Andrew’s Note: Today we present the fourth in our series on Burns, first aid for burns and treatment for burns drawn from U.S. Army Subcourse MD0576, Wound Care [Approved For Public Release; Distribution is Unlimited]. Today’s lesson discussions chemical injuries and chemical burns. Needless to say, seek professional medical care immediately in the event of illness or injury and take action yourself only if you have been properly trained. Many of the therapies discussed in this series should only be attempted by a licensed medical professional.
a. General. Chemical burns, as previously mentioned, are caused when the skin comes in contact with a caustic substance, a substance capable of burning, corroding, or destroying living tissue. Such substances include acids, alkalis, white phosphorus, and napalm. The depth of a chemical burn depends on how strong the chemical is and how long the chemical has been in contact with skin. If the chemical contains phosphorus, glowing particles may be seen on the casualty’s skin. Burning will continue as long as the chemical is on the skin.
b. Immediate Care. Chemical burns are the only type of burn that requires immediate care of the burn wound. The chemical must be washed from the body surface as soon as possible.
c. Phosphorus. Many antipersonnel weapons used in modern warfare contain white phosphorus. Phosphorus ignites on contact with air. Fragments of phosphorus from these weapons may be driven into soft body tissue. Most skin injuries from phosphorus burns, however, are caused by clothing catching on fire. This results in conventional thermal burns.
d. Treatment. The goal is to remove all contaminating chemicals from the patient’s body–chemicals on his skin, chemicals embedded in his body, or chemicals in clothes touching his body. Chemicals in contaminated clothing left on the patient will continue to burn him. Follow the procedures and guidelines given below
(1) Initial treatment. Speed is essential. Remove the patient’s contaminated clothing. Then, immediately begin flushing the area of a chemical burn with water. Be careful not to contaminate yourself.
(2) Antidote. After an initial flushing for five minutes, remove the patient’s clothing rapidly. Douse the patient again with water containing chemical antidote. Possible antidotes include diluted vinegar for alkali burns and baking soda (one teaspoon per pint of water) for acid burns.
(3) Eye care. If the patient’s eyes have been involved, flush with copious amounts of water. Be sure to rinse under the patient’s eyelids. (Have the patient remove contact lenses before you begin flushing with water.)
CAUTION: NEVER use a chemical antidote in the eyes.
(4) Evacuation. Transport the patient to a medical treatment facility.
e. Special Cases of Chemical Burns.
(1) Dry lime chemical burn. When combined with water, dry lime produces a highly corrosive substance. To treat a patient burned by this substance, remove the patient’s clothing. Brush the lime from the skin (unless large quantities of water, suchas from a garden hose, are available for immediate flushing).
(2) Phenol (carbolic acid). This substance is not water-soluble and will not be removed well by water irrigation. It is alcohol-soluble and should be washed with any available alcohol product prior to prolong flushing with water. (If alcohol is not available, use water for flushing.)