Chemical burns are acute skin and mucous membrane damage caused by normal temperature or high temperature chemicals directly to skin irritation, corrosion, and chemical reaction heat, often accompanied by eye burns and respiratory damage. Some chemicals can also be absorbed through the skin and mucous membranes to cause poisoning, so chemical burns are generally different from fire burns and boiling water burns. Groups of 3 or more chemical burns chemical burns means a one-time occurrence.

According to the analysis of chemical system casualties during the “Eighth Five-Year Plan” of the Ministry of Chemical Industry, the top three causes of deaths were:

1 Explosion accident, 280 deaths ( 24.1 % of the total deaths ) ;

2 Poisoning and asphyxiation accidents, 182 deaths (15.6 % ) ;

â‘¢ falling from height accidents, 163 deaths (14.0%). In the top two deaths, there are chemical burns of varying degrees in a considerable proportion. Therefore, how to organize salvage and how to carry out emergency rescue for such sudden, group, and multidisciplinary diseases has become an important issue in the field of burn surgery.

( I ) Classification of Group Chemical Burns

1988 National Conference rescue of mass burn casualties proposed scheme, according to the number burned into mild (10 to 50 the number of wounded), moderate (51 to 250 the number of burns), severe (number of wounded more than 251) Three Species. If comprehensive consideration is given to the severity of the wounded, the scope of the mobilization of the rescue force, and the social loss to the environment, the group of chemical burns can be classified into three categories: general, major and catastrophic. See Table 3 - 8 . The emergency rescue of group chemical burns mainly refers to the latter two.

( B ) common causes of group chemical burns

1 Tankers with corrosive substances in the process of transportation explode, causing tons of chemicals to cause mass chemical burns.

2 Irritative, corrosive gas that is accidentally released, and contact with moisture on the body surface and airway surface to cause acid burns or alkalis to cause chemical burns.

3 The accidental leakage and splashing of corrosive chemicals in the production process.

4 In the event of explosion and combustion of flammable gases, there are often groups of chemical burns.

( III ) Emergency Rescue Organization

The emergency rescue of major and catastrophic chemical burn accidents, due to its wide coverage and complicated technology, has gone far beyond the scope of medical emergency alone . Therefore, in the ordinary course of time, we should formulate practical and feasible emergency rescue “preplans” for major chemical hazards. The group of chemical burns is listed as one of the important issues so that once an accident occurs, the emergency rescue system is quickly established according to the plan.

(1) The rescue team's site of major and disastrous groups of chemical burn accidents should establish an authoritative, efficient, and capable headquarters as soon as possible in accordance with the plan. The main local administrative leaders personally commanded. The commanding group should normally locate the hospitals, schools, and institutions with obvious signs and convenient transportation, and quickly establish and establish effective communication and communication facilities to ensure the smooth command and organization work and coordinate and arrange the volunteer forces that come to the rescue.

(2) The on-site emergency rescue team is composed of engineering emergency rescue personnel and stretcher rescue personnel. It is responsible for plugging, decontamination, search and rescue of the wounded, maintaining order at the scene and defending state assets.

(3) The medical emergency team is composed of medical personnel and is responsible for the screening, classification, and emergency treatment of the wounded on the scene, and organizes relevant experts to conduct consultations to ensure that the rescue work is carried out scientifically and effectively. In the case of screening the wounded at the scene, color marking may be used, for example, purple, red, yellow, green cloth armbands or cards, representing special heavy, heavy, medium, and mild burns, so as to distinguish them.

(4) The rescue logistics team guarantees the supply of medical emergency supplies and necessary supplies for the victims, and is responsible for contacting and arranging transport; transporting wounded persons, medicines, equipment, or other necessities. All rescue workers and members of the on-site emergency rescue team must wear reliable personal protective equipment when they are on site .

( IV ) On-site casualty handling principles

â‘  Any chemical burns, first to remove contaminated clothing, rinsed with tap water for 2 to 30 minutes (less than 10 minutes rinsing eye burns), and treated with litmus pH paper nearly neutral. Burns with large areas and symptoms of shock flushing should be quick and concise. When the number of people is large, flushing can be performed with adjacent water sources ( river, pond, lake, sea, etc. ) .

â‘¡ Select upwind from the nearest clinic or health center for on-site first aid place, arrange burns surgeon in charge of admissions, registration admitted to preliminary estimates burn area, and according to classification standard chemical burns (GB 1637 - 96) Perform preliminary classification and do not use color labels to perform different methods for first aid treatment.

3 Burn wounds are debrided and wrapped with a disposable dressing to prevent secondary injury or contamination. For some chemical burns, such as hydrofluoric acid burns, consider using neutralizing agents; but do not apply colored external medications on the wound so as not to affect the observation of wounds.

4 For those who have severe internal injuries such as visceral rupture, pneumothorax, and fractures, they should be given priority and they should be transferred to hospitals with surgical conditions as soon as possible.

For patients with moderate to severe burns, intravenous channels should be quickly established to facilitate fluid resuscitation, reduce the incidence of shock, or allow the patient to get through the shock level, creating conditions for future treatment.

( e ) Transferring the wounded

When the severity of chemical burns and accidents surpasses the medical level or capacity of on-site first-aid power, in order to seek better medical conditions and strive for better medical results, the medical emergency team shall promptly make recommendations for the transfer and distribution of patients. , At the same time, make preparations before transfer, and be aware of:

1 In advance, contact with the receiving unit should be obtained, as close as possible to the nearest transfer, shorten the transfer distance.

2 All the wounded must first undergo debridement and bandaging treatment. If the wound is exposed during transit, it will increase the difficulty of nursing and increase the chance of infection. Medical personnel should be escorted on the way forward.

3 For moderate, severe, and extremely severe burns, it may be preferable to transfer to a hospital with a burn center or a specialist ward after 48 hours of fluid resuscitation. The moderate and mild burns with stable conditions may be transferred separately to better conditions. One or several hospitals.

4 pairs of craniocerebral injury, fracture or other complex injuries, chemical poisoning or unstable condition, should not be transferred in a hurry, subject to preliminary treatment, until the condition is stable can be transferred.

5 After close observation, to determine that there is inhalation injury or judging that upper airway obstruction may occur during transfer, a tracheotomy should be performed before transshipment to avoid accidents on the way.

6 When using an aircraft transfer, the head should be kept low when taking off and landing to ensure the blood flow; the speed of transportation should not be too fast for the transshipment by car, so as to reduce the bumps so as not to aggravate the shock. The position of the head should be the direction of travel. in contrast.

(7) Observe changes in consciousness, breathing, pulse, and blood pressure on the way, and record the condition and amount of fluid taken in and out. After arriving at the receiving unit, details of the condition and treatment process should be introduced and all medical records should be handed over.

The information in this article comes from the Internet and was reorganized and edited by China Rescue Equipment Network.