A burning issue

Chemical burns are often serious, because the chemical continues to burn for as long as it remains in contact with the body. St John South Africa explains how to manage them

Burns are injuries to the skin and tissue caused by heat, radiation or chemicals. The severity of a burn is determined by the depth (degree of the burn), amount of burnt body surface (percent of body area), body area that is affected and the age and physical condition of the person.

Chemical burns are considered “critical”, as they can be life threatening, or cause permanent disability or disfigurement. In critical burns, all the major systems of the body can be affected; not just the burnt tissue.

Common complications include shock, infection, breathing problems (caused by the inhalation of fumes or smoke) and swelling. Burn victims must seek immediate medical help so that the extent of the injuries can be properly assessed.

A corrosive chemical or poison will keep burning while it is present on the skin, resulting in redness, itching and blisters. The faster the chemicals can be removed from the skin, the less tissue damage there will be.

Chemical burns to the skin:

• First ensure that you wear gloves! Assess the nature of the chemical spill and the extent of the “danger zone”. Get a bystander to cordon off the area and report the incident to management.

• Remove the chemical from the body by flushing the area with large amounts of cool water. If the chemical is a dry powder, first brush off loose particles with a cloth. Do not delay flushing to remove clothing; rather do so while flushing the area.

• Remove items that may become constricting, due to swelling or blistering – such as rings.

• Continue flushing for 15 to 20 minutes. Loosely cover the burn area with a clean, fluff-free, preferably sterile dressing. Make sure securing tape does not touch the burnt area. If the burn area is large, use a clean sheet or tablecloth.

• Arrange for medical help and provide first aid for shock. If the casualty begins to feel an increased sensation of burning, flush the area again for another ten minutes.

Do not use chemical neutralisers, such as vinegar, soda or alcohol, unless advised to do so by a medical doctor.

Chemical burns to the eyes:

Corrosive chemicals, whether solid or liquid, can permanently injure the eyes. Casualties normally suffer intense pain and are very sensitive to light.

• Put on protective gloves.

• Sit or lay the casualty down. Tilt the head back and turn it slightly to the injured side. If only one eye is injured, protect the uninjured eye.

• If the chemical is a dry powder, carefully brush it off the skin away from both eyes.

• Flush the injured eye with cool water. Gently keep the eye open with your fingers. Flush for at least 15 minutes. Ensure the uninjured eye is not contaminated; if the casualty’s own hand is being used to protect the uninjured eye, ensure that it is free of and protected against chemicals.

• Don’t waste time trying to remove contact lenses. If flushing the eyes doesn’t wash the lenses out, have the casualty remove them and throw them away.

• Cover the injured eye with a fluff-free dressing. If both eyes are injured, cover the more seriously injured eye. Cover both eyes only if the casualty is comfortable with it, as not being able to see at all adds to the stress of the incident.

• Get medical help immediately. Give ongoing casualty care until help arrives.

Ingested or inhaled chemicals/poisons:

All poisons may affect consciousness, breathing and circulation. Poisons that have been swallowed usually cause nausea, abdominal cramps, diarrhoea and vomiting. They can discolour the lips, cause burns in or around the mouth, or leave an odour on the breath.

• If you suspect the casualty has swallowed a poisonous substance, contact the Poison Information Centre (PIC) on 0861 555 777.

• Do not give fluids (dilute a poison) unless told to do so by the PIC.

• If the casualty is conscious, wipe any poisonous or corrosive residue from their mouth and face and rinse out the mouth.

• Never induce vomiting except on the advice of the PIC, as this may cause more damage.

Poisons that have been inhaled may cause problems with breathing. Symptoms include coughing, chest pain and difficulty breathing. Prolonged exposure to natural gas or carbon monoxide can cause headache, dizziness, unconsciousness, stopped breathing and cardiac arrest.

• Assess the possible presence of a poisonous gas or vapour. Ensure your own safety – it may be best to wait for professional rescuers.

• Inhaled poisons should be cleared from the lungs as quickly as possible by moving the person away from the source to fresh air.

• If the casualty is unresponsive, call for medical help immediately. If breathing is not present, begin cardiopulmonary resuscitation (CPR), starting with chest compressions, ensuring an open airway and rescue breaths, or compressive-airway breathing (C-A-B). Use a face mask or shield with a one-way valve.

• If the casualty vomits, keep the airway open by clearing out the mouth and putting them into the recovery position.

• If the casualty goes into convulsions, prevent them from getting injured.

• Get medical help.

If you work with chemicals, make sure you use the correct personal protective equipment, are aware of safety procedures and know the specific first aid for the chemicals used in your workplace. The material safety data sheet (MSDS) for each chemical contains this information.

The Workplace Hazardous Materials Information System (WHMIS) is used to identify hazardous materials in the workplace and to help employees protect themselves against these real dangers. WHMIS includes labelling products with supplier labels and workplace labels.