Materiały źródłowe

• #1 Topical chemical burns: Initial evaluation and management – UpToDate

  https://www.uptodate.com/contents/topical-chemical-burns-initial-evaluation-and-management

  Chemical burns require immediate treatment because the duration of contact, in addition to the potency and concentration of the toxic agent, determines the degree of tissue destruction. In most cases, the management of topical chemical burns consists of the following: […] The most important component of active therapy is thorough irrigation of all wounds and areas of exposure with copious amounts of water. We recommend that clinicians err on the side of copious irrigation even if a burn appears superficial. […] Ideally, water irrigation is started immediately at the scene of exposure since pre-hospital irrigation reduces burn severity and the length of hospitalization. […] The principles of management of chemical burns are similar to those for thermal injuries (with the addition of clinician protection, immediate decontamination, and extensive irrigation). These include airway stabilization as needed, fluid resuscitation, tetanus prophylaxis, and analgesia.

• #2 Cutaneous chemical burns: assessment and early management

  https://www.racgp.org.au/afp/2015/march/cutaneous-chemical-burns-assessment-and-early-mana

  Chemical burns are common and may cause significant physical, psychological, social and economic burden. Early treatment of chemical burns is crucial and may reduce the period of resulting morbidity. […] Early management should be conducted with consideration of clinicians safety, and appropriate precautions should be taken. Excluding specific situations and chemical exposure, copious irrigation with water remains the mainstay of early management. Referral to a centre of higher acuity may be required for expert evaluation. […] Prompt removal of chemical contact is mandatory. […] Irrigation should then be performed with warm water under a tap with appropriate drainage to prevent further injury. Early irrigation dilutes the chemical concentration and has been shown to reduce the severity of the burn and hospital stay.

• #3 Chemical Burns | Burn and Reconstructive Centers of America

  https://burncenters.com/burns/burn-services/chemical-burns/

  Chemical burns can happen anywhere from work, at home or even at school. […] Chemical burns account for 5% of all burn admissions. […] A chemical burn occurs when an external agent (chemical) causes tissue irritation or damage as a result of direct contact. […] Most chemical burns are caused by either strong acids or bases, with prolonged exposure leading to severe injuries, scarring, disability or worse. […] All chemical burns should be considered as potential medical emergencies. […] Chemicals come in both liquid and powder forms. Never pour water on a chemical burn from a powder, as this could create a new caustic agent. For liquid chemical burns, irrigating with water is recommended. Never try to neutralize a chemical burn. […] The guidelines on treating a chemical burn depend on the severity of the burn and where it is located. A healthcare professional should assess all chemical burns, especially more severe burns that have penetrated through several layers of skin.

• #4 Cutaneous chemical burns: assessment and early management

  https://www.racgp.org.au/afp/2015/march/cutaneous-chemical-burns-assessment-and-early-mana

  Neutralisation of chemicals is contentious but is generally not indicated because of the risk of further heat production and thus continuing injury. Several neutralising agents have shown some benefit, but irrigation with plain water remains the most efficacious, accessible and cost-effective treatment. […] Complete wound evaluation: the microcirculation of the wound is evaluated by pinprick test for pain and capillary return time. […] Assessment regarding the depth of the chemical burn is notoriously difficult, as burns may be deceptively superficial. […] Debridement of blisters and non-viable tissue is advocated as early as possible via surgical or non-surgical approaches. […] Given the difficulty in assessing injury extent and depth, caution is generally advised. Chemical burns should be treated as full-thickness burns until proven otherwise.

• #5 Chemical burns – Basics of Burn Carealign-left

  https://basicsofburncare.org/chemical-burns/

  Chemical burns can cause extensive tissue damage. They differ from thermal burns and require a specific approach. This includes taking a modified 5-point history and considering different treatment options. […] First aid for chemical burns […] Different types of chemicals have different impacts on the skin, and therefore some causative agents have specific first aid approaches. […] Acids cause coagulating necrosis and therefore must be irrigated with plenty of lukewarm water. Early excision of these burns is required. […] Alkalis are found commonly in the form of caustic soda, which is present in many households as drain unblocker. These chemicals penetrate the skin easily. Therefore, immediate prolonged irrigation (> 1hr) with water is required. […] Burns caused by hydrofluoric acid are not immediately noticeable. To treat these burns, firstly remove all clothing and immediately irrigate with copious amounts of water.

• #6 Chemical Burns Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/769336-treatment

  Prompt wound irrigation is the most critical aspect in limiting the extent of dermal burns from exposure to caustic substances. Animal studies have shown that irrigation of both acid exposures and alkaline exposures within several minutes decreases the pH change in the skin and the extent of dermal injury. A burn center case series found that patients who received irrigation within 10 minutes had a 5-fold decrease in full-thickness injury and a 2-fold decrease in length of hospital stay. […] The first priority in treatment is to ensure complete removal of the offending agent. Thorough decontamination is key. Adequate irrigation is difficult to define and depends on the amount of exposure and the agent involved. […] After initial decontamination, the full extent of the injury must be ascertained and the patient must be treated as a typical burn patient. Based on the degree of injury, ensure adequate fluid resuscitation and take precautions to prevent complications (eg, hypothermia, infection, rhabdomyolysis).

• #7 Chemical burns: First aid

  https://www.mayoclinic.org/first-aid/first-aid-chemical-burns/basics/art-20056667

  Major chemical burns need emergency medical help. Minor chemical burns can usually be treated with first aid. […] For major chemical burns, apply first aid as follows until emergency help arrives. For minor burns, take the same steps. A minor burn might need emergency care if it affects the eyes, mouth, hands or genital areas. Babies and older adults might need emergency care for minor burns as well. […] Protect the burned person from further harm. Remove dry chemicals. Put on gloves and brush off any remaining material. Remove contaminated clothing or jewelry and rinse chemicals off for at least 20 minutes, in a shower if it’s available. Protect eyes from the chemicals. Cover the burn. Loosely cover the area with gauze or a clean cloth. Rinse again if needed. If the area is still painful, rinse for several more minutes. […] For major burns, watch for signs of shock. Symptoms include cool, clammy skin, weak pulse and shallow breathing.

• #8 Acid and chemical burns | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/acid-and-chemical-burns/

  Burns caused by acid, alkaline or caustic chemicals can be very damaging and need immediate medical attention. […] After phoning 999, to help prevent severe injuries from a chemical burn: try to carefully remove the chemical and any contaminated clothing. […] Rinse the affected area continuously with clean water as soon as possible to remove any residual chemical. […] Immediate treatment for chemical burns in hospital includes: continuing to wash off the corrosive substance with water until its completely removed, cleaning the burn and covering it with an appropriate dressing, pain relief, a tetanus jab if necessary. […] Minor burns affecting the outer layer of skin and some of the underlying layer of tissue normally heal with good ongoing burn care, leaving minimal scarring. […] If the burn is severe, you may be referred to a specialist burns unit, which may be in a different hospital. […] Specialist burns teams include occupational therapists, physiotherapists and mental health professionals who can support your recovery.

• #9 Chemical burns — first aid and treatment | healthdirect

  https://www.healthdirect.gov.au/chemical-burns

  If you think someone has a chemical burn, call triple zero (000). Ask for an ambulance. If you can, let them know what chemical caused the burn. For help and advice about poison, call the Poisons information Hotline on 13 11 26. […] If the chemical is on your skin, wash it off straight away with cool running water. Keep the affected area under water for at least 20 minutes. Continue washing even after the chemical seems to have been removed. This helps to reduce tissue damage. […] After washing, cover the burn with a sterile dressing that won’t stick to the skin. […] If the chemical is in the eye, tilt the head to the side. This is important as it will protect the other eye. Then gently wash cool water over the eye for 20 minutes. […] Your doctor may advise you to: keep your wound clean and stop it from drying out; apply ointments or dressings to the wound; take medicines for pain relief. […] More serious burns will need treatment in hospital. The wound will be carefully watched and treated at the hospital. This is important to control your pain and prevent infection.

• #10 First Aid for Chemical Burns | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.first-aid-for-chemical-burns.sig256946

  Most chemical burns of the skin are treated first by rinsing (flushing) the chemical off your body with a large amount of room temperature water, but not all chemicals are treated this way. It is important to treat the burn correctly to avoid further complications. […] Hydrofluoric acid is flushed with a large amount of water and treated with calcium gluconate. You need immediate medical care. […] Some chemical burns are made worse if rinsed (flushed) with water. […] Carbolic acid or phenol does not mix with water, so use isopropyl (rubbing) alcohol first to flush the chemical off the skin and then flush with water. If alcohol is not available, flush with a large amount of water. Do not flush the eye with alcohol. […] Sulfuric acid is flushed with a mild, soapy solution if the burns are not severe. Sulfuric acid feels hot when water is added to the acid, but it is better to flush the area and not leave the acid on the skin. […] The most important first aid for a chemical in the eye is to immediately flush the substance out with large amounts of water to reduce the chance of serious eye damage. For any chemical burn to the eye, see the topic Burns to the Eye.

• #11 First Aid for Chemical Burns – Boris Bentsianov, MD

  https://www.brooklynentdoc.com/patient-education/health-library?DOCHWID=sig256946

  Hydrofluoric acid is flushed with a large amount of water and treated with calcium gluconate. You need immediate medical care. […] Some chemical burns are made worse if rinsed (flushed) with water. Carbolic acid or phenol does not mix with water, so use isopropyl (rubbing) alcohol first to flush the chemical off the skin and then flush with water. If alcohol is not available, flush with a large amount of water. Do not flush the eye with alcohol. Sulfuric acid is flushed with a mild, soapy solution if the burns are not severe. Sulfuric acid feels hot when water is added to the acid, but it is better to flush the area and not leave the acid on the skin. Dry powders, such as dry lime, are brushed away first, because adding water can make a liquid that burns. After the powder is brushed away, flush with water for 20 minutes. Metal compounds are covered with mineral oil.

• #12 Chemical Burns | Burn and Reconstructive Centers of America

  https://burncenters.com/burns/burn-services/chemical-burns/

  Chemical burns can happen anywhere from work, at home or even at school. […] Chemical burns account for 5% of all burn admissions. […] A chemical burn occurs when an external agent (chemical) causes tissue irritation or damage as a result of direct contact. […] Most chemical burns are caused by either strong acids or bases, with prolonged exposure leading to severe injuries, scarring, disability or worse. […] All chemical burns should be considered as potential medical emergencies. […] Chemicals come in both liquid and powder forms. Never pour water on a chemical burn from a powder, as this could create a new caustic agent. For liquid chemical burns, irrigating with water is recommended. Never try to neutralize a chemical burn. […] The guidelines on treating a chemical burn depend on the severity of the burn and where it is located. A healthcare professional should assess all chemical burns, especially more severe burns that have penetrated through several layers of skin.

• #13 Topical chemical burns: Initial evaluation and management – UpToDate

  https://www.uptodate.com/contents/topical-chemical-burns-initial-evaluation-and-management

  Skin decontamination — Complete removal of the toxic chemical is essential. Tissue damage continues for as long as the chemical remains in contact with skin. […] Water irrigation — Continue water irrigation if already started at the scene of exposure, otherwise immediately begin irrigation with copious amounts of water. […] For acid or alkali skin exposure, we suggest continuous water irrigation until the pH of any exposed tissue becomes neutral. […] Antidotes do not play a major role in the treatment of most chemical burns. Water irrigation is of primary importance and should not be delayed while an antidote is sought. […] Eye contact with a caustic chemical requires immediate evaluation and treatment to prevent permanent vision loss. Immediate water irrigation reduces the risk for chronic conjunctivitis and sight-threatening corneal ulceration. […] Initial irrigation — Irrigation initiated at the scene is continued at the emergency department. […] In a patient with a symptomatic HF burn, we recommend treatment with a fluoride neutralizer (eg, calcium) in addition to copious water irrigation.

• #14 Chemical burns — first aid and treatment | healthdirect

  https://www.healthdirect.gov.au/chemical-burns

  If you think someone has a chemical burn, call triple zero (000). Ask for an ambulance. If you can, let them know what chemical caused the burn. For help and advice about poison, call the Poisons information Hotline on 13 11 26. […] If the chemical is on your skin, wash it off straight away with cool running water. Keep the affected area under water for at least 20 minutes. Continue washing even after the chemical seems to have been removed. This helps to reduce tissue damage. […] After washing, cover the burn with a sterile dressing that won’t stick to the skin. […] If the chemical is in the eye, tilt the head to the side. This is important as it will protect the other eye. Then gently wash cool water over the eye for 20 minutes. […] Your doctor may advise you to: keep your wound clean and stop it from drying out; apply ointments or dressings to the wound; take medicines for pain relief. […] More serious burns will need treatment in hospital. The wound will be carefully watched and treated at the hospital. This is important to control your pain and prevent infection.

• #15 Eye injuries – chemical burns | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eye-injuries-chemical-burns

  A chemical burn occurs when a liquid (including fresh concrete and hand sanitiser) or powder chemical contacts the eye. […] However, splashes from acids or alkali chemicals are serious and may cause vision loss. Rinse the eye and seek urgent medical attention. […] In many cases, prompt and thorough rinsing of the eye (with saline or fresh water), dramatically reduces the risk of injury and long-term damage. […] Treatment differs according to the chemical agent and the severity of the injury, but may include: pain-relieving medication, topical antibiotics to reduce the risk of infection, medicated eye drops, lubricants applied to the eye surface to prevent the eyelids from sticking to the cornea as it heals, anti-inflammatory medication, in more serious cases, hospital admission is necessary and treatment is given for any complications.

• #16 Chemical burn or reaction Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/injury/chemical-burn-or-reaction

  Note: If a chemical gets into the eyes, flush them with water right away. Continue to flush the eyes with running water for at least 15 minutes. Get medical help right away. […] Call for medical help right away if the person is having difficulty breathing, is having seizures, or is unconscious. […] Do not apply any household remedy such as ointment or salve to a chemical burn. […] Do not try to neutralize any chemical without consulting the poison control center or a health care provider.

• #17 Chemical Burns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22350-chemical-burns

  Chemical burns require immediate treatment. Call 911 and then: […] Once you arrive at the hospital, your healthcare team will: […] The American Burn Association recommends that anyone with a chemical burn should seek care at a burn center or call the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. […] If you have a severe burn, you may need surgery to remove the burned portion of your skin. Some people need a skin graft. A surgeon takes healthy skin from elsewhere on your body and attaches it to the burned area. Surgery can also repair perforations in your gastrointestinal tract. […] Seek help right away for any type of chemical burn. […] You should seek medical attention from your healthcare provider for any chemical burn, even if it seems mild. Immediate treatment is essential to prevent scarring or complications.

• #18 Chemical Burns: Causes, Symptoms, Treatment, Prevention, Care

  https://www.webmd.com/first-aid/chemical-burns

  Especially wash away any chemical in your or the person’s eye. Sometimes the best way to get large amounts of water to your eye is to step into the shower. […] Medical treatment […] IV fluids may be needed to normalize blood pressure and heart rate. […] The IV access may also be used for any medications needed to treat pain or protect against infection. […] Decontamination will begin (likely water irrigation). […] You will be given any antidote to counteract the chemical, if appropriate. […] Antibiotics often are not needed for minor chemical burns. […] Wounds will be cleaned and bandaged with medicated creams and sterile wraps as needed. […] Consultation with other medical specialists may be done. […] Pain from a burn can often be severe. Adequate pain control will be addressed by your doctor.

• #19 Chemical Burn Treatment, Symptoms, Remedies

  https://www.emedicinehealth.com/chemical_burns/article_em.htm

  Most people with minor chemical burns do not need to be admitted. Most can go home after arranging follow-up care with a doctor. Patients with major chemical burns however, need to be admitted to a hospital. Ingestion or inhalation of chemical burns may need to be admitted for observation, depending on the potential severity of tissue damage. […] Specific medical treatment depends on the chemical that the patient was exposed to. Some of the general steps taken to medically treat chemical burns are as follows: IV fluids may be needed to normalize blood pressure and heart rate as any type of burn (fire, chemical, sun exposure) often results in dehydration of the patient. The IV access may also be used for any medications needed to treat pain or protect against infection. Decontamination will begin (likely water irrigation). Some people may be an antidote to counteract the chemical, if appropriate. Antibiotics often are not needed for minor chemical burns. Wounds will be cleaned and bandaged with medicated creams and sterile wraps as needed. Consultation with other medical specialists may be done if indicated. Pain in a burn can often be severe. Adequate pain control will be addressed by the doctor. If there is any indication of breathing problems, a breathing tube may be placed in the patient’s airway to help maintain the airway and provide adequate ventilation. […] After leaving the emergency department, call the designated doctor within 24 hours to arrange follow-up care. Patient’s should call sooner if any new problems or concerns arise.

• #20 Chemical burns: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/318084

  Chemical burns often require some kind of medical treatment or a trip to the hospital. […] Treatment will depend on the cause, severity, deepness of burns, and the extent of tissue that has been damaged. […] Depending on the severity of the burn, doctors will employ different methods to treat chemical burns, such as: antibiotics and anti-itch medicines, fluids given through the vein fluid loss in common with burn injuries, cleaning and removing dead tissue, skin grafting removing healthy skin from one part of the body to cover the wound. […] More serious chemical burns require rehabilitation, which may include: skin replacement, pain management, plastic surgery, occupational therapy, counseling. […] The first step in treatment is to determine the burn type, as follows: first degree burns affect the top layer of the skin, second degree burns cause injury to the second layer of skin, third degree burns affect the deepest layers of the skin and tissues underneath.

• #21 Chemical Burns | Burn and Reconstructive Centers of America

  https://burncenters.com/burns/burn-services/chemical-burns/

  Once a physician has cleaned, treated and dressed your wound, you may be able to treat it at home by yourself while it is healing. […] All chemical burns should be assessed by a healthcare professional as soon as possible, no matter how minor they are. […] Monitor your burn for any changes. If it is not getting better each day, or you notice any new signs or symptoms, contact your physician as soon as you can. […] The time it takes to recover from a chemical burn on the skin will depend on how much damage there is and how deep the injury goes. […] First-degree acid burns on the skin are the most common type of chemical injury and usually heal in around 7-10 days. […] After the appropriate medical treatment, healing can take a few weeks. […] Third-degree chemical burns are rare but possible in the event of exposure to flames, explosions and powerful chemicals. […] By applying these basic chemical safety rules, you can reduce the chances of a chemical injury.

• #22 Acid and chemical burns | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/acid-and-chemical-burns/

  Burns caused by acid, alkaline or caustic chemicals can be very damaging and need immediate medical attention. […] After phoning 999, to help prevent severe injuries from a chemical burn: try to carefully remove the chemical and any contaminated clothing. […] Rinse the affected area continuously with clean water as soon as possible to remove any residual chemical. […] Immediate treatment for chemical burns in hospital includes: continuing to wash off the corrosive substance with water until its completely removed, cleaning the burn and covering it with an appropriate dressing, pain relief, a tetanus jab if necessary. […] Minor burns affecting the outer layer of skin and some of the underlying layer of tissue normally heal with good ongoing burn care, leaving minimal scarring. […] If the burn is severe, you may be referred to a specialist burns unit, which may be in a different hospital. […] Specialist burns teams include occupational therapists, physiotherapists and mental health professionals who can support your recovery.

• #23 Chemical burn or reaction Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/injury/chemical-burn-or-reaction

  Chemical exposure is not always obvious. You should suspect chemical exposure if an otherwise healthy person becomes ill for no apparent reason, particularly if an empty chemical container is found nearby. […] If the person has a chemical in their eyes, see first aid for eye emergencies. […] Flush the chemicals off the skin surface using cool running water for 15 minutes or more unless the chemical exposure is to dry lime (calcium oxide, also called 'quick lime’) or to elemental metals such as sodium, potassium, magnesium, phosphorous, and lithium. […] Minor chemical burns will most often heal without further treatment. However, if there is a second or third degree burn or if there is an overall body reaction, get medical help right away. In severe cases, don’t leave the person alone and watch carefully for reactions affecting the entire body.

• #24 Chemical Burns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22350-chemical-burns

  Chemical burns require immediate treatment. Call 911 and then: […] Once you arrive at the hospital, your healthcare team will: […] The American Burn Association recommends that anyone with a chemical burn should seek care at a burn center or call the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. […] If you have a severe burn, you may need surgery to remove the burned portion of your skin. Some people need a skin graft. A surgeon takes healthy skin from elsewhere on your body and attaches it to the burned area. Surgery can also repair perforations in your gastrointestinal tract. […] Seek help right away for any type of chemical burn. […] You should seek medical attention from your healthcare provider for any chemical burn, even if it seems mild. Immediate treatment is essential to prevent scarring or complications.

• #25 Chemical Burns: Causes, Symptoms, Treatment, Prevention, Care

  https://www.webmd.com/first-aid/chemical-burns

  If there is any indication of breathing problems, a breathing tube may be placed in your airway to help. […] If needed, a tetanus booster will be given. […] Itching as a burn heals can be a serious problem. You may need special medication to soothe it. […] For severe burns, you may need surgery. In a process called skin grafting, a piece of healthy skin from somewhere else on your body or from a donor can be transplanted to replace the damaged skin. […] Cosmetic or reconstructive surgery may be needed to deal with scarring. […] Physical and occupational therapy can keep scars from limiting your range of motion. […] Counseling and support groups can help with emotional issues caused by trauma from the injury or disfigurement. […] […] […] Emergency Medical Care for Chemical Burns

• #26 How to Perform First-Aid Treatment for Chemical Burns | Medlink Healthcare Group

  https://www.mhg.sg/first-aid-for-chemical-burns/

  Burns that are classified as deep partial thickness, full thickness, and fourth degree must be given urgent medical attention as these burns are prone to infections and other complications. […] Treatment for these severe chemical burns may include: […] Skin replacement or grafting […] Pain management […] Cosmetic surgery […] Occupational therapy, for redeveloping motor skills if burns happened on the extremities.

• #27 Acid and chemical burns | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/acid-and-chemical-burns/

  Burns caused by acid, alkaline or caustic chemicals can be very damaging and need immediate medical attention. […] After phoning 999, to help prevent severe injuries from a chemical burn: try to carefully remove the chemical and any contaminated clothing. […] Rinse the affected area continuously with clean water as soon as possible to remove any residual chemical. […] Immediate treatment for chemical burns in hospital includes: continuing to wash off the corrosive substance with water until its completely removed, cleaning the burn and covering it with an appropriate dressing, pain relief, a tetanus jab if necessary. […] Minor burns affecting the outer layer of skin and some of the underlying layer of tissue normally heal with good ongoing burn care, leaving minimal scarring. […] If the burn is severe, you may be referred to a specialist burns unit, which may be in a different hospital. […] Specialist burns teams include occupational therapists, physiotherapists and mental health professionals who can support your recovery.

• #28

  https://111.wales.nhs.uk/encyclopaedia/a/article/acidandchemicalburns

  Get medical advice as soon as possible if you think you have an acid or chemical burn. You’ll need to be treated as soon as possible. […] An acid or chemical burn needs immediate first aid. […] Call 999 for medical help. […] Treatment for acid and chemical burns needs to be checked and treated in hospital. […] You may need: painkillers to help ease pain, antibiotics to treat infection, or to stop you getting an infection, fluids, usually given through a vein. […] If your burn is severe, you may also need: surgery to help your burn wounds to heal, reconstructive surgery if your burn affects your movement or physical appearance, physiotherapy if the burn has a lasting effect on your movement.

• #29 Chemical Burns Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/769336-treatment

  Hydrofluoric acid burns require special consideration. They should initially be treated as any other burn, with thorough irrigation. However, due to the penetrating power of the fluoride ion, specific neutralization procedures are indicated. […] Admission is recommended for large surface area or circumferential dermal burns, for burns by substances with systemic toxicity, or for pain control. […] Transfer all significant dermal burns that cannot be handled locally to a regional burn center. Always decontaminate the burn area, initiate fluid resuscitation, and administer analgesic agents prior to transfer. […] For severe dermal burns, consult a general surgeon or a burn service. Burns to the hands, face, or perineum may require the appropriate specialties.

• #30 Hydrofluoric acid burn – Wikipedia

  https://en.wikipedia.org/wiki/Hydrofluoric_acid_burn

  A hydrofluoric acid burn is a chemical burn from hydrofluoric acid. Where it contacts the skin it results in significant pain, swelling, redness, and skin breakdown. Complications can include electrolyte, heart, lung, kidney, and neurological problems. […] Initial treatment of exposure involves removing contaminated clothing and washing with large amounts of water over at least 30 minutes. Other measures include applying calcium gluconate cream. If pain continues calcium gluconate can be injected into the affected area or given by injection into a vein or artery. Surgical removal of the affected tissue may be required. […] The calcium gluconate is a source of Ca2+ that sequesters the fluoride ions. Other special rinsing solutions may also be used. Inhaled HF may require oxygen therapy and tracheal intubation. In this situation nebulized calcium gluconate may be used.

• #31 Chemical burns – Basics of Burn Carealign-left

  https://basicsofburncare.org/chemical-burns/

  Speed and thorough washing of the acid is most important for hydrofluoric acid burn wounds. Immediate treatment with calcium-gluconate gel (a specific treatment) is required: massage the gel into the skin until the pain has subsided. […] Contact of the skin with cement (lime) does not immediately cause a burn. However, prolonged exposure (> 45 minutes) to this substance occurs when clothing becomes impregnated, and this can then become a significant issue. […] Petrol and diesel will only cause burns after prolonged exposure. Be aware of the systemic effects of these substances, as the endothelial cell damage caused may lead to liver, lung, spleen or kidney damage. […] Wounds caused by white phosphorus should be kept under running water and irrigated until definitive treatment can be provided.

• #32 Topical Chemical Burn – CHEMS Field Treatment Guidelines

  https://chemsftg.com/topical-chemical-burn/

  For all patients in whom a hydrofluoric acid exposure is confirmed or suspected: Vigorously irrigate all affected areas with water or normal saline for a minimum of 15 minutes. […] Apply a cardiac monitor for oral or large dermal exposures significant HF exposures. […] If available, apply calcium preparation: Calcium prevents tissue damage from hydrofluoric acid. […] Apply generous amounts of the calcium gluconate gel to the exposed skin sites to neutralize the pain of the hydrofluoric acid. […] Although generally low yield, there may be benefit to intravenous pain medication along with the topical calcium gluconate gel for pain control. […] For patients who have ingested hydrofluoric acid or who have a large dermal exposure consider intravenous calcium chloride, 20 mg/kg, 0.2 mL/kg, max of 10 cc, as symptomatic hypocalcemia can precipitate rapidly as manifest by muscle spasms, seizures, hypotension ventricular arrhythmias and QT prolongation.

• #33 Chemical (Alkali and Acid) Injury of the Conjunctiva and Cornea – EyeWiki

  https://eyewiki.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunctiva_and_Cornea

  Chemical (alkali and acid) injury of the conjunctiva and cornea is a true ocular emergency and requires immediate intervention. Early recognition and treatment ensures the best possible outcome for this potentially blinding condition. […] Irrigation is the cornerstone of managing chemical burns and should be initiated by bystanders and continued as transfer of care takes place between emergency medical services (EMS), ED physicians, and the ophthalmologist. Early irrigation is critical in limiting the duration of chemical exposure. The goal of irrigation is to remove the offending substance and restore the physiologic pH. It may be necessary to irrigate as much as 20 L to achieve this. […] Patients with mild to moderate injury (grades I and II) have a good prognosis and can often be treated successfully with medical treatment alone. The aims of medical treatment are to enhance recovery of the corneal epithelium and augment collagen synthesis, while also minimizing collagen breakdown and controlling inflammation.

• #34 Chemical (Alkali and Acid) Injury of the Conjunctiva and Cornea – EyeWiki

  https://eyewiki.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunctiva_and_Cornea

  Chemical (alkali and acid) injury of the conjunctiva and cornea is a true ocular emergency and requires immediate intervention. Early recognition and treatment ensures the best possible outcome for this potentially blinding condition. […] Irrigation is the cornerstone of managing chemical burns and should be initiated by bystanders and continued as transfer of care takes place between emergency medical services (EMS), ED physicians, and the ophthalmologist. Early irrigation is critical in limiting the duration of chemical exposure. The goal of irrigation is to remove the offending substance and restore the physiologic pH. It may be necessary to irrigate as much as 20 L to achieve this. […] Patients with mild to moderate injury (grades I and II) have a good prognosis and can often be treated successfully with medical treatment alone. The aims of medical treatment are to enhance recovery of the corneal epithelium and augment collagen synthesis, while also minimizing collagen breakdown and controlling inflammation.

• #35 Chemical (Alkali and Acid) Injury of the Conjunctiva and Cornea – EyeWiki

  https://eyewiki.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunctiva_and_Cornea

  Antibiotics: A topical antibiotic ointment like erythromycin ointment 4 times daily can be used to provide ocular lubrication and prevent superinfection. Stronger antibiotics (e.g., a topical fluoroquinolone) are employed for more severe injuries (e.g., grades II and above). […] In the first week following injury, topical steroids can help calm inflammation and prevent further corneal breakdown. […] Debridement should be performed as early as possible because necrotic tissue serves as a source of inflammation and can inhibit epithelialization. […] The purpose of AMT is to rapidly restore the conjunctival surface and to reduce limbal and stromal inflammation. […] Limbal stem cell transplants have been employed to replace this critical group of cells. […] While there is variability in treatment strategies of chemical burns, most authors recommended a graded approach depending on the severity of injury. Mild burns (Roper-Hall grade I) respond well to medical treatments and lubrication, while more severe burns necessitate more intensive medical therapies and surgery.

• #36 Management Strategies of Ocular Chemical Burns: Current Perspectives | OPTH

  https://www.dovepress.com/management-strategies-of-ocular-chemical-burns-current-perspectives-peer-reviewed-fulltext-article-OPTH

  Ocular chemical burns are absolute ophthalmic emergencies and require immediate management to minimize devastating sequelae. Management of alkali and acid burns is started at the scene of the accident by copious irrigation. Treatment is directed at improving epithelial integrity and stromal stability, reduction of undue inflammation, and prevention or timely management of complications. To ascertain the best possible outcome, numerous biological medications and surgical interventions have been merged into conventional therapeutic regimens. These include autologous and umbilical cord serum preparations, platelet-rich plasma, amniotic membrane transplantation, limbal stem-cell transplantation, and anti-angiogenic agents. […] Appropriate management of ocular chemical burn requires caring for epithelial defects, inflammatory response, and complications through steps that promote epithelialization, reduce inflammation, and prevent complications. This will break a vicious cycle that each of these factors, if left untreated, may bring about, and thus, may adversely affect outcomes.

• #37 Chemical (Alkali and Acid) Injury of the Conjunctiva and Cornea – EyeWiki

  https://eyewiki.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunctiva_and_Cornea

  Antibiotics: A topical antibiotic ointment like erythromycin ointment 4 times daily can be used to provide ocular lubrication and prevent superinfection. Stronger antibiotics (e.g., a topical fluoroquinolone) are employed for more severe injuries (e.g., grades II and above). […] In the first week following injury, topical steroids can help calm inflammation and prevent further corneal breakdown. […] Debridement should be performed as early as possible because necrotic tissue serves as a source of inflammation and can inhibit epithelialization. […] The purpose of AMT is to rapidly restore the conjunctival surface and to reduce limbal and stromal inflammation. […] Limbal stem cell transplants have been employed to replace this critical group of cells. […] While there is variability in treatment strategies of chemical burns, most authors recommended a graded approach depending on the severity of injury. Mild burns (Roper-Hall grade I) respond well to medical treatments and lubrication, while more severe burns necessitate more intensive medical therapies and surgery.

• #38

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq6005

  Burns can occur when a harmful chemical, such as a cleaning product or an acid, splashes onto the skin. […] The treatment for most chemical burns is to remove the chemical from the skin by flushing the area with plenty of water. But some chemicals can’t be removed with water. They may need to be removed from the skin in other ways by the doctor. […] Follow-up care is a key part of your treatment and safety. […] If your doctor told you how to care for your burn, follow your doctor’s instructions. If you did not get instructions, follow this general advice: Wash the burn every day with a mild soap and water. Don’t use hydrogen peroxide or alcohol, which can slow healing. […] Call your doctor or nurse advice line now or seek immediate medical care if your pain gets worse. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if the burn is not getting better each day.

• #39 Chemical Burns: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chemical-burns-care-instructions.abq6005

  Burns can occur when a harmful chemical, such as a cleaning product or an acid, splashes onto the skin. […] The treatment for most chemical burns is to remove the chemical from the skin by flushing the area with plenty of water. But some chemicals can’t be removed with water. They may need to be removed from the skin in other ways by the doctor. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. […] If your doctor told you how to care for your burn, follow your doctor’s instructions. If you did not get instructions, follow this general advice: Wash the burn every day with a mild soap and water. Don’t use hydrogen peroxide or alcohol, which can slow healing. […] Call your doctor now or seek immediate medical care if: Your pain gets worse. […] Watch closely for changes in your health, and be sure to contact your doctor if: The burn is not getting better each day.

• #40

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq6005

  Burns can occur when a harmful chemical, such as a cleaning product or an acid, splashes onto the skin. […] The treatment for most chemical burns is to remove the chemical from the skin by flushing the area with plenty of water. But some chemicals can’t be removed with water. They may need to be removed from the skin in other ways by the doctor. […] Follow-up care is a key part of your treatment and safety. […] If your doctor told you how to care for your burn, follow your doctor’s instructions. If you did not get instructions, follow this general advice: Wash the burn every day with a mild soap and water. Don’t use hydrogen peroxide or alcohol, which can slow healing. […] Call your doctor or nurse advice line now or seek immediate medical care if your pain gets worse. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if the burn is not getting better each day.

• #41 Chemical Burns: Causes, Symptoms, Treatment, Prevention, Care

  https://www.webmd.com/first-aid/chemical-burns

  Name, strength, and volume or quantity of the chemical causing the burn (Give a container of the chemical to emergency personnel, if possible.) […] Length of time of contact with the chemical […] Always seek emergency care for any burn that is larger than 3 inches in diameter or is very deep. Also seek emergency care for any chemical burns involving the face, eyes, groin, hands, feet, or buttocks or if it is over a joint. […] Even if the exposure was very small and you have completed basic first aid, call your doctor to review the injury and the chemical involved and to make sure no further emergency treatment is needed. The doctor can arrange appropriate treatment or will direct you to go to a hospital’s emergency room. If you’re the person with the burn, ask your doctor if you need a tetanus shot. […] […] […] Chemical Burn Follow-Up […] After leaving the emergency department, call your doctor within 24 hours to arrange follow-up care. Call sooner if any new problems or concerns arise.

• #42 Chemical burns

  https://dermnetnz.org/topics/chemical-burn

  The main treatment aims of burn wound management are: […] Carefully monitor wound, […] Keep wounds clean, […] Prevent the wound drying out, […] Manage secondary infection. […] Commonly used topical antibacterials include 1% silver sulfadiazine cream, 0.5% silver nitrate solution and mafenide acetate 10% cream.

• #43 Topical Nitric Acid Burns: Initial Assessment and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10412252/

  To conclude, the interest of our publication is to underline the importance and effectiveness (with a concrete example) of the main treatment aims of chemical burn wound management. The early and abundant irrigation with water or sterile isotonic saline solution, the use of panthenol-containing creams and covering with silver sulphadiazine dressing, carefully monitoring wounds, keeping wounds clean and moist, and preventing and managing secondary infection allow the healing.

• #44 Chemical burns

  https://dermnetnz.org/topics/chemical-burn

  The main treatment aims of burn wound management are: […] Carefully monitor wound, […] Keep wounds clean, […] Prevent the wound drying out, […] Manage secondary infection. […] Commonly used topical antibacterials include 1% silver sulfadiazine cream, 0.5% silver nitrate solution and mafenide acetate 10% cream.

• #45 Chemical burns – Basics of Burn Carealign-left

  https://basicsofburncare.org/chemical-burns/

  Chemical burns can cause extensive tissue damage. They differ from thermal burns and require a specific approach. This includes taking a modified 5-point history and considering different treatment options. […] First aid for chemical burns […] Different types of chemicals have different impacts on the skin, and therefore some causative agents have specific first aid approaches. […] Acids cause coagulating necrosis and therefore must be irrigated with plenty of lukewarm water. Early excision of these burns is required. […] Alkalis are found commonly in the form of caustic soda, which is present in many households as drain unblocker. These chemicals penetrate the skin easily. Therefore, immediate prolonged irrigation (> 1hr) with water is required. […] Burns caused by hydrofluoric acid are not immediately noticeable. To treat these burns, firstly remove all clothing and immediately irrigate with copious amounts of water.

• #46 Management Strategies of Ocular Chemical Burns: Current Perspectives | OPTH

  https://www.dovepress.com/management-strategies-of-ocular-chemical-burns-current-perspectives-peer-reviewed-fulltext-article-OPTH

  The very first step after exposure of the ocular surface to chemical agents is to institute continuous irrigation. Prompt irrigation takes priority over looking for the chemical composition of the offending agent or waiting for specific fluids. Although some authors have proposed a certain duration or amount of irrigation, it is generally accepted that irrigation should be continued until the ocular surface pH has been neutralized. […] Several topical and systemic medications have been proposed to promote re-epithelialization. Intact epithelium plays an important role in preserving stromal stability because it can effectively inhibit digestive enzymes from reaching underlying stroma. It is also critical in smoothing the ocular surface and expediting visual rehabilitation. Here, we summarize the measures that are used to enhance epithelial growth and stromal stability.

• #47 Management Strategies of Ocular Chemical Burns: Current Perspectives | OPTH

  https://www.dovepress.com/management-strategies-of-ocular-chemical-burns-current-perspectives-peer-reviewed-fulltext-article-OPTH

  The administration of topical 1% and 2% hyaluronic acid in experimental animal studies has been associated with improved corneal epithelialization. It provokes the process of wound healing, possibly through induction of formation of hemidesmosomes. However, the evidence for benefit in the human chemical burn is sparse. […] These are concentrates of growth factors that are normally present in patients autologous serum or umbilical cord serum. There is a good body of evidence in humans that these preparations are superior to conventional treatment. Serum is a rich source of various growth factors, cytokines, and vitamins, and has been shown to accelerate the process of wound healing and re-epithelialization and decelerate corneal vascularization and limbal damage. […] The efficacy of umbilical cord serum is proposed to be superior to the pure autologous serum, though it has more accessibility issues.

• #48 Management Strategies of Ocular Chemical Burns: Current Perspectives | OPTH

  https://www.dovepress.com/management-strategies-of-ocular-chemical-burns-current-perspectives-peer-reviewed-fulltext-article-OPTH

  The amniotic membrane is a fetal membrane that covers the amniotic fluid around the fetus. It consists of a single cuboidal epithelium overlying a basement membrane. The basement membrane contains collagen, laminin, and fibronectin which provide a bed for extension of the native corneal epithelial cells over the membrane. […] Many human studies have demonstrated the benefits of AMT. Patient satisfaction was increased due to the reduction of pain, photophobia, and epiphora. […] Although some authors have reported improvement of visual acuity especially in lower grades, randomized clinical trials have failed to prove such findings. […] Limbal stem cell deficiency (LSCD) is a disabling long-term complication of ocular chemical burn. It may be partial or total; center-involving or non-center-involving. The sequelae include conjunctivalization of the cornea, recurrent epithelial erosions, scars, persistent epithelial defects, ulcers, melting, and perforations.

• #49 Carbon dot based dressing for therapy of chemically-induced cutaneous burns | Scientific Reports

  https://www.nature.com/articles/s41598-025-90893-5

  Chemical burns are a significant concern in Ukraine, with a growing interest in new treatments. […] This study aimed to evaluate the efficacy of carbon dots (CD) derived from citric acid and urea in promoting healing of both acidic- and alkali-induced burns in a rat model. […] Daily application of CD dressings significantly reduced the burn area and inflammation in alkali-induced burns during the first week, i.e. accelerated burn healing process, although the treatment was less effective in acid burns. […] Overall, CD accelerated healing, particularly in alkali burns, and had a systemic effect on immune and inflammatory responses. […] Clinical protocols for treating burn victims and managing the aftermath offer general guidelines, such as pain management, the use of corticosteroids for inflammation, antibiotic therapy, and shock treatment, depending on the injury’s severity.

• #50 Carbon dot based dressing for therapy of chemically-induced cutaneous burns | Scientific Reports

  https://www.nature.com/articles/s41598-025-90893-5

  However, these protocols lack specific strategies tailored to the unique characteristics of chemical burns. […] Thus, gaining a clearer understanding of the mechanisms driving chemical burns and the process of tissue regeneration, as well as identifying agents with strong anti-inflammatory, antibacterial, and wound-healing properties, is essential for creating more targeted treatment methods. […] Given this background, the study aimed to explore the capacity of carbon dots, synthesized from citric acid and urea, to enhance the healing of chemically-induced skin burns and to reduce the overall damage caused to the body. […] The application of carbon dots in wound healing shows promising results by accelerating tissue regeneration, enhancing cell migration, and modulating inflammatory responses. […] These properties make CDs a valuable tool in developing advanced burn care treatments and therapeutic strategies for tissue repair.

• #51 Chemical Burns: Causes, Symptoms, Treatment, Prevention, Care

  https://www.webmd.com/first-aid/chemical-burns

  Any chemical burn can be a legitimate reason to get emergency medical help. Always call 911 if you don’t know how severe the injury is or whether or not the person is medically stable. Also call 911 if you have any concerns about a chemical injury. […] Emergency personnel are trained to assess the extent of a chemical burn, begin treatment, and take patients to the hospital. […] Emergency workers also may determine the need for more involved decontamination of both you and the accident site prior to going to the hospital. When you contact 911, tell the dispatcher as much of the following information as possible: […] How many people are injured and the location where they are […] How the injury happened […] Whether emergency personnel can reach the victims or whether the victims are trapped

• #52 Chemical Burns: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22350-chemical-burns

  Chemical burns require immediate treatment. Call 911 and then: […] Once you arrive at the hospital, your healthcare team will: […] The American Burn Association recommends that anyone with a chemical burn should seek care at a burn center or call the National Poison Control Hotline (1-800-222-1222) immediately for information on treatment. […] If you have a severe burn, you may need surgery to remove the burned portion of your skin. Some people need a skin graft. A surgeon takes healthy skin from elsewhere on your body and attaches it to the burned area. Surgery can also repair perforations in your gastrointestinal tract. […] Seek help right away for any type of chemical burn. […] You should seek medical attention from your healthcare provider for any chemical burn, even if it seems mild. Immediate treatment is essential to prevent scarring or complications.

• #53 Chemical Burns: Causes, Symptoms, Treatment, Prevention, Care

  https://www.webmd.com/first-aid/chemical-burns

  Name, strength, and volume or quantity of the chemical causing the burn (Give a container of the chemical to emergency personnel, if possible.) […] Length of time of contact with the chemical […] Always seek emergency care for any burn that is larger than 3 inches in diameter or is very deep. Also seek emergency care for any chemical burns involving the face, eyes, groin, hands, feet, or buttocks or if it is over a joint. […] Even if the exposure was very small and you have completed basic first aid, call your doctor to review the injury and the chemical involved and to make sure no further emergency treatment is needed. The doctor can arrange appropriate treatment or will direct you to go to a hospital’s emergency room. If you’re the person with the burn, ask your doctor if you need a tetanus shot. […] […] […] Chemical Burn Follow-Up […] After leaving the emergency department, call your doctor within 24 hours to arrange follow-up care. Call sooner if any new problems or concerns arise.

• #54 Hydrochloric Acid on Skin: Side Effects, Precautions, and Safety

  https://www.healthline.com/health/hydrochloric-acid-on-skin

  Hydrochloric acid burns are one of the most frequently treated types of chemical burns. […] If your skin comes into contact with hydrochloric acid, it can result in severe burns that need medical attention. […] If you have a chemical burn, you should follow these steps immediately: Flush your skin of the hydrochloric acid by running cool water over the affected area for 10 minutes. […] Burns larger than 3 inches across or those on your hands, feet, face, or groin require prompt medical attention. […] Hydrochloric acid can cause a severe chemical burn if it comes into contact with your skin. […] You can reduce your chances of having a chemical burn by taking the proper precautions when handling dangerous chemicals.

• #55 Chemical burn or reaction Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/injury/chemical-burn-or-reaction

  Note: If a chemical gets into the eyes, flush them with water right away. Continue to flush the eyes with running water for at least 15 minutes. Get medical help right away. […] Call for medical help right away if the person is having difficulty breathing, is having seizures, or is unconscious. […] Do not apply any household remedy such as ointment or salve to a chemical burn. […] Do not try to neutralize any chemical without consulting the poison control center or a health care provider.

• #56 Understanding First-Degree Chemical Burn Treatment

  https://www.thewoundpros.com/post/understanding-first-degree-chemical-burn-treatment

  Flushing the affected area with cool running water is the most important step in treating a first-degree chemical burn. Immediately rinse the burn area under cool, running water for at least 10 to 20 minutes. This helps to remove any residual chemicals and cool the burned skin, reducing pain and preventing further penetration of the chemical into the skin. […] Avoiding home remedies or self-treatment: It’s important to refrain from applying home remedies or self-treatment solutions such as ointments, creams, or ice to the burn area. These can potentially worsen the condition or interfere with subsequent medical evaluation and treatment. […] Seeking medical attention after a first-degree chemical burn is highly recommended to assess the severity of the burn and determine the appropriate course of treatment.

• #57 Chemical Burns: Causes, Symptoms, Treatment, Prevention, Care

  https://www.webmd.com/first-aid/chemical-burns

  Name, strength, and volume or quantity of the chemical causing the burn (Give a container of the chemical to emergency personnel, if possible.) […] Length of time of contact with the chemical […] Always seek emergency care for any burn that is larger than 3 inches in diameter or is very deep. Also seek emergency care for any chemical burns involving the face, eyes, groin, hands, feet, or buttocks or if it is over a joint. […] Even if the exposure was very small and you have completed basic first aid, call your doctor to review the injury and the chemical involved and to make sure no further emergency treatment is needed. The doctor can arrange appropriate treatment or will direct you to go to a hospital’s emergency room. If you’re the person with the burn, ask your doctor if you need a tetanus shot. […] […] […] Chemical Burn Follow-Up […] After leaving the emergency department, call your doctor within 24 hours to arrange follow-up care. Call sooner if any new problems or concerns arise.

• #58 Topical Chemical Burn – CHEMS Field Treatment Guidelines

  https://chemsftg.com/topical-chemical-burn/

  Rapid recognition of a topical chemical burn. […] Initiation of emergent and appropriate intervention and patient transport. […] If dry chemical contamination, carefully brush off solid chemical prior to flushing the site as the irrigating solution may activate a chemical reaction. […] If wet chemical contamination, flush the patients skin (and eyes, if involved) with copious amounts of water or normal saline. […] Provide adequate analgesia per the Pain Management guideline. […] Consider the use of topical anesthetic eye drops, Tetracaine, for chemical burns of the eye. […] For eye exposure, administer continuous flushing of irrigation fluid to eye. […] Early airway intervention for airway compromise or spasm associated with oropharyngeal burns. […] Initiate intravenous fluid resuscitation if necessary to obtain hemodynamic stability.

• #59 Cutaneous chemical burns: assessment and early management

  https://www.racgp.org.au/afp/2015/march/cutaneous-chemical-burns-assessment-and-early-mana

  Referral to secondary or tertiary centres is required for formal assessment by specialist services. Full-thickness chemical burns may require admission for surgical debridement and grafting of non-viable tissue. […] Current guidelines suggest water irrigation is the safest, most efficacious and readily available treatment option in the early stages of care of chemical burns.

• #60 Cutaneous chemical burns: assessment and early management

  https://www.racgp.org.au/afp/2015/march/cutaneous-chemical-burns-assessment-and-early-mana

  Neutralisation of chemicals is contentious but is generally not indicated because of the risk of further heat production and thus continuing injury. Several neutralising agents have shown some benefit, but irrigation with plain water remains the most efficacious, accessible and cost-effective treatment. […] Complete wound evaluation: the microcirculation of the wound is evaluated by pinprick test for pain and capillary return time. […] Assessment regarding the depth of the chemical burn is notoriously difficult, as burns may be deceptively superficial. […] Debridement of blisters and non-viable tissue is advocated as early as possible via surgical or non-surgical approaches. […] Given the difficulty in assessing injury extent and depth, caution is generally advised. Chemical burns should be treated as full-thickness burns until proven otherwise.

• #61 Chemical Burns First Aid | St John Ambulance

  https://www.sja.org.uk/get-advice/first-aid-advice/burns-and-scalds/chemical-burns/

  Severe chemical burn: […] If the burn is severe, call 999 or 112 for emergency help. Pass on any details you may have of the chemical to ambulance control. […] First make sure that the area around you and the casualty is safe. Wear protective gloves, (if available, an apron and eye protection) this will prevent you from coming into contact with the chemical. […] Flood the burn with cool or lukewarm running water until the ambulance arrives, to disperse the chemical and stop it burning. […] Do not delay starting treatment by searching for an antidote. […] Never attempt to neutralise acid or alkali burns unless you are trained to do so. […] Carefully remove any contaminated clothing. […] If there is someone else available to assist you, who has protective gloves on, they can do this while you continue to cool the burn. […] If the burn is minor and you have not yet called for help, send the casualty to hospital. Monitor their level of response whilst waiting for help.

• #62 Topical Nitric Acid Burns: Initial Assessment and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10412252/

  To conclude, the interest of our publication is to underline the importance and effectiveness (with a concrete example) of the main treatment aims of chemical burn wound management. The early and abundant irrigation with water or sterile isotonic saline solution, the use of panthenol-containing creams and covering with silver sulphadiazine dressing, carefully monitoring wounds, keeping wounds clean and moist, and preventing and managing secondary infection allow the healing.

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