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Chemical burn PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Chemical burn" by Dr Rekha Gyanchand.

This medical PowerPoint presentation talks about chemical burn, a type of injury caused by contact with a harmful chemical substance. Chemical burns can occur from exposure to a wide range of chemicals, including acids, bases, solvents, and oxidizers.

Chemical burns can be very serious and may cause damage to the skin, eyes, and other tissues. The severity of the injury depends on several factors, including the type of chemical, the duration of exposure, and the amount of chemical involved.

Symptoms of a chemical burn may include redness, swelling, blistering, and pain at the site of contact. In severe cases, the burn may cause tissue damage or death, and may require medical attention.

If you experience a chemical burn, it is important to immediately flush the affected area with water for at least 20 minutes to help dilute and remove the chemical. Remove any contaminated clothing or jewelry, and seek medical attention if necessary.

Tags : Chemical burn, Emergency Medicine, Emergency Medicine PowerPOint presentation

Published on : Apr 03, 2023 | Views : 815 | Downloads : 0

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Slide 1-

Chemical burn Dr Rekha Gyanchand Cornea Consultant, Lions Eye Hospital Bangalore
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Chemical injuries of the eye may produce extensive damage to the ocular surface epithelium,cornea & anterior segment,resulting in permanent unilateral or bilateral visual impairment DEFINATION
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INCIDENCE 80% of ocular chemical burns were due to industrial and/or occupational exposure Ocular burns are more common in males than in females Lime burn(chunna) very common in India
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ETIOLOGY- ALKALI Ammonia---Fertilizers,Refrigerants,cleaning agents Lye(NaOH)- Drain cleaners Potassium hydroxide- Caustic potash Magnesium Hydoxide –Sparklers Lime-(Ca(OH)2- Plaster,whitewash,cement AMMONIA,LYE & LIME IS MOST SERIOUS BURNS
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ETIOLOGY-ACID Sulfuric acid- Industrial cleaners,Battery acid Sulfurous acid-Bleach,Refigerants Hydrofluoric acids-Glass polishing Acetic acids-Vinegars MOST SERIOUS IS HYDROFLUORIC ACID(Low molecular wt.)
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BIO CHEMICAL CHANGES-Alkali Alkali substances are lipophilic and penetrate more rapidly than acids. Saponification of cell membrane fatty acids causes cell disruption and death. In addition, the hydroxyl ion hydrolyzes intracellular glycosaminoglycans and denatures collagen. Liquefactive necrosis, The damaged tissues stimulate an inflammatory response, which damages the tissue further by the release of proteolytic enzymes . Alkali substances can pass into the anterior chamber rapidly (approximately 5-15 min) exposing the iris, ciliary body, lens, and trabecular network to further damage. Irreversible damage occurs at a pH value above 11.5.
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BIO CHEMICAL CHANGES - Acid burns Acid burns cause protein coagulation in the corneal epithelium, which limits further penetration. Thus, these burns usually are nonprogressive and superficial. Hydrofluoric acid is an exception.
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PATHOPHYSILOGY LEUCOCYTIC WAVE CHEMICAL BURN PED 12-24hrs(PMN+MONONUCLEAR LEUCOCYTES) KERATOCYTE DAMAGE Extensive LSC damage PHAGOCYTIC DEG. STROMAL THINNING TYPE I COLLAGENES mmp-8 Plasminogen activities STERILE CORNEAL ULCER 7 days inflam.cells Vit C Vit A Na hyalurnote Heparin Tetracyclin,collagenase inhibitor,oral antioxidents steroids steroids prostaglandins
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Signs & Symptoms Pain Redness Irritation Tearing Inability to keep the eye open Sensation of something in the eye Swelling of the eyelids Blurred vision
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EQUIPMENTS IN EMERGENCY ROOM Saline bottle Drip set & Nasal Cannula pH strip or urine dip strips Fluroscein stain Edta Retractors Scleral conformer( sterilised)/Prokara rings Glass rods not used
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Classification of severity of ocular surface Burns by Roper-Hall Grade Prognosis Cornea Epith. Conjunctiva/limbus I Good Yes No limbal ischaemia 2 Good Yes <1/3/ <1/3 Corneal haze, iris details visible 3 Good Yes >1/3 Iris details obscured 4 Guarded Yes >1⁄2 limbal ischaemia Cornea opaque, iris and pupil obscured corneal haze as an important prognostic variable. Rapid changes Br J Ophthalmol. 2004 October; 88(10): 1353–1355
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Modification in GRADING Dua et al, limbal fluroscein staining as a marker of limbal stem cell damage. Fornices & mucocutaneous junction of the conjunctiva are important for conjunctival regeneration Limbal involvement prefered over limbal ischemia(Transient)
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New classification of ocular surface burns. DUA et al Grade Prognosis Clinical findings Conj.invol. Analogue scale I Very good 0 clock hours of limbal invol. 0% 0/0% II Good <3 clock hours of limbal invol. <30% 0.1–3/1–29.9% III Good >3–6 clock hours of limbal invol. >30–50% 3.1–6/31–50% IV Good-Guard.>6–9 clock hours of limbal invol. >50–75% 6.1–9/51–75% V Guard-poor >9–<12 clock hours of limbal invol.>75–<100% 9.1–11.9/75.1– 99.9% VI Very poor Total limbus (12 clock hours) involved Total conjunctiva (100%) involved 12/100% *The Analogue scale records accurately the limbal involvement in clock hours of affected limbus/% of conjunctival involvement. Only bulbar & fornices conjunctiva is considered
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Estimation of conjunctival injury. For example, 1/6th+1/6th = 1/3rd. BULBAR2/3 & TARSAL 1/3
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DIAGRAM
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PROGNOSIS ALKALI pH > 11 More then 2quadrent ischemia Corneal anesthesia ACID pH < 2.5 Corneal anesthesia Ischemia Severe iritis Lens opacification
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Mc. CULLEY CLINICAL COURSE OF CHEMICAL INJURY Acute up to 1 week Early Repair 1-3weeks Late repair >3wks (Balance between collagen synthesis & collagen degradation)
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TREATMENT IMMEDIATE Eye Wash for 45min EDTA sol-0.01-0.05 molar sol Na.EDTA mechanical removal of calcium REDUCE INFLAMMATION Pred.acetate intensive x10days MPS E/d 1% qid & depo 10mgs weekly after 10days Citrate Topical10 mgs 2hourly Tab.Vit C 2gms QID Cycloplegic PROMOTE RE-EPITHELIZATION & TRANSDIFFERATION AT Retinoic acid 0.01% Sodium Hyaluronate(healon) REPAIR & MINIMIZE ULCERATION Ascorbate Tab & drops Tetracycline Collagenase inhibitors(Acetylcystine 10-20% & Na edta) Oral antioxidents
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TREATMENT LIMBAL ISCHEMIA(Revascularization) Heparin e/d Heparin injection(750units) OTHERS Anti-glaucoma e/d Scleral conformer(G3&G4) AVOID PHENYLEPHRINE PATCHING Steroids after 10days
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THANK YOU