Phosphorus burn combined with poisoning
Introduction
Introduction Phosphorus pentoxide (chemical formula: P2O5, molecular formula: P4O10), phosphorus oxide produced by burning phosphorus in air. It has strong water absorption and strong dehydration, and can even dehydrate concentrated sulfuric acid to form sulfur trioxide. Extremely deliquescent, it is a powerful desiccant. It produces metaphosphoric acid with cold water and orthophosphoric acid with hot water. 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.
Cause
Cause
Phosphorus is a protoplasmic poison that inhibits the oxidation process of cells. Phosphorus absorption is more abundant in liver and kidney tissues, which may cause extensive damage to organs such as liver and kidney. At the same time, the corresponding chemical reaction of phosphorus in water will cause a large amount of heat release, and the high temperature generated by the exotherm may cause local skin or mucous membrane burns.
Examine
an examination
Related inspection
Blood routine urine routine serum phosphorus (Pi) skin color urine phosphorus
After phosphorus burns, the main symptoms are headache, dizziness, fatigue, nausea, severe liver and kidney dysfunction, hepatomegaly, liver pain, jaundice, oliguria or anuria, and protein and cast in urine.
Inhalation injury and phosphorus poisoning can cause shortness of breath, irritating cough, lungs and dry and wet rales, severe pulmonary insufficiency and ARDS, chest radiographs suggest interstitial pulmonary edema, bronchial pneumonia.
Some patients may have low calcium, hyperphosphatemia, heart rhythm disorders, mental symptoms and cerebral edema. Phosphorus burn wounds are deeper, can damage the bones, the wound surface is brown, and the III degree wound can be bronze or black when exposed.
Diagnosis
Differential diagnosis
1, acid burn
Commonly used are sulfuric acid, hydrochloric acid, and nitric acid burns. In addition, there are hydrofluoric acid, carbolic acid, oxalic acid and the like. They are characterized by dehydration of tissues, precipitation of proteins, and coagulation. Therefore, the wounds become rapidly formed and the boundaries are clear after burns, thus limiting the continued erosion to the deep.
2, alkali burns
Alkali burns commonly found in clinical practice include caustic soda, lime and ammonia, and their incidence is higher than that of acid burns. Alkali burn is characterized by binding to tissue proteins to form a basic protein compound, which is easy to dissolve, further deepens the wound; saponifies the adipose tissue; dehydrates the cells to death, and produces heat and damage. Therefore it causes damage more severe than acid burns. 1 caustic burn: caustic refers to sodium hydroxide and potassium hydroxide, which is highly corrosive and irritating. After the burn, the wound surface is sticky bone or soapy eschar, the color is red, generally deep, usually above the deep II degree, the pain is severe, the wound blank is painful after the tissue is detached, the wound is sunken, the edge is sneak, and it often lasts for a long time.
3, cyanide burns and combined poisoning
Cyanide can be divided into inorganic cyanide and organic cyanide according to its chemical structure, and the latter is called nitrile compound. When cyanide enters the body, cyanide ions rapidly combine with the ferric oxidase of oxidized cytochrome oxidase, hindering the reduction of cytochrome to a cytochrome oxidase with ferrous iron, so that the cells cannot get enough oxygen, resulting in "Intracellular suffocation." In acute poisoning, the difference of arteriovenous blood oxygenation can be reduced from 4% to 5% of normal to 1% to 1.5%, which may cause paralysis of the respiratory center and cause death.
4, asphalt burns
Asphalt, known as tar, has a high degree of adhesion and is widely used in building construction, engineering anti-corrosion and moisture-proof, paving and so on. 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 occur in exposed parts of the skin, such as hands, feet, face and so on. Large-range asphalt burns should not be scrubbed with gasoline to avoid acute lead poisoning. After the asphalt is burned, it can be immediately placed in cold water to cool it. Then the olive oil or sesame oil can be used to remove the bitumen on the wound surface. It can also be wiped with turpentine oil, but it is irritating, so it is suitable for small and medium-sized wounds. After phosphorus burns, the main symptoms are headache, dizziness, fatigue, nausea, severe liver and kidney dysfunction, hepatomegaly, liver pain, jaundice, oliguria or anuria, and protein and cast in urine. Inhalation injury and phosphorus poisoning can cause shortness of breath, irritating cough, lungs and dry and wet rales, severe pulmonary insufficiency and ARDS, chest radiographs suggest interstitial pulmonary edema, bronchial pneumonia.
