2, Figure 2)

.

The time of presentation at hospital was recorded as on the 1st day after the burn in 6 patients, on the 2nd day in 7, the 5th day in 4, the 10th day in 1 and the 14th day in 1 (mean time to presentation at hospital 3. 44±3.53 days, range: 1–14 days). The mean length of hospital stay was 5.5 days. Pain was assessed according to a VAS on presentation and routinely during the stay thereafter. The mean VAS value was 6.4. When the anesthesia types were examined, use of the sedo-analgesia method was seen to be predominant. As a result of the routine cultures taken, there was determined to be production in 3 patients and no productive agent in 16 patients (Table 1). The types of chemical burns of the patients are shown in Figures 3–5

As the first intervention, cold water was applied to 5 patients, normal tap water to 2, ice to 1 and a fire extinguisher to 1 patient. No intervention was made to 10 (52.63%) patients (Table 3).

When the location where the burn trauma happened was examined, the majority were seen to have been in the home and there was also a high rate in the workplace (Table 4).

Of the patients, 84.21% (n=16) received only burn wound dressing by using Alloplastic Dermis Equivalent + Collagen + Antibiotic Baktiras, whereas 15.79% (n=3) received burn wound debridement and reconstruction with auto skin grafts. Intermingled allo and auto skin grafts were applied in 3 patients with cement burns (alkaline burns).

Microorganisms growing in the injury cultures of the patients: Staphylococcus aureus in 2 patients, following Staphylococcus epidermidis in 1 patient. Systemic antibiotics used included cefotaxime, trimethoprim and sulfamethoxazole. All the patients were discharged from the hospital.

Discussion

In this study, in addition to the agents of chemical burns previously frequently reported in literature, evaluation was also made of the physiopathological injury of uncommon and different chemical burns in patients who presented at our Burns Unit, and the first interventions and treatments applied are discussed.

Chemical burns formed from contact with acid or alkaline chemical substances are generally seen as a result of workplace accidents or oral intake by children.² The substances commonly included in these products are hydrochloric acid, phosphoric acid, sulfuric acid, hydrofluoric acid, sodium hydroxide and potassium hydroxide. Acid burns result from chemicals with a low pH and are usually less severe than alkali burns.

The common use of chemical substances in many areas of life has increased the possibility of exposure and burns. Insufficient personal protection in the workplace and lack of knowledge about chemicals cause an increase in these types of burns. Lack of knowledge and experience increases exposure in children in particular even more. There is a cluster effect in children aged over 2 years and below 5 years.³ Small children are very active and tend to explore their surroundings, but they do not have sufficient cognitive skills to understand the caustic and burn potential of these substances. Leaving chemicals such as cleaning materials and personal care products at random in the home increases the possibility of contact by children. Of the current cases, 10 presented because of burns caused in the home by accidental or incorrect use of acetone, white vinegar, IL-33 wart medication, hydroquinone (Expigment 4%) and drain cleaner. The remaining 9 cases were workplace accidents or accidents in the external environment (Table 4).

The mean age of the patients in the current study was 29.4 years, which was higher due to the exclusion of oral and inhaled burns. In addition, the higher age can be attributed to the insufficient knowledge of adults in Turkey about the use of chemical substances.

Less frequently seen causes of chemical burns are exposure to metals, phenols, calcium oxide, alcohol, solvents and acetic acid.

In several sources, chemicals are classified as acid, alkaline, organic and inorganic components. The most common substances in chemicals are acid in character. Acids affect proteins through denaturization and coagulation. These properties prevent penetration of the acidic substance to deeper tissues. As a result of the cellular dehydration and protein denaturization and coagulation that develops after exposure to an acidic substance, there is less fluid loss and edema, thereby creating a characteristic dry surface for acid burns.²

One type of acidic burns is from IL-33, which is used in Turkey in the treatment of warts in a mixed weak acidic solution. No burn case related to this was encountered. It is possible that throughout the world there are no burns related to this drug which is included in combined acid types for warts in Turkey. No reports of this type of burn were found. This drug is common in homes in Turkey as it is used in the treatment of warts caused by the Verruca vulgaris virus, and it is therefore a drug with a greater possibility for accidents. As the bottle is small with a safety cap, burns are not often encountered. However, small local burns are formed around the treatment area which do not require presentation at hospital. As the burn associated with this drug is acidic in character, it is a deep burn with protein denaturization and coagulation necrosis and is slow to heal. There is a high likelihood of a requirement for grafting and of scar formation. The first intervention requires irrigation with a large amount of water.

Although the content varies according to the type of fruit, white vinegar is formed of amino acid, potassium hydrate, aldehyde, propionic acid, 4–5% acetic acid, 1% alcohol, pectin and fruit flavoring. It is a sour fruit juice frequently used in Turkey in salads and pickling. It is used in the home most often in autumn when pickles are prepared for winter. Severe burns and even death can be caused by the alcohol content and especially because the skin is thin.⁴ The content of 4–5% acetic acid causes burns of the skin and esophagus in newborn infants and children. When these chemicals are examined, these burns are seen to have the same characteristics as acid burns. The first intervention and treatment is similar to that for acid burns (Table 3).

Alkaline components cause soaping and liquefaction necrosis on the skin surface epithelium and they penetrate to deeper tissues.²

Despite the increase in new technologies, the opening of an airbag in a traffic accident releases nitrogen, carbon monoxide, carbon dioxide, ammonia and various hydrocarbons, which cause inhaler and aerosol complications, and the sodium hydroxide within the bag causes alkaline burns.^5,6 Patients brought to the emergency department (ED) with this type of trauma must be evaluated in respect of corrosive alkaline burns and inhaler complications in addition to cervical and chest trauma. The current study cases with airbag burns were unfortunately not applied with the necessary first interventions before arrival at ED and this increased the wound depth in these patients.

Lengthy contact with wet cement can cause severe burns as alkaline burns similar to airbag burns. Wet cement destroys the skin in 3 ways, firstly with allergic dermatitis through a reaction with hexavalent chromate ions, secondly by wear from the fine aggregate in cement and thirdly by alkaline burns as it has a pH of 12.5.⁷ In contrast to thermal burns, these types of burns have an insidious onset. Cement entering from a tear in a boot that is not noticed continues to corrode and deepen skin necrosis. A few hours after exposure, the first symptoms emerge of a burning feeling, pain, redness and vesicular symptoms. After 12–48 hrs, a full thickness burn is formed.⁸ To prevent cement burns, dirty clothes must be removed and the skin must be immediately washed with plenty of water. The first treatment should be started at the site of the accident.

Retrospective studies have shown that a high rate (75% or higher) of cement burns are full thickness burns requiring wound excision and grafting.⁹ In a study by Lewis et al⁷, 51% of patients were unaware of the risk of cement burns and had taken no precautions. The current study patients were building laborers and, as in the Lewis et al study, were unaware of the risks of these chemicals, and the burn was noticed the following morning. Most of the current study patients had no knowledge about the first interventions for these types of substances. When the patients were admitted to hospital, debridement was performed followed by dressings with materials equivalent to alloplastic skin and healing was obtained without any requirement for grafting.

Organic solvents cause wounds through dissolution of the lipid membrane which leads to impaired physiological processes. Inorganic solvents cause wounds through a denaturisation mechanism.⁷

Acetone, which is an organic solvent, was another chemical in this study for which no case was found in literature. Impairment of the skin barrier through treatment with diethyl ether, acetone and water causes dry skin, including increased transepidermal water loss and decreased hydration of the stratum corneum.^10,11 Following induction of dry skin, various pruritogens and factors related to pruritogens become unstable in cutaneous cells.^12,13 Acetone solvent is frequently used in the home as nail polish remover and glue solvent. Adults leaving these around after use increases the risk of young children in particular coming into contact with these chemicals. In the first intervention after the accident for this type of burn, decontamination of the chemical with fast-flowing water is extremely important. As infants and children have thin skin, the skin becomes dry and irritated. After impairment of the skin barrier, skin inflammation and necrosis develop.

Some chemicals cause thermal burns due to the different chemical reactions formed and exacerbation other than in acidic and basic conditions, and because of the high heat generated. The best examples of this are cyanoacrylate, liquid oxygen, hot bitumen and hydroquinone-like medical drugs. Recent publications have shown that there has been an increase in skin burns in addition to eye burns of cyanoacrylate and other strong superglues.^14–20 Cyanoacrylate [Ch3C(CN) CO2R] is a monomer formed as a result of the reaction of formaldehyde with alkaline cyanoacetate.²⁰ When this molecule is in contact with hydroxyl groups (–OH) (eg, water), it is reduced to exothermic polymerization.¹⁸ In the presence of cotton fibers, which are abundant in cellulose and hydroxyl (–OH) groups, the abovementioned exothermic polymerization is accelerated, and when this is in the form of downward contact, it also causes a rapid and strong reaction which may cause thermal burns.^17,18,21 When there is contact at temperatures higher than 40°C, skin damage forms and when temperatures exceed 80°C, full thickness burns occur within a second. Kelemen et al²² reported full thickness burns in 3 cases with a mean age of 14 years. In the same study, a mean temperature of 68° C was measured after contact of 4 different brands of glue with fabric. The 2 cases in the current study with cyanoacrylate burns were aged 2 and 5 years and in both cases full thickness burns formed.

Oxygen can be in liquid form and in this form can be more effectively transported and stored in large amounts. Liquid oxygen is widely used for medical and industrial purposes. It is used as an oxidant for liquid fuels in the propulsion systems of aircraft and submarines.²³ Due to its cryogenic property, if liquid oxygen comes into contact with the skin, it causes numbness, severe skin irritation and frostbite. If it is ignited, it causes severe thermal burns. There is very little information in medical literature about the emergency treatment for liquid frozen burns. In the application of first aid specifically for contact with liquid oxygen, the clothes that have been wet or splashed with liquid oxygen must be removed immediately. It is also necessary to wash the contaminated skin immediately with soap or mild detergent and water.²⁴ In the current study, a 45-year-old male working on an industrial site developed 2nd- and 3rd-degree burns on 4–5% of both calves as a result of leakage from an oxygen tube. However, the patient only applied tap water to the burned region for 15 mins. When the patient was hospitalized, debridement was performed followed by dressings with materials equivalent to alloplastic skin and healing was obtained in 10–12 days without any requirement for grafting.

Hot bitumen burns are relatively rare and the majority are seen in the paving and roofing industries. The term bitumen is used to mean mineral products formed by raw petrol and asphalt oil, and long-chain petrol and coal or fossil hydrocarbons.²⁵ Direct contact with the skin when temperature transfer continues when adhering causes full thickness burns. Complete removal of the bitumen can result in suboptimal wound healing in bitumen burns and can increase the infection potential. In literature, the importance has been emphasized of early cooling and the use of Medi-Soll adhesive remover or liquid solvents such as petrol-based creams for the removal of bitumen.²⁶ However, treatment recommendations are based to a great extent on reports of small surface area burns.^27,28 The patient in the current study with bitumen burns applied cold water as soon as the bitumen made contact with the skin and then removed it with vaseline when it had dried and presented at the hospital the next day. These procedures applied by the patient were compatible with the recommendations in literature of cooling then removal with oil.

Hydroquinone prevents the transformation of DOPA to melanin by tyrosinase inhibition. Although it has been used in treatment at varying concentrations for more than 50 years, it is used most often at 2–5%. Commonly seen short-term side effects are irritation, erythema, stinging and irritant or contact dermatitis. In the mid and long term, milia and exogenous ochronosis may develop.^29–31 When literature was examined, no case was found of burn forming after long-term use of hydroquinone. Therefore, the case in the current study can be considered to be the first case in literature of the rare chemical burn of hydroquinone. This chemical burn that formed was potently acidic in character and caused clotting necrosis. In the first intervention, irrigation is required with continuously strong flowing water.

As in all burns, the first aid to be applied to a chemical burn is important in respect of monitoring the burn. The first intervention required is to remove the chemical and clean the patient. In the treatment of burns formed with chemical agents, the burned area must be washed with plenty of water.^32,33 The earlier that neutralization with water is started, then the less severe the damage will be. In the washing procedure, saline or tap water can be used. Irrigation should be made gently with a high volume of water at low pressure. The duration of washing should be at least 30 mins and this can be extended to 1 hr in severe cases. During the irrigation, necrotic tissues and any foreign bodies that are present must be cleaned. It was observed in the current study that most of the patients had insufficient knowledge on this subject. While 10 patients had made no intervention, 5 patients had applied cold water for a short time, 1 patient had applied ice and 2 patients had correctly applied tap water but not for a sufficiently long period. Therefore, it was determined that in these patients, although the burn area was small, the depth of the burn was greater.

In extensive and moderate chemical burns, the first hours are of vital importance. Therefore, the patient should contact the nearest health care institution immediately. In these types of burns, metabolic effects can emerge in addition to the skin burn. For small burns not to become infected, the patient should present at a health care facility on the same day for antiseptic intervention and treatment. For outpatients with moderate and small burns, the first intervention is generally delayed. The reason for infection usually originates from skin flora. The most common agent is Staphylococcus. Wound infection or increased wound depth is often seen in delayed cases.³⁴

Some studies have reported that neutralization of alkaline burns with weak acids applied immediately after the trauma is more effective than neutralization with water.³⁵ However, it is known that when washing with neutralizing substances the healing process can be negatively affected by a thermal trauma forming additional to the chemical burn injury because of the excessive heat created as a result of the reaction between the acid and the neutralizing substance.³⁵ It would therefore be more appropriate to apply neutralization treatment only to some selected cases. The types of burns in the current study and the first interventions to be made are summarized in Table 1.

If chemical burns are not treated, they can cause short-term, long-term and life-long health problems.^36,37 Cutaneous wounds and the clinical status of the patient must be rapidly evaluated and treatment must be provided immediately. Appropriate early management is very important for the reduction of patient morbidity.

Conclusion

Chemical burn injuries represent a small proportion of total burn injuries. However, they are a specific type of injury requiring immediate initial intervention and treatment management. It is especially important to draw attention to the importance of prevention in working environments and in home environments. Patients should be treated by specialist physicians and consult a burn center as soon as possible. The first intervention is very important in such burns. With the exception of some particular chemicals, the gold standard initial treatment is washing with abundant water. Non-sterile and water-soluble new chemical neutralizers should also be kept in mind. In delayed cases, wound depth and infection rate increase.

In this study, the importance of the first intervention, the importance of early presentation at hospital and the treatment applied have been discussed in light of the information in literature.

Limitation

There were few cases in this study as these were patients with uncommon chemical burns. Further clinical studies with a high number of patients will provide a more advanced perspective on the results obtained. In addition, as the intensive care unit of our burns unit has not yet entered into operation, no evaluation was made of patients with large burns (over 20%) who needed intensive care. Future articles are planned to encompass a wider area and more patients after intensive care.

Acknowledgments

The authors thank Nurse Medeni Akbalık, who helped with the data collection process, and Specialist Doctor Ünal Öztürk, who helped with the calculation and interpretation of statistics. No funding was used toward the development of this study and there are no financial interests or conflicts of interests related to this work.

Author contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

All the authors have no conflicts of interests to declare in this work.

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31. Prignano F, Ortonne J-P, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin. 2007;25(3):337–342. doi:10.1016/j.det.2007.04.006

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37. Stone R, Shanmugasundaran S, Christine JK, Lauren HM, Nicholas EC, Ryan MC. Advancements in regenerative strategies through the continuum of burn care. Front Pharmacol. 2018;9(9):672. doi:10.3389/fphar.2018.00672

Woman releases shocking images of the chemical burns she was left with after bleaching her hair

Published at 09:21 on 21 November 2019 Updated: 09:22

WARNING: GRAPHIC IMAGES – Izi Corner’s scalp was so badly damaged that now, at just 25, she has had to undergo a hair transplant.

BODY

A young woman who sustained agonising chemical burns whilst having her hair professionally bleached at a salon has released graphic pictures of her injuries after her scalp was so badly damaged that she needed a hair transplant at just 25.

Fancying a change from her naturally brunette hair, in February 2016 patisserie student  Izi Corner, then 22, booked an appointment to have her locks bleached then dyed pink, at a salon near her Manchester home, after being pleased with several haircuts she had received at a sister branch.

But disaster struck when, after the bleach was applied, she was placed under a heat lamp and felt a painful burning sensation at the back of her head – not realising until later that she had sustained chemical burns, which a doctor said had left her hair follicles severely damaged.

Izi now (PA Real Life/Collect)

Now, after living with a 4cm bald patch for years, she has finally had her confidence restored thanks to a £2,500 hair transplant at central Manchester’s Farjo Hair Institute, saying: “Looking back, I feel silly to have got so upset, but I did feel like my world fell apart.

“The physical pain was agony – I wouldn’t wish it on anybody. I feel much better now, knowing that I’m making steps to get it sorted.”

Despite never having any problems or reactions when using packet dyes at home, which she had done several times, Izi had sought professional help to bleach her hair, as she wanted to do it responsibly.

Izi with a dressing on her head (PA Real Life/Collect)

“I’d used box dyes before with no problems, but I figured doing something drastic like bleaching my hair was best done by a professional – or so I thought, anyway,” she said.

Going to a local salon, where she had been for haircuts but not for colour treatments, she explained what she wanted.

“They told me that a colleague at their sister branch was very good with colour, so to book that way, which I did,” she said. “As it was somewhere I’d been before, I didn’t think there’d be any issues.”

Today is National Burn Awareness Day. Here is our video on how to treat burns and scalds #BeBurnsAware Please watch and share. pic.twitter.com/eWKxAfbiEE

— St John Ambulance (@stjohnambulance) October 19, 2016

So, in February 2016, Izi settled into the hairdresser’s chair, excited to see her new bright pink tresses come to life.

“I was told that, with the bleach, I may feel a little discomfort, but not to worry, as it was totally normal,” she said. “It was applied, then I was put under a heat lamp. After about 10 to 15 minutes, I started feeling this burning pain at the top of my head.

“I tried to ignore it, remembering what they’d said about some discomfort being normal, but it soon escalated to the point where I actually thought my hair was on fire. I even leaned forwards to see if I could see any smoke.”

WARNING – GRAPHIC IMAGE – Izi’s wound (PA Real Life/Collect)

Worried, Izi alerted staff, who agreed to rinse the bleach off under cold water, which she said instantly soothed the agonising sensation.

With no idea of the damage that had been caused at this point, she agreed to continue with the appointment and have the pink dye applied to complete her look.

“It was at the back of my head, so I couldn’t see it and I kept being reassured that everything was fine,” she said. “So, I carried on, got the pink put in, had my hair styled and went to pay. It was originally supposed to be in the £70 bracket, but they ended up charging me just £35, which they said was a goodwill gesture to make up for the distress.”

Izi with her pink hair (PA Real Life/Collect)

Heading home, Izi thought little more of her dramatic appointment until later that evening, when she noticed the patch on her head that had been feeling “burnt” was weeping and that the hair around it was clumping together.

With plans to head to Nottingham for the weekend for a friend’s birthday, she had little time to think about what was happening and just hoped that her discomfort would soon subside.

“In Nottingham, I didn’t do anything to my hair just in case – didn’t wash or style it,” she said. “Then, when I got home on Sunday, I finally washed it and all the pink dye came right out.”

WARNING – GRAPHIC IMAGE – Izi’s wound (PA Real Life/Collect)

She continued: “I thought that was strange and then the pain started again. It was so severe that I was taking ibuprofen every four hours and waking up in the night when it wore off.

“My hair kept getting stuck to the scab that had formed, so my mum said for me to wash my hair and she’d gently comb it all out when it was wet.

“As soon as she did, though, the scab literally came off in her hand and we saw this infected wound underneath.”

Alarmed, Izi headed to the minor injuries unit of Trafford General Hospital, where it was confirmed she had suffered a chemical burn.

She was given antibiotics, but warned that the damage to her hair follicles was so great that she would be unlikely to see her hair regrow on the wound site.

“When I heard, at first it was such a shock. I felt numb, it didn’t seem to make any sense to me,” she continued. “When it sank in I felt so down, I told my sisters, ‘When it’s healed over I’m just going to shave all my hair off.’”

WARNING – GRAPHIC IMAGE – The scab that came off Izi’s head (PA Real Life/Collect)

After finishing her course of antibiotics, Izi went to her GP, as hospital staff had instructed her to do, and was given cream and dressings to keep her burn clean.

“I’d have to coat the burn in cream, dress it, then wear a pair of tights over my head to keep it all in place,” she recalled.

“In my opinion, the chemical burn happened because the heat lamp was too close to my head and it sparked a reaction in the bleach.”

WARNING – GRAPHIC IMAGE – Izi’s wound (PA Real Life/Collect)

In time, Izi was put in touch with a trichologist – a branch of dermatology that deals with the hair and scalp – who gave her the details of the Farjo Hair Institute.

Following a consultation, where it was explained that she would need a maximum of three procedures, costing £2,500 a time, she had her first in October 2019.

She was able to fund the treatment with compensation she received as a result of the accident.

“I wanted to wait until the winter so I wouldn’t have to worry about keeping the area out of the sun and risking further damage,” she explained. “At the appointment, I was numbed with a local anaesthetic and then they got to work. They made me feel really comfortable – although it was a bit surreal. I was sat there watching TV with all this going on.”

Using special microscopes, medics took root hairs from elsewhere on Izi’s head before transplanting them into her bald patch.

“The worst bit was when they took the hair for the graft. It felt really tight, but it was literally over in a few minutes,” she said.

WARNING – GRAPHIC IMAGE – Izi’s wound (PA Real Life/Collect)

Now, Izi must wait a year to see how her scalp reacts to the transplant, and whether new hairs begin to grow. After that, she will meet again with medics to discuss whether she needs to have a second or third procedure.

She concluded: “I have short hair anyway, so luckily it would naturally fall over the bald patch, but there were quite a few times when people would point it out to me and ask what it was, which made me self-conscious.”

“I know people have it far worse, but for your hair to suddenly fall out like that was really quite a shock, and it shouldn’t have happened. Still, I feel much better knowing that Farjo Hair Institute are able to help.”

Woman Shares 2nd Degree Facial Burn Healing Process: Before and After Photos

After a cooking accident left her with burns covering most of her face, Bonnie Norman decided to share photos of her healing process on Reddit, in order to educate others on the resilience of the skin.

As Yahoo! reports, Norman was working in the kitchen at a Fort Worth, Texas-based bakery when a “tray full of hot sugar glaze” splashed onto her skin. As anyone who’s ever attempted to make homemade caramel knows, sugar gets extremely hot — and the accident left Norman with painful, second-degree burns all over her chin, nose, cheeks, and forehead. After receiving treatment at a hospital, Norman began taking pictures of her skin to document the (slow) healing process. She later shared four of these images on Reddit, writing, “Skin is amazing. I suffered facial burns in a work accident and here is my healing process in pictures.”

The first image, taken shortly after the accident, shows the immediate damage inflicted by the hot sugar glaze — mostly redness and obvious irritation. In the second photo, Norman’s skin is far more raw-looking, with blisters and scabs on her nose, chin, and lips. The third image is similar, though slightly more healed; and the final photo shows Norman’s skin now — slightly pink in some areas, but on the whole, back to normal.

As Norman explained to Yahoo!, she decided to share the photos on Reddit because she “found the healing process so interesting and amazing. The drastic improvement in the photos really shocked me,” she added.

Of course, Norman was lucky, all things considered: As she wrote on Reddit, “I’ve lost some eyebrow, but the burns weren’t deep enough to harm the hair follicles.” She also managed to avoid getting any of the hot sugar on her eyes, and was able to let her skin heal itself naturally without any surgeries or grafts.

It’s super interesting to see how fully her skin healed — and Reddit agrees: Since posting five days ago, Norman’s thread already has more than 300 comments. Still, burns can be way more severe than this, so always exercise caution around open flames, hot materials, and — of course! — direct sunlight (read up on our fave SPFs here).

More on burns and skin damage:

Now, watch one acid attack survivor on how she learned to accept her “stolen face”:

Lung Damage From Vaping Resembles Chemical Burns, Report Says

kathleen fimple

You will see the animals on the wall. So, there’s a rainbow trout and an antelope and a deer above the fireplace. So, yeah.

kathleen fimple

You guys can sit —

kathleen fimple

That room’s a mess, but we could pull some things off —

kathleen fimple

My daughter made this.

kathleen fimple

That’s what we used for the funeral.

kathleen fimple

He played guitar, so we’ve got guitar picks, and “Grandma’s Feather Bed” was a song we all liked to sing together.

kathleen fimple

There’s a shotgun shell, there’s the antler — this knife has an antler.

kathleen fimple

He was a Scout leader.

kathleen fimple

Those were from the casket spray.

kathleen fimple

He was a lifelong smoker.

julie bosman

What did he smoke?

kathleen fimple

Marlboros.

julie bosman

Not the lights, the —

kathleen fimple

Oh, no. No, no.

julie bosman

How did he feel about his smoking? Was he like, “Ugh, I hate this,” or, “I love it, and I don’t want to quit.” Or how —

kathleen fimple

I love it, and I don’t want to quit. And also, a lot of denial, especially early on. My grandpa lived to be, whatever, 80-something, and he smoked.

kathleen fimple

Eventually, I think he reconciled that, yes, smoking was bad, and it could cause cancer.

kathleen fimple

In his 30s, while we were first married, he quit several times briefly.

kathleen fimple

He’d stop for a month or two, and then, yeah.

dulcia steffen

So that he would see her face every time he pulled out a cigarette. I was like, O.K., I’ve tried all the little tactics.

kathleen fimple

We’d go to church, and he sing a line, and then he’d stop, and then he’d have to pick it up later because he’d have to catch his breath in between. And he used to whistle all the time — he couldn’t whistle anymore.

kathleen fimple

I think that was when he started vaping.

julie bosman

Do you know how he got the idea?

kathleen fimple

No. We both, I had kind of seen advertisements for it and things, but it was his idea, and he bought one and came home with it.

julie bosman

Do you know which brand?

kathleen fimple

Mistics.

dulcia steffen

Then he had blu, and then he went to Juul.

kathleen fimple

And he only went to Juul less than a year ago.

kathleen fimple

There was a cough, cold going around —

kathleen fimple

And it probably, in some ways, was less obvious to us because he had a smoker’s cough. So he coughed, but it was also obvious that this was worse.

kathleen fimple

That’s probably why he went, though, in April, just because you kept pushing him.

dulcia steffen

Yeah.

kathleen fimple

Dr. Simon said, “You have pneumonia, and you’re going to the hospital.”

dulcia steffen

His hands were like ice.

kathleen fimple

They were starting to turn blue.

dulcia steffen

He couldn’t blink, and his mouth was propped open, and he wasn’t breathing very often. And his last breath I could tell because there was just a slight twitch in his neck.

kathleen fimple

I was in a meeting when the Department of Health called.

kathleen fimple

He asked about any exposure in the past to moldy wood, or wood chips, to asbestos, to pesticides. Then they asked about symptoms.

kathleen fimple

Did he lose weight, was he coughing?

kathleen fimple

I said, I don’t know why vaping — I mean, yes, he vaped, but I don’t think it’s from vaping. They said he had pneumonia. Lifelong smoker, C.O.P.D. —

dulcia steffen

It was a straight replacement for cigarettes.

kathleen fimple

Yeah.

dulcia steffen

Yeah, and part of it was habit. Years and years of habit, when you get in the vehicle, you light up a cigarette. So when he’d get in the vehicle and start to drive, he would vape.

kathleen fimple

I knew it wasn’t the perfect solution, but again, figured it was better.

julie bosman

Right.

kathleen fimple

For him, and for us.

julie bosman

Did you ever think, could they be dangerous?

kathleen fimple

No. No, I —

dulcia steffen

You know, when they first marketed them, they said it was a safer alternative. We assumed it was healthier for those around him as well.

archived recording 1

This morning, Nebraska health officials have announced the state’s first vaping-related death.

archived recording 2

That’s right, the person was over 65, and from the Douglas County, which is the Omaha area. The individual died in May, but the State Health Department just identified it as vaping-related.

archived recording 1

There is breaking news tonight in the nationwide vaping crisis. Another death, and new reports of possible lung disease. The C.D.C. is looking into dozens of cases.

archived recording 2

The C.D.C. can confirm 31 cases —

archived recording 3

200 potential cases —

archived recording 4

380 cases —

archived recording 5

The 450 cases span —

archived recording 6

530 cases —

archived recording 7

It’s unclear just what’s causing the problem. The C.D.C. says it will continue to investigate.

kathleen fimple

And it showed pneumonia in the lower lobe of one lung. But the rest of his lungs, both sides and upper and lower were filled with what they call ground glass opacity.

kathleen fimple

And I said, well, how does that — is that different from just a long-term smoker? And he said, yes. This is not what you would see in just, routine, if you will, long-term smoking.

julie bosman

Is that unthinkable? Do you have any — I mean, is that something that he might have possibly done?

kathleen fimple

I don’t think he would have even known where to go to get it.

dulcia steffen

We’ve been to Colorado since it was legalized, and he wouldn’t touch it.

kathleen fimple

He was never interested.

dulcia steffen

No. So I don’t think he would have ever considered getting it black-market, either.

julie bosman

Do you know where he bought it?

kathleen fimple

Walmart. Walgreens or Walmart.

julie bosman

Walgreens or Walmart.

kathleen fimple

I don’t think he bought them anyplace else.

dulcia steffen

He never went to any of the vape shops or anything.

kathleen fimple

Oh, never. Never.

dulcia steffen

To think that that box right there could be the sole reason he’s dead, in some ways, is like looking at a gun with a bullet. It’s just a method of death.

archived recording (donald trump)

Last night, the United States brought the world’s number one terrorist leader to justice. Abu Bakr al-Baghdadi is dead.

archived recording (donald trump)

Capturing or killing Baghdadi has been the top national security priority of my administration.

archived recording (donald trump)

The thug who tried so hard to intimidate others spent his last moments in utter fear, in total panic and dread, terrified of the American forces bearing down on him.

archived recording (donald trump)

He was a sick and depraved man, and now he’s gone.

Chemical Burns – Do’s and Don’ts You Must Follow – By Dr. Shivashankar B. Sajjanshetty

A chemical burn can occur owing to a number of substances, for instance, if the skin comes in contact with strong acids, bases, irritants, gasoline, paint thinner and drain cleaners then it react with your skin. Chemical burns are also termed as caustic burns. The symptoms usually depend on the intensity of a burn, which include redness, irritation, numbness, pain, the skin turning black and dead or even vision loss, if the chemicals come in contact with the eyes.

What are the Do’s and Don’ts?

1. Do away with those chemicals, which have caused the burn or wipe off the dry chemicals. It is safe to use towels or put on gloves for this work.

2. Remove jewelry or any contaminated clothing to avoid further burning and inflammation of the skin.

3. Rinse off the affected area immediately with cold water.

4. Loosely wrap the area with sterile gauze or a bandage.

5. If required, you can even opt for pain relievers such as naproxen sodium, ibuprofen or acetaminophen.

6. Consider taking a tetanus injection, but at the same time, ensure that your booster is up-to-date.

7. Refrain from applying an antibiotic ointment over the burnt area or neutralizing it with an alkali or acid. This may aggravate the burn.

When should you seek an emergency care?

1. When the person exhibits sign of shock such as shallow breathing, pale complexion or is experiencing bouts of fainting.

2. When the chemical burn pierces through the upper layer of the skin, occupying an area of above 3 inches in diameter.

3. When the chemical burn has spread to the buttocks, groin, face, feet, hands, eyes or even the limb. If you wish to discuss about any specific problem, you can consult a dermatologist.

Bengay And Icyhot May Cause Chemical Burns

Tara Godoy, the President of University Park Legal Nurse Consulting in the Northern San Francisco Bay Area recently brought to our attention via a posting on the Expert Witness Network that the FDA earlier this month has issued a consumer advisory warning the public that popular topical pain relieving products such as IcyHot and Bengay have been linked to a risk of a rare chemical burn injury. These products are sold in creams, gels and patches and are designed to provide temporary relief for pain to muscles and joints. As you might suspect, millions of us (this author included) have used these products without any knowledge of this risk. The FDA said, in its September 13, 2012 alert that there is a risk of first to even third-degree burns requiring hospitalization from applying these products. To date, the FDA has reported 43 such cases involving those brands as well as Capzasin, Flexall and Mentholatum. According to the FDA, “when applied to the skin, the products produce a local sensation of warmth or coolness..these products should not cause pain or skin damage.” Most of the burns, according to FDA chemist Reynold Tan, “are associated with products containing the active ingredients menthol, methyl salicylate and capsaicin.” According to the FDA, most of the severe burns came from products containing menthol or a menthol/methyl salicylate combination that had more than 3% menthol or 10% methyl salicylate. Only a few cases involved capsaicin.

Although the number of cases is very small compared to the millions of us who use these products, the FDA has issued the following advice for consumers:

1. Don’t apply these products to irritated or damaged skin
2. Don’t apply bandages on top of these products
3. Don’t apply heat from a heating pad, hot water bottle or lamp to the area where you have applied these products for fear of increasing the risk of serious burns
4. Seek medical attention immediately if you experience burning pain or blistering
5. Doctors should instruct patients on how to use these products
6. Report any adverse side effects immediately to the FDA’s MedWatch Program

We thank Tara Godoy for bringing this important issue to our attention.

Feel free to pass this issue of the Goldhaber Warnings Report on to any friend or colleague.

Dr. Gerald M. Goldhaber, the President of Goldhaber Research Associates, LLC, is a nationally recognized expert in the fields of Political Polling and Warning Label Research. His clients include Fortune 500 companies, as well as educational and governmental organizations. He has conducted hundreds of surveys, including political polls for candidates running for U.S Congress, Senate, and President. Dr. Goldhaber also served as a consultant to President Reagan’s Private Sector Survey for Cost Control.

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DO NOT REPRODUCE WITHOUT WRITTEN PERMISSION BY AUTHOR.

What are 90,000 and what is the difference?

Burns are one of the most common household injuries, along with cuts.In addition, victims of accidents and disasters often receive burns of varying severity. The latter cases are dealt with by a relatively young medical science – combustiology. Combustiologists study treatments for serious injuries and the pathological conditions caused by them (for example, burn shock).

Degree of burns

To begin with, determine the degree, i.e. depth and area of ​​damage. Based on this, doctors select treatment regimens.

1. degree – only the upper layer of the epidermis is affected.
   • Symptoms: edema, redness. Hospitalization is needed if more than 10% of the skin is affected or if the damage is localized on the head. In other cases, treatment can be carried out at home.

2. degree – all layers of the epidermis are affected.
   • Symptoms: peeling of the epidermis, blistering.If a significant part of the skin is damaged, burn disease can develop – a pathological condition that causes malfunctions in the work of internal organs. Hospital treatment is required.

3. degree
   1. the epidermis and the dermal layer underlying it are affected, but with the preservation of a certain number of viable cells.
      • Symptoms: severe pain, blisters filled with yellow fluid, skin tone red to burgundy, minor hemorrhages.Treatment is strictly in the hospital, because skin grafting is often needed.
   2. complete damage to the dermal layer, probably subcutaneous tissue.
      • Symptoms: blisters with blood, acute pain, alternating with loss of sensitivity, a sharp drop in pressure. When spreading to large areas of the body, burn shock is likely (loss of plasma, impaired renal function, etc.) Hospitalization is mandatory.

4. degree – deep damage to the skin and subcutaneous structures (tissue, muscles, bones).
   • Symptoms: the skin is covered with a black or brown crust, nervous excitement, heart palpitations, high blood pressure. Then burn shock develops. The condition is life-threatening, urgent medical attention is required, treatment is only inpatient.

Types of burns

In addition to the degree, for the correct provision of first aid and further treatment, it is necessary to take into account the cause of the burn: fire, steam, aggressive chemical compounds, etc.d.

1. Thermal burn is the most common type that occurs due to contact with fire or high temperature substances. Main subspecies:
   • Burns from fire – manifest themselves as sharp pain, burning, redness of the skin.
   • Burns with boiling water – in addition to pain and redness, they are accompanied by swelling and blisters with a light, transparent liquid. The surface of the bladder is tense, when a rupture opens a wound, which is then covered with a scab.This type is dangerous, first of all, by infection of damaged tissues.
   • Steam burn – in the initial stages, the symptoms are the same as in the previous species, because steam is high temperature evaporated water. Such burns occur in the kitchen or when cleaning. More serious degrees of injury arise from industrial accidents, non-observance of safety measures, etc.

Treatment of 1st and 2nd degree burns

Skin is a unique natural barrier that protects our body from the environment.

Features of the structure of the skin:

1. The epidermis is the outermost layer of the skin and is regularly renewed.
2. Dermis is the next, deeper layer of the skin, which contains nerve fibers, blood vessels, hair follicles.
3. Subcutaneous adipose tissue is the deepest layer that has a nourishing and protective function. This layer consists of connective tissue elements and fat cells.

Burns are one of the most common causes of skin damage.Throughout life, a person often comes into contact with hot liquids, steam, hot metal elements, chemicals. It should be remembered that the larger the area of ​​the lesion, the more difficult the general condition of the victim.

Classification of burns depending on what caused the burn:

– thermal burn resulting from contact with fire, hot steam, electrical appliances, boiling water;

– electrical burn – is obtained as a result of tissue damage by an electromagnetic field as a result of an electric shock, lightning;

– chemical burn resulting from interaction with acids, alkali.A very severe and dangerous type of burn.

– radiation burn – quite rare, but still occurring as a result of prolonged contact of the skin with the sun’s rays.

The general classification of burns divides their types into 4 degrees, which have their own symptoms of manifestation and require a different approach in the treatment of burns.

1st degree burn.

With this burn, the epidermis layer suffers without touching the deep skin layers.

A 1st degree burn is manifested by redness, swelling, no blisters.At the site of the burn, the victim feels a burning sensation, pain that is relieved by contact with cold water.

Treatment of 1st degree burns.

In the event of a burn, treatment in a hospital clinic in Novorossiysk is not required; burn treatment is carried out at home.

The following actions must be performed:

– immediately stop contact with a hot object, steam, liquid

– Rinse the burn area with cold water

– apply a sterile bandage to the burn site to avoid infection

2nd degree burn.

In case of a 2nd degree burn, the epidermis layer and the upper dermis are damaged. In the place of the burn, there is severe pain, redness, and a sharp formation of blisters filled with liquid occurs.

In the case of a 2nd degree burn, hospital treatment is also not required if the victim feels generally satisfactory.

Action to be taken for home burn treatment:

– immediately stop contact with the damaging factor

– place the burned area under cold water

– Apply anti-scald cream to a clean and dry burn area, apply a sterile bandage

In the event of a grade 2 burn, do not pierce the blisters formed, this can lead to infection of the wound and subsequently lead to a scar.

If a large surface of the skin is damaged by a burn, you need to contact the Medici Medical Center, where you will be provided with the necessary assistance. “Also seek the help of Medici specialists if the burn has occurred on the face.

90,000 What to do with different types of burns in a child. Recommendations of the doctor of the primary health care center No. 1

The child’s burn takes the third place in childhood traumatism

About what parents need to know about burn injuries, Ogulsana Belyaeva, the pediatrician of the primary health care center No. 1, told.

What are burns?

Burns are tissue damage caused by local exposure to high temperatures, chemicals, ionizing radiation or electric current.

Burns are distinguished by the degree of tissue damage:

1 degree. Only the skin is affected. There is reddening of the skin, slight edema, fever at the site of the burn, itching, burning. Healing occurs on its own in 7-10 days, no treatment is required, no scars remain.

2nd degree. There is edema, redness, blisters with transparent contents, sharp soreness. With the right approach to treatment, it heals in 2-3 weeks, leaves no scars.

3rd degree. It is characterized by edema, the appearance of blisters with bloody contents, sensitivity is reduced or absent. Such burns are treated in the hospital. The wound heals with the formation of scars and scars.

4th degree. It is characterized by damage to the skin, subcutaneous fat, muscles. The wound is deep, black, not sensitive to pain.As with third-degree burns, treatment is carried out in a hospital. After recovery, scars remain.

Not only the depth is important, but also the area of ​​the burn. The easiest way to evaluate is by the palm of the baby. An area equal to the palm is equal to one percent of the entire body area. The larger the area, the worse the forecast.

Features of burns in children:

– thinner skin compared to adults, therefore burns in children are deeper

– the child is helpless at the time of injury, does not immediately react, is not able to help himself, which is why the exposure of the traumatic agent can be longer, which deepens the trauma

– burn shock in children can occur with a smaller burn surface than in adults.

Chemical burns in a child

Children receive chemical burns quite often. Poorly cleaned household chemicals become the reason. Unfortunately, children are not only doused, but also drink liquid from beautiful packages.

Features of symptoms when exposed to various chemicals:

– Acids. A scab develops at the site of injury, the burn spreads slowly into the depths of the burn, a dense crust forms, which prevents wound infection.

– Alkalis.The burn deepens quickly, the surface of the wound is weeping, and infections of the wound are frequent.

Help with chemical burns of the skin:

1. Take off or cut clothes from the damaged area of ​​the body.

2. Rinse the wound with running water for 15 minutes.

3. Apply a dry aseptic bandage, seek the help of a surgeon.

4. For severe pain, give an anesthetic (ibuprofen, paracetamol).

Chemical eye burn, first aid:

1.Rinse your eyes under running water as soon as possible, try to open your eyes.

2. Flush the wound for at least 15 minutes.

3. Apply a dry aseptic dressing.

4. Seek help from an ophthalmologist.

If the child drank household chemicals, immediately call an ambulance. Before the doctor arrives, try to give your baby a drink of water and induce vomiting. Unfortunately, the younger the baby, the more difficult it is to do it.

Thermal burn in a child

Thermal burns are caused by boiling water, steam, contact with a hot surface (iron, stove, hot dishes), flame.Most often, small children are scalded with boiling water.

What to do in case of thermal burn:

1. Remove clothing from the burned area. If it is not possible to remove it, cut it off and place the wound under cold water.

2. After cooling the burn area, apply a bandage over the area. The bandage should not press, it should lie loosely.

3. If you see a 2nd degree burn in a child, there are blisters and severe pain, do not pierce the blisters.

4. Give the victim some water or any drink according to the child’s taste (tea, fruit drink, juice).

5. Give the child the dose of the pain reliever at the age-appropriate dosage.

6. If the area of ​​the burn is more than 10%, even if it is a 1st degree burn, it is better to show it to a doctor. If a child burns with boiling water of 2 degrees or more and an area of ​​more than 10%, you need to take the baby to a burn hospital.

What not to do in case of burns:

– do not wash the wound with anything other than water,

– do not rub the wound with a cloth and do not immerse the victim in a bath,

– do not treat the surface with antiseptics,

– do not smear fresh burns with oils, petroleum jelly, baby cream,

– do not smear burns with alcohol-containing solutions,

– do not pierce the bubbles, this can lead to infection of the wound,

– do not apply medicinal ointments and cream immediately to a still hot burn, this can aggravate the situation.

Treatment of burns in children

Treatment must be prescribed by a doctor. If you decide to take a risk and treat a small 1-2 degree burn yourself, pay attention to the fact that all ointments and creams cannot be rubbed. They need to be applied to the skin, as if creating a protective layer. The bandages should not press on, they should be applied loosely. It is impossible to apply the plaster on the burnt surface.

The most famous remedies for burns for children:

• Dermazin. Approved for use in children from 2 months.Burn cream is used to apply to the skin 1-2 times a day. Can be used under a bandage or on exposed skin. You need to bandage every day. The drug resists the spread of wound infection well.

• Panthenol. Ointment for burns for children with dexpanthenol. Recommended for the treatment of 1st degree burns. It is applied after cooling the burned skin.

Prevention of burns

– try to keep the child away from hot household appliances,

– do not take the baby in your arms when preparing dinner, especially do not hold him over a boiling pan,

– pouring lunch for a child, check the temperature dishes,

– wash your hands with your child, each time checking the temperature of the water flowing from the tap,

– do not let children play with open fire,

– keep household chemicals, medicines and hazardous chemicals under lock and key.

The doctor spoke about the danger of getting a chemical burn from the hogweed | News | Izvestia

Head of the burn department of the Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky Sergey Bogdanov told on Thursday, May 27, about the danger of cow parsnip.

According to him, the juice of this plant is a strong irritant both as an allergen and as a chemical. As a rule, this occurs in early spring or summer, during the flowering period of the plant.

“The hogweed burns are thermal.They are especially difficult in children, because they have thin skin and even a little is enough for the lesion to become deep. If you hold a sheet of cow parsnip on the skin, there will immediately be a chemical burn and damage. Usually the inner surfaces of the shoulders, thighs, open areas of the body, where the skin is more delicate, suffer, ”the doctor said in an interview with the Zvezda TV channel.

Bogdanov noted that the burns themselves are not very deep and heal on their own, without skin grafting. If the plant touches, it is necessary to rinse this place well with water and lubricate with hormonal creams to reduce the allergic component, and only then use water-soluble ointments and antibacterial drugs.If nothing is done with a fresh burn, the lesion will gradually worsen more and more.

On May 23, lawyer Anna Ponomareva said that agricultural plots overgrown with weeds could be grounds for imposing a fine on their owners, Ridus writes.

According to her, the legislation provides for administrative responsibility for overgrowing with weeds from 50% of the land.

Weeds include hemp, thistle, Sosnovsky cow parsnip, field mint, medicinal dandelion, wormwood, yarrow, field thistle, wild radish, black henbane, ragweed and nightshade.

Earlier, on May 14, it was reported that the online map, which displays the addresses of Sosnovsky’s hogweed growing in the Moscow region, and plans to combat this dangerous weed, were updated on the geoportal.

As of May 12, in the Moscow region, more than 2 thousand hectares of land were cultivated from hogweed. The first stage of work takes place from May 1 to June 10. Specialists dig up the weed, mow it down repeatedly, cut the inflorescences, burn it out, plow the land, and then sow it with other crops.There are three stages in total for the current season. It is planned to cultivate about 16 thousand hectares of land

Treatment of tongue burns in children and adults at the dentist “Zuub.rf”.

A tongue burn is an injury in which the mucous membrane is damaged, and in some cases even muscle tissue. This problem brings a lot of discomfort – from pain and inability to eat, drink fluids, to death. It is very important to urgently contact a specialist who, having studied the cause of the burn, will prescribe treatment.If you neglect the help of a qualified dentist, there can be serious complications up to necrotic decomposition of soft tissues, an infectious lesion of the whole body.

Types of tongue burns

Depending on the cause of origin, the following types of injury are distinguished:

• Chemical burns of the tongue or oral cavity – when tissues are damaged as a result of exposure to aggressive chemical compounds;
• Thermal – when the surface is exposed to a high temperature object.
• Electric – occurs as a result of tissue contact with electricity. For example, when performing dental procedures. Electric current affects not only the tissues of the tongue, but the entire body as a whole.

Symptoms of tongue burn

Symptoms depend on the scale of soft tissue lesions:

First degree – a burn occurs due to a short exposure to high temperatures on the tissue. The patient has slight redness, there is swelling of the mucous membrane.Often, a burn condition is triggered by eating too hot food or liquid.

Second degree – there is swelling of the mucous membrane, redness, multiple blisters on the surface.

Third degree – accompanied by the death of tissues, large blisters, reddening of the surface, the organ itself, as it were, “changes its consistency.” Typically caused by exposure to gases, high temperature liquids or chemical compounds.

Fourth degree – severe damage when the tissues are charred.Such a burn condition is rarely compatible with life.

How to properly treat a tongue burn?

Treatment methods depend on the type of thermal injury.

What to do in case of a thermal burn of the tongue?

• rinse mouth with cool water;
• to apply ice or a cold object to the damaged area;
• treat the burn site with a disinfecting solution;
• rinse with disinfectant to prevent bacteria from entering the mouth;
• use local anesthetic formulations;
• while the tongue is recovering, eat fluids, fruits and vegetables rich in vitamins C and B.Exclude spicy, pickled food, foods that can have a mechanical effect on tissues (nuts, crackers, seeds, etc.).

If there are bubbles on the surface of the tongue, it is necessary to urgently seek help from a dentist! Blisters should never be opened by yourself! You may need inpatient treatment under the supervision of a doctor.

How to treat a chemical burn of the tongue?

• Rinse the mouth thoroughly;
• Neutralize corrosive chemical.Depending on the source of the burn, a certain neutralizer is used;

Pay attention! If the oral cavity is burnt with an alkaline solution, it should not be rinsed with water, as moisture promotes more active penetration into the soft tissues of the tongue.

• after neutralization, the burning sensation should go away. For pain relief, it is worth using anesthetics and antihistamines;
• If the mucous membrane is badly burned, with damage to the structure of the tongue and muscle tissue, it is necessary to urgently go for an examination to the doctor.

How exactly to neutralize a chemical burn of the oral cavity?

Carbolic acid is well neutralized with glycerin.

Soda and water neutralize acidic compounds.

If alkali gets into the mouth, rinse the cavity with citric acid diluted in water.

In case of exposure to aggressive household chemicals, the oral cavity should be rinsed with cool running water.

This is important! Tongue burns take a long time to heal.Unfortunately, these tissues cannot be made motionless for a certain time, the tongue is constantly in motion. On average, it can take several weeks for a tongue to heal after an injury.

Treatment of a burn of the oral cavity in a child

According to statistics, a large percentage of patients who go to the doctor for help as a result of a burn of the mouth or tongue are children. Little patients under one year old and older can unconsciously “taste” household chemicals or alcoholic drinks accidentally left on the table by their parents.Also, common causes of burns are eating food that is too hot.

The mucous membrane of the tongue in a child is more delicate and thin, and therefore requires more delicate handling in case of a burn. For treatment, you urgently need to contact a pediatric dentist.

90,000 treatment in Moscow. Medneil Clinic

The ubiquity and popularity of gel polish is quite understandable and justified – it is convenient and fast, the coating is worn for a long time and suffers little from external influences.But this medal also has a downside – immediately after the appearance of gel varnishes on the market, dermatologists and podologists have significantly increased work – it turns out that their use is not so safe as it was previously thought.

Causes of nail burns after manicure:

• Chemical attack. It is easy to assume that not all bases are the same. In an effort to optimize costs and increase profits, manufacturers use various cheap components that have an adverse effect on the nail apparatus.Due to the relative novelty of the gel polish technology, to date it has not been established exactly which substances cause a chemical burn of the nail bed, however, there is a clear trend in relation to individual manufacturers. In our practice, we have not come across bases that would never cause burns and onycholysis, as well as in most cases. Individual predisposition also appears to play an important role.
• Thermal exposure. Very often, patients who come to an appointment with nail burns say that during a manicure in the salon they felt a “burning sensation under the lamp” more than usual.Heating causes denaturation – a change in the structure of the protein in the cells and intercellular space of the nail bed, onychoblasts – the cells responsible for the attachment and growth of the nail, are damaged, and the nail exfoliates. Usually, the development of a burn is caused either by improper use of a UV or LED lamp (too high power, or the duration of exposure), as well as an excessively applied base layer.

Symptoms of nail burns from gel polish:

• Onycholysis (detachment of the nail from the bed).This is the most common and sometimes the only symptom of a burn. It develops within a few days (and sometimes weeks) after visiting a beauty salon. Often it is not noticed for a long time under the gel polish, and sometimes it is ignored during repeated treatment, aggravating the course.
• Subungual hyperkeratosis, develops along with onycholysis – the detachment cavity is filled with keratin, which leads to a thickening of the nail.
• Change in nail color is another companion of onycholysis, the nail turns white, and when an infection is attached, it turns green (Pseudomonas aeruginosa or mold) or turns yellow (fungus)
• The symptom of “subungual splinters” is the appearance of thin longitudinal stripes of dark black color under the nail.It occurs as a result of damage to the smallest vessels of the nail bed.
• Pain, burning, rash on the skin of the fingers.

Treatment

Treatment of nail burns from gel polish is very similar to the treatment of conventional onycholysis. Onycholysis, large in area, is treated by conservative removal of the exfoliated part of the nail, the use of local antiseptic agents, and the removal of hyperkeratotic layers. The nail is restored with the help of long-term use of gelatinous solutions of various concentrations, growth activators.When attaching bacterial or fungal flora, antibacterial and antimycotic drugs are additionally used. Patients with onycholysis are shown vitamins, iron and calcium preparations, restorative agents. Contact with water, cosmetic varnishes and household chemicals is contraindicated.

Our clinic has accumulated vast experience in treating burns from gel polish and other types of nail dystrophy.

Contact us, we will be happy to help you! You can make an appointment with a doctor in person or online by calling +7 (495) 120-67-80

Prevention and first aid for phytochemical burns by Sosnovsky’s cow parsnip.

Almost 70 species of hogweed are found in the world’s flora. At the end of the 40s of the twentieth century, it began to be used as a forage crop. The very first and most highly productive among other species was selected Sosnovsky hogweed (Heracleum sosnowskyi). However, the milk of the cows gave off bitterness and the cultivation of this culture was discontinued. The hogweed is an aggressive plant. Once it got to the fields and found itself without proper care, it began to spread and occupy all the free areas.

The danger of hogweed is that all parts of the plant contain furocoumarins – substances that dramatically increase the body’s sensitivity to ultraviolet radiation. Contact with stems, leaves, flowers, the ingress of hogweed juice on the skin when exposed to ultraviolet radiation leads to phytochemical burns: local skin hyperemia (redness) occurs, itching increases, edema develops, epidermal blisters with transparent (serous) contents are formed. Even superficial burns of limited area heal over a long time, often with the development of local inflammation, hyperpigmentation (dark spots on the skin), which remains for several months.With extensive damage in the first hours after contact with the plant, in addition to local manifestations, a sharp deterioration in the general condition develops (weakness, decreased blood pressure, severe headache, dizziness, nausea, increased body temperature).

The main measure for the prevention of phytochemical burns with hogweed is the complete exclusion of skin contact with this plant. Strict adherence to the rules of individual protection is necessary so that the hogweed juice or dew with the juice dissolved in it from the plants does not fall not only on unprotected areas of the body, but also does not wet the clothes.

First aid in case of contact with Sosnovsky cow parsnip juice on the skin:

• rinse the affected area with plenty of running water;
• apply a sterile bandage to the affected area;
• for the next 48 hours, avoid exposure to direct sunlight, since furocoumarins penetrated into the skin retain their aggressive properties for a long time.
• if bubbles appear, consult a doctor.You may need not only local, but also general complex treatment. With extensive areas of damage and deterioration of the general condition, treatment is required in the conditions of the intensive care unit and intensive care unit.

Phytochemical burns with hogweed in children, due to age-related anatomical features, are often extremely difficult.