1/7. An unusual cause of burn injury: skin exposure to monochloroacetic acid.Chemical burns can be complicated by the absorption of some of the toxic products through the skin and a subsequent systemic toxicity. We report here the case of a 3-year-old child who was accidentally exposed to monochloroacetic acid and sent to our burn unit with second-degree burn wounds. Regardless of the entry route, monochloroacetic is rapidly and very effectively absorbed and induces a severe toxic syndrome. In the case of skin resorption, the severity of the intoxication is directly related to the area of the contaminated skin contaminated with fatalities when the exposure level reaches more than 5% of the body surface. In the case of a chemical burn with a suspicion of systemic toxicity or in case of burn with an unusual product, the correct attitude is to contact a poison information center, to immediately wash the exposed skin, and to start treating the systemic toxicity as soon as possible. The availability of specific antidotes in the case of unusual poisoning can be a problem.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/7. hydrofluoric acid-induced burns and life-threatening systemic poisoning--favorable outcome after hemodialysis.BACKGROUND: skin contact with hydrofluoric acid (HF) may cause serious burns and life-threatening systemic poisoning. The use of hemodialysis in fluoride intoxication after severe dermal exposure to HF has been recommended but not reported. CASE REPORT: A 46-year-old previously healthy man had 7% of his body surface exposed to 71% HE Despite prompt management, with subsequent normalization of the serum electrolytes, recurrent ventricular fibrillation occurred. On clinical suspicion of fluoride-induced cardiotoxicity, acute hemodialysis was performed. The circulatory status stabilized and the patient fully recovered. High fluoride levels in the urine and serum were confirmed by the laboratory. DISCUSSION: There is no ultimate proof that the favorable outcome in this case was significantly attributable to the dialysis. However, most reported exposures of this magnitude have resulted in fatal poisoning. As our patient had normal serum electrolytes and no hypoxia or acidosis at the time of his arrhythmias, it was decided that all efforts should be focused on removing fluoride from his blood. The rationale for performing hemodialysis for this purpose is clear, even though such intervention is more obviously indicated in patients with renal failure. CONCLUSION: Hemodialysis may be an effective and potentially lifesaving additional treatment for severe exposure to HF when standard management has proven insufficient.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/7. Chemical burn with cresol intoxication and multiple organ failure.In general, immediate water irrigation is recommended for all chemical burns. Very few chemicals cannot be safely washed off the skin with water, however cresol is one of the exceptions. A 40 per cent TBSA cresol chemical burn that subsequently developed systemic intoxication and multiple organ failure is reported. The patient survived after intensive general supportive treatment, repeated haemodialysis and wound care.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
4/7. methemoglobinemia resulting from absorption of nitrates.Three cases of toxic methemoglobinemia resulted from absorption of nitrate salts through burned skin areas. In addition to the unusual route of intoxication, this report emphasizes the occupational hazard of methemoglobinemia in workers exposed to nitrogen salts and the importance of rapid diagnosis and treatment. The diagnosis of methemoglobinemia should be suspected in any case of cyanosis refractory to oxygen therapy. Appropriate treatment should include oxygen, methylene blue, and exchange transfusion in clinically severe cases.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
5/7. Formic acid burn--local and systemic effects. Report of a case.Formic acid is an organic acid which has mainly been used in industry, but in recent years its use in agriculture has greatly increased in the Scandinavian countries. Formic acid is more caustic to the skin than acetic acid. However, reports on formic acid burns are scarce in the medical literature, and no serious burn has previously been described. A few reports on formic acid ingestion have been published. It is of great interest that formic acid has been shown to play the major role in the methanol poisoning syndrome. A case of severe burn with undiluted formic acid is reported. In the beginning, the dermal injury seemed to be of minor degree, but then the patient, a 15-year-old girl, developed signs of systemic formic acid intoxication, including metabolic acidosis, intravascular hemolysis and hemoglobinuria. These signs were similar to those described as a result of formic acid ingestion. The systemic effects were successfully treated without late sequelae, but the burn turned out mainly to be full-thickness, resulting in major scarring, as commonly seen after various chemical burns.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/7. phenol burns and intoxications.phenol burns and intoxications are life-threatening injuries. Roughly 50 per cent of all reported cases have a fatal outcome. Only a small number of cases have been reported with high serum concentrations after phenol burns who survived. In our own experience a patient with 20.5 per cent total body surface area deep partial skin thickness phenol burns and serum concentrations of 17,400 micrograms/litre survived after immediate and repeated treatment of the scalds with polyethylene glycol (PEG) and silver sulphadiazine. A literature review of experiences with phenol intoxications reveals the advantages of PEG application. Questions on the need for enforced diuresis and haemodialysis as well as the initial treatment procedures are discussed. Advantages of different solutions for local therapy are reported.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
7/7. burns following petrol sniffing.Two patients with burns following petrol sniffing are presented. They sustained an 8 per cent and a 70 per cent total body surface area burn. The majority of the burned areas of both patients were full thickness and were treated by early excision and autografting, and in one patient with cultured epidermal autografts also. Both patients came from disorganized families, had behavioural problems and poor school performance. Clothes soaked with petrol, altered mental state and cigarette smoking are major risk factors for thermal injury while inhaling petrol. In order to recognize acute and chronic intoxication, burns unit staff should be aware of the clinical signs related to inhalation of petrol, especially because some of the burned petrol sniffers might not admit to petrol abuse. The social worker and psychologist are very likely to be vital in the rehabilitation of such patients.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |