First aid for chemical burns: skin and other organs

In this article we will tell you:

• What can a chemical burn be like?
• How to understand what exactly got into your eyes?
• The first signs of a chemical burn to the eyes
• First aid for chemical burns
• Why is it necessary to go to the doctor after a chemical burn to the eyes?
• How to assess the degree of eye damage from a chemical burn?
• How are patients with chemical eye burns treated?
• How to prevent eye burns?

Chemical burns to the eyes account for about 10% of eye injuries for which people consult doctors. And since this happens so often, everyone should know how to properly provide first aid for a chemical burn to the eyes.

Most of them happen at work, for example, in industries where they work with chemicals. Chemical burns also often occur in the home from cleaning products or other common household products. They can also be very dangerous and cause irreparable damage to the organ of vision, they must be treated seriously and immediately.

What can a chemical burn be like?

• Alkaline. This is the most dangerous type of chemical injury to the eye - alkali dissolves the tissue of the eye and penetrates deep into it. The higher its concentration, the faster necrosis occurs. Possible if ammonia bleach, cleaner, lime, cement or magnesium comes into contact with eyes;
• Acidic. It is caused by vinegar, acetone, peeling solutions or glass polish. Typically, with such a burn, only the cornea is affected. But concentrated hydrofluoric or sulfuric acid can melt tissue right down to the lens. Damage to the cornea itself can also cause loss of vision - a thorn appears on the eye;
• From other irritants, such as pepper spray.

How to understand what exactly got into your eyes?

In order not to waste precious time finding out the cause, it is better to consult a doctor as soon as possible. It is very difficult to visually determine what caused the burn. For example, if there are crusts, one can only assume that acid has gotten into the eyes, but in reality it is difficult to see them. Everything is complicated by the fact that due to the reflex, the eyelids are tightly closed during a burn. Therefore, the conclusion is usually made based on what the person has worked with. If the victim has used ammonia bleaches, cleaners, lime, cement or magnesium, this is definitely an alkaline injury.

Burn disease

Medical care for burns also includes treatment of burn disease. The destruction of tissue is accompanied by the release of toxins that poison the body. As a result, the functioning of internal organs is disrupted, primarily the liver, spleen, kidneys, and heart. Massive infusion therapy is needed, aimed at quickly removing decay products and maintaining the functioning of internal organs.

Regardless of the area and depth of the burn, the injury itself does not pose a danger to human life. But with extensive and deep lesions, there may be a deterioration in the quality of life. It is burn disease that poses the greatest danger, so its treatment and prevention should be given the greatest attention.

First aid for chemical burns:

❗ Do not try to wash off acids with alkali and vice versa - this can only worsen the damage. Also, do not rinse with water if lime or superglue gets into your eyes. According to experts, treating a combined corneal burn is much more difficult. Try to see a doctor as soon as possible for examination and treatment.

❗ Regardless of the type of chemical burn to the eyes, the first thing to do is to carefully open the eyelids and thoroughly rinse the eyes from the outer edge to the inner. This can be done using a rubber bulb, a pipette, a syringe without a needle, or simply with your palms. The same procedure is performed for thermal burns.

❗ It is best to wash your eyes with purified or boiled water, but running water (12-18°C) will also do. You can bend over and put your eye under the faucet. The procedure time is at least 20 minutes. This is necessary in order to reduce the concentration of the substance. After you have washed the substance from the victim’s eyes, you can drip a 4-5% solution of lidocaine, novocaine or another anesthetic and take a pain reliever.

❗ If a powdery chemical gets into your eyes, remove its remnants from your eyes with a dry cotton swab before rinsing.

Precautions and prevention measures

To protect yourself from chemical burns, you should follow simple rules.
When working with aggressive substances, you must wear personal protective equipment, such as gloves, goggles and a respirator. Chemicals should be stored in tightly closed containers (labeled) away from food and places where children can reach them. After use, ventilate the room. It is dangerous to mix substances if you are not sure of the consequences of their combination.

Added: 10/19/2021

Why is it necessary to go to the doctor after a chemical burn to the eyes?

Even if you feel better after first aid, ophthalmologists strongly recommend calling an ambulance or going to the hospital yourself. The fact is that sometimes the first symptoms may indicate a mild degree of damage, and after a day irreversible changes, such as blindness, may occur.

Doctors will help remove possible particles of foreign bodies and rinse the eyes again with neutral antiseptic solutions. They will also determine the severity and depth of the lesion and prescribe therapy based on this.

Complications

A more serious condition in the case of deep burns occurs if they occupy more than 5-11% of the body or the total burn area is more than 20%, then in this case burn disease occurs. This disease is associated with loss of skin and profound impairment of their functions (protection against infection, loss of pain and tactile sensitivity, maintaining water balance, thermoregulation). A serious condition requires a systematic approach and comprehensive treatment aimed at preserving the life of the victim, being in intensive care conditions and a multidisciplinary approach of specialists. It is important to note that for children under one year old, 3-5% of the burn area is sufficient for this complication to appear.

How to assess the degree of eye damage from a chemical burn?

1. I degree - superficial damage with slight redness of the eye shell (conjunctiva) and eyelids, a slight defect in the surface of the cornea. Does not require special treatment and does not threaten vision;
2. Average, or II degree - superficial death of the mucous membrane of the eye and conjunctiva, swelling, damage to the transparent and epithelial layer of the cornea. Grayish-cloudy lesions on the surface of the eye, blisters and peeling on the skin of the eyelids may be visible. In such cases, scars may appear on the surface of the cornea and partial deterioration of vision;
3. Severe, or III degree - damage to up to 50% of the surface of the eyeball. There is a process of tissue death throughout the conjunctiva and its lower layers, sclera and cartilage of the eyelids. If the eyelids are opened, the eye will look pale and very swollen. Due to a burn, the cornea loses its moisture and ceases to be transparent;
4. Particularly severe, or grade IV - redness, swelling, darker areas are visible (deep necrosis). The conjunctiva and sclera darken. Due to a severe burn of the cornea, holes appear on it, it becomes gray, and the internal structures of the eye also suffer. At this stage, the likelihood of complete loss of vision is very high.

Classification

by severity

If we talk about the classification of chemical burns, they are divided by severity:

• Grade 1 is the mildest, in which the upper layers of the epidermis are affected. In this case, slight redness appears on the skin, a burning sensation is present, and slight swelling is possible. Upon contact with acid, superficial spots and crusts form on the skin. Upon contact with alkali, against the background of general hyperemia, weeping areas are formed, which are subsequently covered with a crust, the swelling is more pronounced than with acid lesions. Traces of the lesion disappear on their own within 4-5 days.

• 2nd degree - characterized by damage to the deeper layers of the epidermis, in this case the main symptoms are traces of necrosis, severe hyperemia, and a watery blister may subsequently form on the affected area (rarely). There is uneven deformation of the sweat glands, and the hair follicles and sebaceous glands are partially affected. The patient notes an increase in pain, a pronounced burning sensation, and the likelihood of swelling is higher. With timely assistance and adequate treatment, scarring can be avoided. When affected by acid, areas covered with scabs form, which are torn off after 3-4 weeks, exposing a de-pigmented, pink area with traces of scarring. Alkali burns are accompanied by the formation of a soft scab, which thickens after 3-4 days. Subsequently, the scab festers, and after it is rejected (after 3-4 weeks), a festering wound opens.

• 3rd degree - characterized by the destruction of subcutaneous tissues with their partial death along with hair follicles, sweat and sebaceous glands. At the site of the burn, a deep bubble forms, filled with exudate, possibly with bloody inclusions, as well as a scab, which later turns black. There is a loss of sensitivity in the affected area, which is revealed by the absence of pain.

• Grade 4 is the most severe, affecting not only the subcutaneous fat layers, but also muscle tissue (with prolonged contact with an aggressive chemical, the burn can reach the bone). Such tissue damage is characterized by intense pain, the degree of danger is high, and it is impossible to do without professional help in a hospital setting. If the burn reaches the bone, the periosteum and superficial layers of bone tissue die. Such severe burn injuries are rare, occurring in only 1% of patients.

With a chemical burn of internal organs, identifying the extent of the damage becomes much more difficult. An immediate visit to a doctor is required, who will conduct an examination using special equipment (endoscope, etc.)

by chemical substance

Types of chemical burns are also classified according to the characteristics of the chemical:

• Acid burns – caused by liquid acids, for example, sulfuric, nitric and others.
• Phosphorus - characterized by the inevitable combustion of phosphorus upon contact with the skin.
• Alkali burn - the main chemical compounds in this case are ammonia solution, caustic soda, quicklime, etc.
• Phenols are produced by contact with phenolic chemicals, notable examples being phenylacetic acids and phenolic alcohols.
• Fluoride - occurs when the skin comes into contact with hydrofluoric acid.

An important feature of chemical burns is that the destructive effect of contact with the chemical does not stop when it is removed from the skin. It is necessary to inactivate the chemical, only in this case the reaction will be interrupted.

How are patients with chemical eye burns treated?

First, the hospital conducts diagnostics: they check vision, do an ultrasound of the organ of vision, biomicroscopy, measure intraocular pressure and perform a fundus check. This is necessary to assess the condition of the cornea, anterior chamber, lens, conjunctiva and eyelids. If the doctor detects signs of third or fourth degree damage, the patient is admitted to the hospital. In other cases, treatment at home, taking into account the recommendations of an ophthalmologist, will be sufficient. Typically, the ophthalmologist prescribes anti-inflammatory and antibacterial eye drops and gels for faster tissue healing.

Severe injuries may require surgery. It is done either in the first hours or days after a burn, if necessary to save the organ. Most often, surgical intervention waits until complete healing occurs.

Experts' opinion

Based on the results of numerous clinical studies, La-Cri products are recommended by the St. Petersburg branch of the Union of Pediatricians of Russia.

According to the results of clinical studies conducted by the Union of Pediatricians of Russia, it was proven that when using a complex of products, the level of skin moisture decreased by 4% in comparison, and in the group that used placebo, the level of moisture decreased by 9%.

The conducted clinical study proves the high efficiency, safety and tolerability of products for daily skin care of children with mild and moderate forms of atopic dermatitis and during remission, accompanied by a decrease in the quality of life of patients. As a result of therapy, a decrease in the activity of the inflammatory process, a decrease in dryness, itching and flaking was noted.

Cream "La-Cri" for sensitive skin:

• reduces itching and irritation;
• relieves skin redness;
• moisturizes and gently cares for the skin.

Sources:

1. Mancini A. J., Krouchuk D. P., Pediatric dermatology. Publisher: Practical Medicine, Directory, 2018
2. Kildiyarova Rita Rafgatovna, Pediatrician for every day. Guide for doctors, publishing house GEOTAR-Media, 2021
3. B.A. Shamov, I.G. Safiullina, A.B. Beshimova, T.B. Shamov, Differential diagnosis of atopic dermatitis, Journal of Practical Medicine, 2011
4. Fokina R.A., Atopic dermatitis: stages of development of classification forms, Siberian Medical Journal, 2007