Overview of Chemical Burns
When most people think of “burns,” they think of injury from fire (aka “thermal burns”). Chemical burns, although not caused by heat, can cause similarly devastating burn injuries.
Chemical burns occur when the skin comes in contact with a corrosive substance, such as certain acids, solvents, oxidizers, bases, alkylants and reducing agents. People who work in mining, chemical laboratories or chemical manufacturing often sustain chemical burn injuries at work.
Common chemicals that cause burn injuries include:
- sulfuric acid
- hydrochloric acid
- sodium hydroxide
- silver nitrate
- sulfur mustard
- dimethyl sulfate
Classification of Chemical Burn Injuries
Chemical burns are classified in standard terms of “degree” of injury from moderate to severe (first, second and third-degree burns).
First degree chemical burns, or superficial burns, usually resolve within 72 hours, like sunburn.
Second degree burns, or partial thickness burns, penetrate the entire epidermis, or top layer of the skin. If the second degree burn is superficial, it will penetrate the dermis, or underlying tissue, to variable degrees. This type of second degree burn appears painful, red, and blistered. It is often edematous, or swollen. Dead tissue is debrided, or removed, and a topical antibiotic is given to prevent infection. Second degree chemical burns are incredibly painful, and there is often permanent scarring.
Third degree burns destroy the entire thickness of both dermis and epidermis. The burn site is painless — because all of the nerve endings have been destroyed — and the area appears either waxy or charred. This type of burn requires excision and skin grafting. Recovery is very painful, and permanent scarring — in both the burn sites and donor sites — is a consequence.
All full thickness burns in a circumference around a limb or the chest have the potential to compress the compartments surrounding bone and blood vessels, thus causing a compartment syndrome — a debilitating and potentially catastrophic condition — which must be recognized and treated quickly by medical professionals.
First Aid for Chemical Burns
If you are the victim of a chemical burn, it is most likely to an acid, an alkaline substance, or petroleum. The degree of damage will depend upon the concentration and duration of contact. For this reason, it is essential to remove all garments and brush off any dry powder. Immediately begin to irrigate your skin, with tap water, for 1-2 hours. If your eyes come in contact with the agent, you must immediately irrigate your eyes until help arrives.
Alkali burns are usually the most severe of the chemical burns. No chemical agent has an antidote, except hydrofluoric acid. Concentrations of hydrofluoric acid that are greater than 40% can be fatal in contact with as little as 2% of your body surface area, As with all chemical burns, tissue damage may be underestimated.
Hydrofluoric acid can cause a sudden drop in your calcium levels, which are necessary to maintain a healthy heart rhythm. Treatment of hydrofluoric acid burns is, again, copious irrigation, but calcium gluconate gel should be applied upon arrival at the emergency department. You may need calcium injections or infusions.
If you are in contact with dangerous chemicals in your workplace, you should have received training about handling emergencies such as unintended exposures. There should be an irrigation area for detoxification. 911 should be called immediately, as treatment delay should be minimized.
When you are unintentionally exposed to workplace or household chemicals, as you leave for the emergency department you should have someone wrap the container safely and take it with you, so the physician can approximate the amount damage you may have sustained.
If you have sustained a burn injury — whether at the workplace or some other context — from exposure to a toxic or corrosive chemical agent, you may be entitled to legal compensation for your injuries. Call the Burn Injury Firm toll free at 866-293-2615.