POST # 2 – KEARA
Topic: Explain why immediate neutralization or removal of a chemical spilled on the hand minimizes burn injury and how chemicals splashed in a person’s eye may be treated differently? Burns can be due to more than just thermal burns that often occur from a fire. Hubert and VanMeter (2018) discuss other types of burns such as electrical or chemical burns that cause tissue destruction and inflammation to occur. The inflammatory process from a burn is acute but initiates the release of chemical mediators such as histamines, serotonin, prostaglandins to the site. Vasodilation occurs and capillaries become more permeable, allowing leukocytes to move into the site of injury. If any debris is present, phagocytes are released (Hubert & VanMeter, 2018). Often when this happens, Friedstat (2017) explains that when chemical burns occur, wound infections, cellulitis, and sepsis can happen if the burn is not neutralized as quickly as possible. This makes quick treatment especially important to catch before the burn enters deeper tissue and be re-characterized as a partial thickness burn or full thickness burn (Friedstat, Brown, & Levi, 2017). When a burn occurs from a chemical spill, removal of the substance is needed immediately to reduce the effect of the burn and make it more difficult for the chemical to penetrate deeper into the tissue. In addition, removing any clothing or jewelry is important. Friedstat (2017) explains that removal of the chemical is the most important step in neutralizing chemical burn injuries. Next, gentle irrigation with water or saline to remove any remaining chemicals is important because if irritation is too pressurized, the chemicals can infiltrate deeper into the tissue (Friedstat, Brown, & Levi, 2017). Chemicals splashed in a person’s eye are treated a little differently than surface of skin chemical burns, but have similar steps to follow. Bore (2018) lists the steps of chemical eye splash as first instilling anesthetic eyedrops and irrigate the eye for at least 30 minutes. In certain circumstances, implementing eye drops to neutralize pH of the eye can reduce effect of the chemical burn. For instance, Moghadam (2020) studies the effects of AV gel eye drops for alkali burned cornea and it showed that the defective area was reduced.
Checking labs on a patient with a burn is important because if a burn does not heal and foreign products enter the site, infection can occur. Checking labs that indicate infection such as CBC, white count, CRP, and lactate are useful in assessing infection and potential progression to sepsis. For patients that I may encounter with chemical burns, thorough assessment of the site is important especially if it is a fresh wound and monitoring the progress to ensure the area heals properly. Educating on future accidents and what to do if one occurs is equally as important. In addition, educating patients on signs and symptoms to look out for as the wound heals. Overall, removing the chemical is the best step in treating chemical burns on the skin. References Bore, M. (2018). Emergency management: chemical burns. Community Eye Health Journal, 31(103), 72. Friedstat, J., Brown, D. A., & Levi, B. (2017). Chemical, electrical, and radiation injuries. Clinics in plastic surgery, 44(3), 657–669. https://doi.org/10.1016/j.cps.2017.02.021 Hubert, R. J. & VanMeter, K. C. (2018). Gould’s pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders. Moghadam, M. R., Jafarinasab, M.-R., Yousefi, Z., Moghaddam, A. S., Memarzadeh, H., & Kanavi, M. R. (2020). Aloe vera gel-derived eye drops for alkaline corneal injury in a rabbit model. Journal of Ophthalmic & Vision Research, 15(1), 7–16. https://doi.org/10.18502/jovr.v15i1.5932