A chemical burn is irritation / destruction of internal or external organs of the body caused by exposure to a corrosive or caustic chemical substance, usually by direct contact with the chemical or its fumes. Chemical burns are usually the result of an accident and can occur in the home, at school or more commonly, at work, particularly in manufacturing plants that use large quantities of chemicals. It can also occur as a result of self harm or violence between people.
Most chemical burns are caused by either strong acids or strong bases (alkali). Common chemicals include sulfuric acid, hydrochloric acid, sodium hydroxide, lime, silver nitrate, and hydrogen peroxide. A variety of household products that can cause chemical burns are: bleach, concrete mix, drain or toilet cleaners, metal cleaners, pool chlorinators, paint thinners and car battery fluid.
Acids damage and kill cells by coagulating cells while bases liquefy cells. Prolonged exposure can severely damage tissues and it leads to scarring and disability. Limiting the time of exposure to these chemicals can greatly reduce their damaging effects. Another important factor is concentrated forms of some acids and bases generate a large amount of heat when diluted; this results in a thermal burn as well as a chemical burn.
All chemical burns should be considered potential medical emergencies. Most chemical burns occur on the face, eyes, hands, arms, and legs. Minor burns will require only outpatient treatment. Chemical burns can be deceiving; however, some agents can cause deep tissue damage that is not immediately evident or noticeable. The chemicals diffuse into tissue and damage structures under skin without immediately apparent damage to skin surface. Tissue damage depends on several factors such as the pH of the agent, concentration of the exposed agent, site of contact (eye, skin, mucous membrane), physical form of the agent (i.e., solid, liquid, gas) mode of exposure (ingestion or inhaled), whether skin is intact or not, quantity and duration of exposure, mode of action of the chemical, duration between exposure and decontamination.
Signs and symptoms of chemical burns include redness, irritation or burning, extremely painful or numbness, formation of blisters or black dead skin (tissue necrosis) at the contact site, vision changes, or complete loss of vision if chemicals get into the eyes, cough, vomiting. In severe cases, a person may develop any of the following symptoms: low blood pressure, faintness, weakness, dizziness, shortness of breath or severe cough, headache, muscle twitching, irregular heartbeat. Chemical burns can be very unpredictable. Death from a chemical injury, although rare, can occur.
Immediate first aid is needed, which includes removing or washing off the chemicals which have caused the burn. Irrigate the affected area with copious amounts of room temperature water. Wash for at least 15- 20 minutes. Earlier the irrigation received within 10 minutes of the burn reduces the severity of the wound and time of stay in hospital. If the chemical has come into contact with the eyes, then the eyes should be rinsed continuously for at least 20 minutes followed by seeking immediate medical consultation. After first aid the following treatments is provided: Pain management, Infection control, Skin replacement, Cosmetic surgery, Occupational therapy along with education and counselling.
