For medical professionals only
Beware of secondary injuries!
Recently, a 10-year-old girl in Shijiazhuang applied fire alkali (sodium hydroxide) to her body and played with water, causing severe burns all over her body. According to the child's mother, the child itself suffers from cerebral palsy, the family usually lacks supervision of the child, the tragedy occurred when the child was in a monitoring blind area, the family did not find out in time, and when the child was sent to the hospital, the child's injuries had seriously worsened. Currently, the child is still in the intensive care unit.
Image source: Weibo
Sodium hydroxide is a strong alkali that emits a lot of heat when exposed to water and water vapor, and the resulting solution is highly corrosive. Sodium hydroxide is generally used for industrial purposes, but can also be used for strong decontamination, dredging pipes and so on.
According to the memory of the mother of the girl, the fire alkali was bought two or three months ago to clear the sewers, and after use, it was placed on the refrigerator, and she did not expect to be used as a toy by the child. What happened to us once again made us vigilant.
Source: @Farmer Channel
When will the "five-word recipe" of first aid be used?
Burns are one of the common accidental injuries in children. After burns, local and systemic capillary permeability is increased, a large amount of body fluid exudates, and skin tissue degenerates and necrotic. If there is a serious or large-scale burn that is not treated in time, chemical mediators, cytokines, toxic substances, etc. can easily lead to a systemic inflammatory reaction, secondary infection, organ failure, limb necrosis, and even death.
According to the degree of damage to human tissue, burns can be divided into three degrees:
I-degree burns: the lesions are mild, only hurting the epidermis layer, the skin appears red, local dryness, swelling, feel hot and painful, but no blisters appear.
After 3 to 5 days, the part turns from red to light brown, and the epidermis is wrinkled and shed, generally leaving no scars.
Second-degree burns: injury to the dermis layer, local redness and swelling are obvious, the injured area is hot, the pain is unbearable, and there are obvious blisters.
If there is no secondary infection, it usually heals in 1 to 4 weeks, leaving no scarring, and occasionally pigmentation.
Third-degree burns: the whole skin including the fat, bone and muscles under the skin are injured, the skin is scorched, necrotic, sensory loss, pain is not intense, the burn tissue is not swollen, but the surrounding tissue is swollen.
Skin grafting is required to cure it.
Because the skin of infants and young children is delicate, once the burn is often more serious than that of adults, and it is easy to leave scars, it is necessary to strengthen the monitoring and safety education of the child, such as the timely treatment of burns to avoid aggravation of the injury. In case the child is accidentally injured, parents can adopt the five major treatment principles of "flushing, taking off, soaking, covering and sending".
▌ Rush
Immediately rinse the injured area slowly with cold water for 20 to 30 minutes, and at the same time, you can use a towel or clothing to wrap ice cubes on the burn area to reduce the pain of the child, pay attention not to use ice cubes, alcohol, dry ice directly to prevent frostbite.
▌ Off
Carefully remove your child's clothes, if the skin has been adhered to the clothes, do not pull hard, avoid local skin tearing that causes burns, aggravate the damage to the skin, and if necessary, use scissors to cut the clothes.
▌ Bubbles
If the pain is obvious or if the limbs or trunk are burned in a large area, the burn can be continuously soaked in cold water for 30 minutes to relieve the pain and reduce the degree of burn, but it is necessary to pay attention to if the skin of the wound has been cracked, it is necessary to stop soaking.
▌ Cover
While waiting for the arrival of the 120, gently cover the wound with sterile gauze or clean towels, sheets, etc., to protect the wound, and never break the blisters to avoid infection.
▌ Send
Send to the doctor as soon as possible to avoid delays in treatment.
"Punching, defoiling, soaking, covering, sending" is generally aimed at thermal burns, that is, flames, steam, high-temperature liquids, etc., and there are some special types of burns, the treatment methods are slightly different, and poor treatment will also delay treatment or even aggravate the disease.
Chemical burns (e.g., strong acids and bases)
In addition to causing burns at the contact site, chemicals can also cause progressive local damage or systemic poisoning through local absorption, so in addition to the timely treatment of the injured area, the contact time should be reduced first.
Do not rinse with water: strong acid and strong alkali will react with water will release a lot of heat, and washing with water will burn the skin.
▌Handling:
skin
Take off the clothes contaminated with chemicals, use the appropriate tools to remove chemical powders from your child or absorb excess chemical fluids as much as possible, and then use a large amount of low-pressure flowing cold water to slowly rinse the bare skin, rinse continuously for more than 30 minutes, reduce the concentration of chemicals, and reduce skin damage caused by heat.
It is not recommended to use acid-base neutralization, because acid-base neutralization reactions sometimes produce heat, so it cannot be rinsed with neutralization instead of cold water.
alimentary canal
It is forbidden to induce vomiting and gastric lavage to avoid perforation of the digestive tract and corrosion of the esophagus by reflux.
Oral strong acid, do not take sodium bicarbonate, sodium carbonate and other carbonates orally, so as not to produce a large amount of gas to aggravate flatulence and perforation. Also do not take neutralizers to avoid additional damage from the heat released during the dilution process.
A large amount of water can be taken orally to dilute the concentration of strong acid or strong alkali, but pay attention to the control amount, so as not to cause vomiting. Drinking large amounts of milk or water dilution is only useful within a few minutes of ingesting a corrosive liquid, or may be useful after ingesting a corrosive solid.
Eye
Immediately rinse with plenty of running water or saline for at least 30 minutes, blink while washing, do not cover the eyes or rub with a towel, quicklime burns are forbidden to rinse with saline.
Electrical burns
When current passes through the limb, it can cause strong spasms, and "jumping" deep burns can occur on the surface of the joint (such as elbows, armpits, knees, thighs, etc.). In addition, if the current passes through important organs such as the brain and heart, the consequences are serious.
The power should be turned off immediately, and the electric shock and power supply should be separated by insulated dry objects (such as wooden boards, bamboo poles, plastic pipes), and the injured person should be transferred to a safe area, and immediately dial 120 or sent to the nearest hospital emergency department.
At the same time, the patient's airway is opened to check whether his vital signs are stable, and if the person's heartbeat stops, CPR must be performed on the spot until the ambulance arrives. If bleeding occurs from the wound, it should be bandaged immediately to stop the bleeding.
Resources:
[1] UTD: Initial assessment and management of local chemical burns.
[2] Farmer Channel: 10-year-old daughter playing with fire alkali severe burns single mother tear collapse.
[3] Dr. Huaxi: What should I do if I accidentally burn or burn? West China experts: Remember the 5-word secret (old people with babies must see)
This article was first published: Pediatrics Channel of the Medical Professions
Author: Yuzu
Editor-in-Charge: CiCi