Asphalt burns
Introduction
Introduction Asphalt is called tar, which has a high degree of adhesion. It is widely used in house construction, engineering anti-corrosion and moisture-proof, paving roads, etc. Liquid asphalt causes skin burns to be purely thermal and has no chemical damage. Its characteristics are not easy to remove, high heat, slow heat dissipation, so the wounds are often deep, and most occur in exposed parts of the skin, such as hands, feet, face and so on. The bitumen evaporates to produce a small amount of light-sensitive substances such as acridine, hydrazine, and phenanthrene, which increase the pain after light irradiation. Therefore, patients should avoid sun exposure, avoid the use of light-sensitive drugs, such as sulfonamide, chlorpromazine, promethazine, etc., disable red mercury, gentian violet. Burns can be better and faster.
Cause
Cause
Contact with asphalt chemicals:
With the development of urban and road construction, asphalt is becoming more and more extensive in road construction projects. It can be applied due to its chemical properties of 450 degrees, and it has strong adhesion. When the on-site construction personnel are operating, such as the hand, foot, head and face, etc., the liquid asphalt which is easily soluble in the exposed parts adheres to the skin surface, and the removal is very difficult. The high-temperature asphalt quickly forms a burn wound on the skin, and can be caused by timely treatment. Deep burns.
Examine
an examination
Related inspection
Physical examination of skin fungus microscopic examination of skin diseases
When the asphalt burns, it will cause serious damage to the local area. In this case, it is necessary to actively go to the hospital for treatment. When you arrive at the hospital, you need to check the extent of the local burn, and then according to the situation obtained by the inspection. Choose the right treatment.
Burns can be differentiated by total surface area ratio (TBSA) and then divided according to depth. Once burns (only erythema, no blister) are not included. The commonly used method, called the nine-point method, helps doctors quickly determine the body surface area of a patient's injury.
A more precise method is to distinguish between different proportions of the body of an adult and a child through the Lund-Broude table. A person's hand (palm and finger) is about 1% of the total surface area. The actual average surface area should be 0.8%, so using 1% may slightly overestimate the burn area. 10% of children with burns and 15% of adult burns may have a life-threatening risk due to reduced blood volume and need to be infused as soon as possible and monitored in the burn department.
(1) Nine-point method (adult): 9% (1 9%) of the head and neck, 18% (2 9%) of the upper limbs, 27% (3 9%) of the trunk (including the perineum 1%), and both lower limbs ( Containing buttocks) is 46% (5 9% + 1%), a total of 11X9% + 1% = 100%.
(2) Nine-point method (children): The head of the child is small and small, and varies with age. The calculation is as follows: head and neck body surface area (%) = 9% + (12-age)%, double lower limb surface area (%) =46%-(12-age).
During the treatment period, it is necessary to pay attention to the situation of rest and recuperation, and at the same time pay attention to increase the nutritional status of the diet.
Diagnosis
Differential diagnosis
Differential diagnosis of asphalt burns:
1, acid burn
Commonly used are sulfuric acid, hydrochloric acid, and nitric acid burns. In addition, there are hydrofluoric acid, carbolic acid, oxalic acid, etc., which are characterized by dehydration of tissue, precipitation of proteins, and coagulation. Therefore, the wounds quickly become sputum after burns, and the boundaries are clear, thus limiting the continued erosion to the deep.
(1) Sulfuric acid, hydrochloric acid, and nitric acid burns: sulfuric acid, hydrochloric acid, and nitric acid have a higher incidence of burns, accounting for 80.6% of acid burns. The burnt wound of sulfuric acid is black or brownish black, the hydrochloric acid is yellow, and the nitric acid is yellowish brown. In addition, the color change is also related to the depth of the wound. The tide is the lightest, gray, brown or black. After the acid burn, due to the cover of the suede, the early judgment of the depth is more difficult than the general burn, and it cannot be judged as the concentration burn due to the waterless bubble.
Sulfuric acid, hydrochloric acid, and nitric acid can cause skin burns when in a liquid state, and inhalation damage can be caused by inhalation in a gaseous state. Compared with the three acids, at the same concentration, the sulfuric acid is the strongest in the liquid state, and the nitric acid is the strongest in the gaseous state. After inhalation of gaseous nitric acid, pulmonary edema can occur in a few hours. They can cause upper gastrointestinal burns, laryngeal edema and difficulty breathing, and even ulcer perforation after oral administration.
(2) Hydrofluoric acid burn: Hydrofluoric acid is an aqueous solution of hydrogen fluoride, which is colorless and transparent, has strong corrosiveness, and has the functions of dissolving fat and decalcifying. After hydrofluoric acid burns, the wound may initially have only erythema or leather-like eschar, and then necrosis will occur. The tissue will be eroded to the surrounding and deep tissues, which may cause the bones to become necrotic, forming ulcers that are difficult to heal, and the wounded are heavier. 10% hydrofluoric acid has a greater traumatic effect, while 40% has a slower infiltration of the skin.
(3), carbolic acid burns: the absorption of carbolic acid mainly causes damage to the kidneys. It has strong corrosion and penetrability, and has progressive infiltration damage to the tissue. Therefore, it is first rinsed with a large amount of flowing cold water and then rinsed or bandaged with 70% alcohol. Deep wounds should be cut or cut early.
(4) oxalic acid burn: skin, mucous membrane contact with oxalic acid is easy to form a powdery white intractable ulceration, and oxalic acid and calcium combined to reduce blood calcium, so when treatment with a large amount of cold water rinse, local and system should be timely application of calcium.
2, alkali burns
Commonly used alkali burns are caustic, lime and ammonia, and their incidence is higher than that of acid burns. Alkali burns are characterized by binding to tissue proteins to form basic protein compounds that are easily dissolved and further deepen the wound surface. Saponification of fat tissue, causing cells to dehydrate and kill, and heat damage. Therefore it causes damage more severe than acid burns.
3, phosphorus burn combined poisoning
Phosphorus burns rank third in chemical burns, second only to acid and alkali burns. Phosphorus removal can cause injury in the presence of air, and phosphorus pentoxide is formed by oxidation of phosphorus, which has dehydration and oxygen scavenging effects on cells. Phosphorus pentoxide forms phosphoric acid in the presence of water and produces heat during the reaction to further deepen the wound surface. Inhalation of phosphorus vapor can cause inhalation damage, and phosphorus and phosphide can cause phosphorus poisoning through inhalation of wounds and mucous membranes.
