PATHOPHYSIOLOGY OF CHEMICAL BURN

Ris2 Fac "!s/ Fi!e8C"m()s i"n ? Fi!e.igh e!; In#)s !ial @"!2e!; Occ)pan ". ()!ning s !)c )!es; Chemical E5p"s)!e; In#)s !ial @"!2e! Elec !ical E5p"s)!e ? Elec !ician; Elec !ical P"&e! 9is !i() i"n @"!2e! Acci#en s E5pl"si"n
+n# #eg!ee ()!n in')!% in he !igh si#e ". he hea#; .ace an# nec2; le. )ppe! e5 !emi % an# ches ; !igh ea!; &i h n" e# !e#ness ":e! an# s)!!")n#ing he a!ea; p!esence ". (lis e!s "n he a!ea

Ris2 Fac "!s/ (pa ien >(ase#$ Li.e h!ea ening e:en Inci#en al p")!ing ". s !"ng aci# "! (ase Chemical spilling (s !"ng aci#$ R)le ". Nines/ Hea# 0 1- (.!"n an# (ac2$ Ches (.!"n $ 0 1Ches (ac2 (!igh si#e "nl%$ 0 34,A!m (le. )ppe! e5 !emi % .!"n an# (ac2$ 0 1T" al 0 674,- + n# #eg!ee ()!n

Impai!e# s2in in eg!i % !8 s2in an# iss)e #amage sec"n#a!% " ma'"! chemical ()!n +n# #eg!ee

B"#% in c"n ac &i h he s !"ng aci# Ma'"! ()!n *+,- ("#% s)!.ace a!ea in a#)l s

9is )!(e# ("#% image !8 #is!)p e# s2in an# iss)e mem(!ane

S2in an# iss)e !a)ma8#is!)p i"n

Hema "l"g% !es)l as ". / @BC0714AB(inc!ea se#$; Ne) !"phils0 =4A3(inc!ease#$

Inc!ease capilla!% pe!mea(ili %

SURGICAL TREATMENT/ Eme!genc% 9e(!i#emen

N"cicep "!s ". he #e!mis

9is!)p i"n ". cell mem(!ane

Open &")n#

S"#i)m; &a e! an# p!" ein shi. .!"m I<S " ITS

Ris2 ."! #e.icien .l)i# :"l)me !8 capilla!% #amage (!es"l:e#$

S im)la i"n ". he he!m"sensi i:e pain !ecep "!s S)l amicillin C,=mg TI9 Clin#am%cin 6==mg BI9

In.lamma "!% p!"cess

Si e8l"ca i"n/ Le. si#e ". he hea#; .ace an# nec2; le. )ppe! e5 !emi % an# ches ; le. ea!

Inc!ease c"ncen !a i"n ". (l""# cells

9ec!ease ci!c)la ing (l""# :"l)me )p " ,=-

H%p"na !emia

Mig!a i"n ". ne) !"phils

Ris2 ."! in.ec i"n !8 l"ss ". p!" ec i:e #e!mal (a!!ie! sec"n#a!% " #es !)c i"n ". s2in an# iss)e

Inc!ease (l""# :isc"si %

H%p":"lemia

Pain imp)lse

PATHOPHYSIOLOGY OF CHEMICAL BURN Ne) !"phils !eleases lipases incl)#ing ph"sph"lipase A+(p!"#)ces AA .!"m mem(!ane ph"sph"lipi#s$
9)!ing a#missi"n a he ER/ *Pain !a e# as 7=87=; 7= as he highes an# m"s pain.)l; !a#ia ing "n he hea# pa! ; le. )ppe! e5 !emi %; ches an# (ac2; pain cha!ac e!iDe# as ()!ning an# pinching pain; agg!a:a e# (% ")ch an# m":emen *G!imacing an# c!%ing *Una(le " m":e a..ec e# "! ()!ne# a!ea *sc!eaming

P!ima!% a..e!en ne)!"n in he pe!iphe!al ne!:e

Inc!ease m%"ca!#ial #ep!essan .ac "!

Massi:e s !ess; SNS ac i:a i"n

9ec!eas e in BP

Sec"n# "!#e! ne)!"n in he #"!sal h"!n ". he spinal c"!#

C%cl""5%genase c"n:e! s AA " P!"s aglan#in

A#!enal c"! ic"i# h"!m"ne an# ca ech"lamine !elease

Release ". " he! (i"chemical pain me#ia "!s

Pe!iphe!al :as"c"ns !ic i"n

Tach%ca!#ia

Pain is m"#i.ie# (% m"#)la i"n .ac "!s Spin" halamic !ac B!ain s em

PAIN

halam)s

9)!ing assessmen (la es $ *Pain !a e# as A87=; 7= as he highes an# m"s pain.)l; !a#ia ing "n he hea# pa! ; le. )ppe! e5 !emi %; ches an# (ac2; pain cha!ac e!iDe# as ()!ning an# pinching pain; agg!a:a e# (% ")ch an# m":emen *G!imacing *p!esence ". n)m(ness; ingling an# ()!ning pain "n he a!ea *&i h c"mplain s ". i chiness "n he !igh a!m

Pe!iphe!al !esis ance

Inc!ease# a. e!l"a#

9ec!ease# ca!#iac ") p) (RESOL<E9$

PATHOPHYSIOLOGY OF CHEMICAL BURN S"ma ic sens"!% c"! e5 Ac) e pain !8 #es !)c i"n ". s2in an# iss)es sec"n#a!% " ma'"! chemical ()!n in ')!% +n# #eg!ee @9R ne)!"n ac i:a i"n 0 spinal c"!# &in# )p 0 NM9A ac i:a i"n

PAIN PERCEPTION

Celec"5i( +==mg BI9 T!ama#"l ,=mg BI9

9escen#ing s%s em

Release ". en#"gen")s "pi"i#s; se!" "nin; n"!epineph!ine

Ampli.ica i"n ". pain signals

Inhi(i s inc"ming8 ascen#ing pain imp)lse

Pain pe!sis s

Inhi(i "!% ne)!"ns a!e sh"! li:e# as he% a!e !ea(s"!(e# in " he ne!:es

NM9A !ecep "!s calci)m channel "pens

Pain !eaches he CNS

PAIN ON THE SITE