Thermal bums

Burns. Skin bums resulting from contact with pure fluorine gas are comparable to thermal bums and differ considerably from those produced by hydrogen fluoride (114). Fluorine bums heal much more rapidly than hydrofluoric acid bums. 

Pseudocumene is shipped ia barges, tank cars, tank tmcks, isocontainers, and dmms. Mesitylene is shipped ia tank tmcks, isocontainers, and dmms, whereas durene is shipped molten ia heated tank tmcks, isocontainers, and occasionally as a cast soHd in dmms. Mesitylene, pseudocumene, and hemimellitene are classified as flammable Hquids the higher homologues are classified as combustible. The higher melting PMBs requite additional precautions when handled in the molten state to avoid thermal bums. Detailed shipping and handling procedures are described in manufacturers material... 

The principal safety concern in handling molten benzoic acid is its elevated temperature. Thermal bums may result from improper handling of the molten product (25,26). 

Water reactivity can be hazardous by one or more of several mechanisms. The heat of reaction can cause thermal bums, ignite combustible materials, or initiate other chemical reactions. Flammable,... 

Moreover, the speed of washing is a factor that is not as decisive for thermal bums as it is for chemical bums. 

Meller, D., Pires, R.T., Mack, R.J., et ah Amniotic membrane transplantation for acute chemical or thermal bums. Ophthalmology 107, 980-990 (2000)... 

Yao, Y.F., Zhang, B., Zhou, R, Jiang, J.K. Autologous limbal grafting combined with deep lamellar keratoplasty in unilateral eye with severe chemical or thermal bum at late stage. Ophthalmology 109, 2011-2017 (2002)... 

While rinsing with water will cool deep into the tissue of a thermal bum, rinsing the tissue with water or physiological solution very quickly removes the product but only from the eye surface. Contrary to generally accepted ideas, and as demonstrated by Laux as early as 1965, Josset in 1986 and, more recently, Schrage... 

Although Wells (Ref 2) recommends TEB as a jet motor fuel for high speed aircraft, he cautions that TEB is. . extremely destructive to living tissue and on contact with the skin produce(s) a combined effect of dehydration and thermal bum. The reaction is immediate and deep bums with subsequent scarring result.. 

Renal Effects. Evidence of renal damage was observed in individuals burned once with white phosphorus. Increased blood urea nitrogen (Summerlin et al. 1967), increased urinary levels of protein and urea nitrogen (Walker et al. 1947), and signs of acute renal failure (Songetal. 1985) have been observed. No longer term human studies were identified. Some of the blood/serum chemical changes are also found in thermal bum patients and cannot necessarily be ascribed to white phosphorus toxicity. However, controlled animal studies (discussed below) have shown similar effects that have been attributed to white phosphorus. 

Sulfuric acid is a severely corrosive poison and dehydrating agent in the concentrated liquid form. It readily penetrates skin to reach subcutaneous tissue and causes tissue necrosis, with effects resembling those of severe thermal bums. Sulfuric acid fumes and mists can act as irritants to eye and respiratory tract tissue. Industrial exposure has caused tooth erosion in workers. 

Chemical and thermal burns. The causes of chemical bums include the effect of concentrated acids, alkali, liquid ammonia, chlorosilanes and other aggressive substances. Thermal bums are caused with boiling solutions, hot water, vapour, inflamed gases, incandescent contact mass. Preventive and protective measures mostly include strict observance of all the established technological regulations and equipment maintenance order. 

Figure 26-34 Corneal eschar in patient who sustained a thermal bum from a curling iron. (Courtesy of Pat Caroline.)...

Their effect on the regeneration of connective tissues at wound defects and deep thermal bums has been studied. In experiments carried out and designed for revealing biological activity of obtained compounds (A and B), it has been found that they considerably accelerate wound cicatrizing (see Table 1). 

From the present results, it follows that both silocane (B) and silane (A) provide reliable activation of cicatrizing of the deep non-complicated skin thermal bum. The silocane effect on the average time for primary scab fall-off, as completion of granulation-fibroid tissue development at the site of bum necrosis, was more pronounced the time required is reduced by almost 15%. Somewhat less pronounced (about 6 - 7%) was the activation of secondary scab fall-off, but it is also of practical value, taking into account the fact of non-complicated bum cicatrizing in comparison with solkoseril (a high efficiency preparation in clinical practice), but turned out to be non-effective for a non-complicated burning process in this experiment. 

Henriques FC (1947) Studies of thermal bum injury V The predictability and significance of thermally induced rate processes leading to irreversible epidermal injury. Archives of Pathology 43 489-502. 

Because local inflammatory reactions may comphcate some of the bum injuries, nonsteroidal antiinflammatory dmgs (NSAIDs) may be helpful. Additional bum treatment may include CO -laser debridement, artificial skin or skin grafting (3). Large amounts of fluid loss are uncommon compared to thermal bums, but patients should still receive careful monitoring of fluids and electrolytes (2,3,23). Signs of infection and cultures revealing responsible organisms are indications for systemic antibiotics (24-26). 

Compared to thermal bums, radiation induced bums develop more than a week after exposure. Therefore, patients presenting with bum injuries immediately after exposure are suffering from thermal rather than radiation bums. Table 4.3 illustrates the relationship between exposure dose and cutaneous injury. 

E3. Estes, F. L., and Blocker, T. G., Amino acid excretion after thermal bum. Texas Kept. Biol. Med. 24, 54-66 (1966). 

Most casualties of mustard exposure wiU, however, require some form of medical care— from a few days to many weeks. Eye care and airway care will promote healing within weeks skin lesions take the longest to heal and may necessitate hospitalization for months (Wdlems, 1989). Casualties with mUd to moderate mustard damage will need supportive care. Pain control is extremely important. Fluids and electrolytes should be carefully monitored. Although there is not as great a fluid loss from mustard bums (compared with thermal bums), a casualty will probably be dehydrated when he enters the MTF. Parenteral fluid supplements and vitamins will be of benefit. Casualties who have lost their eyesight because of mustard exposure should be reassured that they will recover their vision. 

Exposure to low concentrations may not produce immediate effects. However, the severity of poisoning is not related to the presentation or magnitude of immediate symptoms. Symptoms may include eye and airway irritation, tearing, shortness of breath, coughing, wheezing, chest tightness, and delayed pulmonary edema. If halogens have been released, there may be redness of the skin, chemical bums or even thermal bums. 

G13. Goodall, M., Stone, C., and Hanes, B. W., Urinary output of adrenaline and noradrenaline in severe thermal bums. Ann. Surg. 146, 479-487 (1957). 

Wl. Walker, J., Changes in the non-protein fractions of the plasma nitrogen following extensive thermal bums. Am. J. Med. 209, 413-414 (1945-1946). 

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