Burn Injury Resource CenterTreatment:
Emergency medical attention should be sought when there is suspicion of poisoning:
If there is skin contact, treatment may include:
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Burns From Hydrofluoric Acid (HF) Part II:
Articles Posted in Medical
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Burns From Hydrofluoric Acid (HF) Part I:
Hydrofluoric acid is a combination of hydrogen fluoride in water; it is used mainly for industrial purposes such as glass etching, metal cleaning and pesticide production. It’s also found in house hold uses such as rust removers and heavy duty cleaners and aluminum brighteners.
Hydrofluoric acid is a weak acid that exists predominantly in the undissociated state that enables the acid to penetrate deep in the skin and soft tissue. Liquefactive necrosis of soft tissue and bones is caused when fluoride is liberated from hydrofluoric acid in tissue. Electrolyte disturbance can happen when the free fluoride ion binds to calcium and magnesium ions. Systemic toxicity can result from exposure to HF due to its ability to penetrate tissue, the degree of toxicity depend on the duration of exposure, the concentration of HF, the exposure route and the size of surface area affected. Any co morbidities should be considered with these factors to determine poisoning severity and treatment type to be given.
Clinical features of exposure to HF:
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Feet Burn In Diabetic Patients
Diabetes mellitus is a chronic disease that has many complications, among which is the effect of diabetes on the blood vessels leading to damage, narrowing and may lead to blockage of the blood vessels, leading to alteration of blood perfusion and subsequent reduction in the oxygen and nutritional delivery to the tissues which will affect wound healing. Diabetes can affect the nerves leading to nerve damage (diabetic neuropathy); nerves affected are responsible for temperature, pressure, texture and pain sensation. The nerves of the lower legs and feet when affected can lead to insensitivity to temperature and pain in the lower legs and feet and patients may experience numbness and tingling sensation in these areas.
Diabetic patients with neuropathy have an increased risk of burn injuries. These burns may happen from soaking the feet in hot water, heating pads, walking on hot surface, and contact with a warming device such as heaters. Because of the impaired sensation of the feet in these patients, they may sustain a burn injury without being aware of it. These patients have poor wound healing due to the effect of diabetes on the nerves and blood vessels and the increased risk of wound infection in diabetic patients.
Burns in diabetic patients even when they are minor may lead to ulceration of the wound, serious infection and even amputation of the limb. Therefore preventing and early recognition of burns in diabetic patients is very important.
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Face Transplant
Face transplant is an advanced medical procedure that involves replacing part or all of the patient’s face with a donor (cadaver) face.
Face transplant can be a partial transplant in which only a section of the tissue is taken from the donor and given to the patient who is receiving it (recipient). It can be a full face transplant in which the entire face is transplanted or the face and the underlying scalp are transplanted. Face transplant is similar to other organ transplant in which the immune system may reject the transplant. The immune system will attack and destroy any tissue that it recognizes as foreign. Even if there is a match in tissue between the donor and recipient, there is still the possibility of rejection. Such patients will have to be on drugs that suppress the immune system for a long period of time. These immune suppressant drugs will increase the risk of infection. There are other risks involved in face transplant such as risks related to surgery like infection.
The world’s first partial face transplant was carried out in November of 2005 in France for a patient who had her face ravaged by her dog, the operation was successful, it took 15-hours and the patient is fine now. The donor of the face should be a person who is on life support who has brain death with no hope of recovering (the face tissue has to be viable receiving blood supply); this may be a concern as the family of the donor must be willing to turn off the life support machine.
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Burns In Pediatrics
One of the most common causes of hospital admission of pediatric patients is burns. Most pediatric burns occur at home. The most common cause of burns in young children is exposure to hot liquids (scald injury) such as hot water. Contact with hot objects is the second most common cause of burn in young children. Pediatric burns differ from adult burns in many aspects.
Their skin is more sensitive and less resistant to heat and because it is harder for them to escape from the burning object, this may lead to longer exposure which may increase the burn severity.
Pediatrics have a smaller body size than adults with a greater body surface area in relation to their weight. Fluid loss is proportionally greater in young children when compared to the same percentage of burn in adults because of their smaller circulating volume and different distribution of body fluids leading to more rapid onset of fluid and electrolyte disturbance and imbalance. Therefore pediatrics especially infants develop hypovolemic shock faster and fluid replacement should be started as soon as possible which is calculated according to certain formulas.
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Burns To The Eyes (Part II)
Flash burns to the eye:
A flash burn to the eye occurs when the person is exposed to a bright ultraviolet light. Causes of flash burn to the eye may include:
- Welding torch.
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Burns To The Eyes (Part I)
Burns to the eyes can be caused by many different things such as chemicals, hot air, steam, sunlight, welding equipments etc.
Chemical burns:
They can be caused by solid chemicals, liquid chemicals, chemical fumes or powdered material. Damage to the eyes may be minimized if they are washed quickly. The most dangerous chemical burns involve strong acids or alkali (base) substances.
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Burn Severity (Part II)
It is important to determine the severity of the burn as this will determine the type of treatment that is necessary and where the burned patient should receive treatment. Minor burns may be treated at home or in a doctor’s office. These are defined as first- or second-degree burns covering less than 15 percent of an adult’s body or less than 10 percent of a child’s body, or a third-degree burn on less than 2 percent BSA. Moderate burns should be treated at a hospital. These are defined as first- or second-degree burns covering 15 percent to 25 percent of an adult’s body or 10 percent to 20 percent of a child’s body, or a third-degree burn on 2 percent to 10 percent BSA. Critical, or major, burns are the most serious and should be treated in a specialized burn unit. These are defined as first- or second-degree burns covering more than 25 percent of an adult’s body or more than 20 percent of a child’s body, or a third-degree burn on more than 10 percent BSA. In addition, burns involving the hands, feet, face, eyes, ears, or genitals are considered critical.
NOTE: these are only guidelines. Classification of the type and extent of a burn should be done only by medical professionals. It is best to err on the side of caution and seek medical attention. What you may consider minor may in fact be severe.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
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Burn Severity (Part I)
A burn is an injury to the tissue; it can be caused by heat, chemicals, electricity, radiation or friction.
Burns can be classified according to the depth of burn: first degree, second degree and third degree burns. It can also be classified into superficial partial thickness which is the first degree, deep partial thickness which is the second degree and the full thickness area which is the third degree burns.
The severity of burn is affected by many factors which are:
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Central Venous Line and Infections (part II)
According to an article in the New England Journal of Medicine in December 2006, there was a 66 percent reduction in central-line associated blood stream infections after 67 hospitals in Michigan implemented a checklist developed by Peter Pronovost, M.D, Ph.D. Health and Human Services Secretary Kathleen Sebelius called on all hospitals across America to use the checklist to reduce central-line infections in ICUs by 75 percent over the next three years, this check list includes:
- Washing hands before and after examining a patient or inserting, replacing, accessing, repairing and dressing the catheter (line).
- Disinfecting the skin of the patient before inserting the catheter and during dressing changes.