Thermal eye bums

Kuckelkom, R., Kottek, A., Schrage, N., Reim, M. Poor prognosis of severe chemical and thermal eye bums the need for adequate emergency care and primary prevention. Int Arch Occup Environ Health 67(4), 281-284 (1995)... 

Kuckelkorn, R., Keller, G., Redbrake, C. Long-term results of large diameter keratoplasties in the treatment of severe chemical and thermal eye bums. Khn Monatsbl Augenheilkd 218, 542-552 (2001)... 

Eye bums are a process that develops during a chemical or thermal exposure that is of exceeding mass, contact time, chemical reactivity, and temperature until the exhaustion of the protective mechanisms of the eye. The most plastic description of this process can be given in images that are obtained by optical coherence tomography [5]. 

B. Burns. Far-infrared laser bums of the cornea and skin are treated similarly to other types of thermal burns. If not perforated, apply antibiotic ointment to the eye then patch. The patient should also receive systemic broad-spectrum antibiotics coverage and systemic analgesic. There is very little likelihood of an isolated eye bum the eyelids, skin of the face, and other parts of the body will be affected and should be treated (see FM 8-230 for treatment of burns). 

HEALTH SYMPTOMS inhalation (headache, sore throat, irritates eyes, skin and mucous membranes) contact (thermal skin bums, dermatitis) ingestion (symptoms parallel those of inhalation). 

ACUTE HEALTH RISKS (note there are no well-documented studies showing the effects of terphenyls on humans). Exposure to terphenyls may cause eye, skin and respiratory irritation have caused transient headache and sore throat may also cause thermal skin bums and readily reversible skin rashes. 

Reim, M. The results of ischemia in chemical injuries. Eye 6, 376-380 (1992) Reim, M., Kuckelkorn, R. Chemical and thermal lesions in the orbital region. Bull. Soc. Beige Ophtalmol. 245, 21-28 (1992) Reim, M., Teping, C. Surgical procedures in the treatment of most severe eye bums. Acta. Ophthalmol. Scand. 67, 47-54 (1989). 

When in contact with some skin or an eye, the very concentrated corrosives, dissolve the water of tissues. Before they really lead to a chemical bum, or simultaneously, these very concentrated corrosives can cause a bum by dehydration and/or by thermal effect. 

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... 

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. 

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 burns. 

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. 

Dexamethasone is a steroid antibiotic combination. Tobramycin inhibits bacterial protein synthesis, causing death dexamethasone suppresses the inflammatory response. The combination is indicated in superficial bacterial ocular infection or risk of bacterial ocnlar infection inflammatory conditions of palpebral and bulbar conjunctiva, cornea, and anterior segments of globe where inherent risk of steroid use in certain infective conjunctivitis is accepted to obtain a diminution of edema and inflammation chronic anterior uveitis and comeal injury from chemical, radiation, or thermal bums, or penetration of foreign bodies, where risk of superficial ocular infection is high, or an expectation, or when potentially dangerous numbers of bacteria will be present in the eye. 

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