Why do alkalis burn

Flush the area for at least 20 minutes. Do not use a hard spray of water because it can damage the burned area. Have the person with the chemical burn remove the chemical if he or she is able. Put on gloves to protect yourself from the chemical, if you need to remove it. As you flush the area, take off any clothing or jewellery that has the chemical on it. If the area still has a burning sensation after 20 minutes, flush the area again with flowing water for 10 to 15 minutes.

Chemical burns not rinsed with water Some alkali burns are made worse if rinsed flushed with water. Dry powders , such as dry lime, are brushed away first, because adding water can make a liquid that burns. After the powder is brushed away, flush with water for 20 minutes. Metal compounds are covered with mineral oil. If you have any concerns with your skin or its treatment, see a dermatologist for advice.

Chemical burn — codes and concepts open. Caustic burn, Corrosive burn. Reaction to external agent. Causes of chemical burns, Acid chemical burn, Alkali chemical burn, Symptoms and signs of chemical burns, Management of chemical burns. References Book: Textbook of Dermatology. Fourth edition. Blackwell Scientific Publications.

It is almost customary to check the pH of the eye as soon as a patient with ocular chemical injury attends the eye emergency department, to ascertain whether the injurious agent was an acid or an alkali. It is important to emphasize that the first step should be to ascertain whether the patient has ingested or inhaled the noxious agent and whether there is risk of asphyxiation from oedema of the respiratory passage or internal damage by ingestion.

Evaluation of vital signs and history from the patient or escorts is important in this regard. Assessment of pH with the litmus paper is a crude but practical means of ascertaining whether the agent was an acid or alkali, but more so to know whether it is normal or not, and to serve as a baseline from which a change can be measured.

Copious irrigation of the open eye s , preferably with a sterile neutral solution, is the essential immediate measure, regardless of the nature of the chemical. Use of topical anaesthesia to relieve pain and to release blepharospasm is often essential copious irrigation over eyelids squeezed shut is known to occur.

If pH is neutral, it is important to re-check after a pause of a few minutes as chemicals from the tissue can leech out indicating that more irrigation is needed. Any visible particulate matter in the conjunctival sac and fornices, examined by double eversion where possible, whether lying on the surface or impregnated in the tissue should be removed or excised.

In this issue of the Journal, Monaghan et al. They make a valid point that the litmus strips are often light exposed, degraded and can give inaccurate measurements of pH. This can be addressed by ensuring a fresh supply of strips are available and stored at the right temperature in coloured glass containers. Accuracy of the pH measurement is not absolutely critical for the management decision, especially if it is measured again, after a few minutes of cessation of irrigation and the process repeated until there is no further change in pH.

The overall acute stage management of chemical burns involves a Prevention of further damage by elimination as much of the injurious agent as possible, b complete and thorough assessment, c control for the acute inflammatory reaction, d facilitation of the healing process and e prevention and management of complications [ 5 ]. Irrigation is the first and important step in preventing further damage and eliminating the injurious agent. Complete and thorough assessment includes systematic examination of every structure of the eye, use of fluorescein stain and classification of the burn.

The latter has been shown to be more reliable in determining prognosis of the injury [ 8 ]. It is imperative to assess the intraocular pressure using finger palpation if other means are unreliable or not practical.

Autologous serum drops help in epithelial healing [ 10 ]. Surgical intervention in the form of tenoplasty and autologous conjunctival grafts from the other eye are important in cases of limbal ischemia [ 11 ]. Finally, antibiotic cover, use of non-adrenergic mydriatics cause vasoconstriction and aggravate ischaemia and antiglaucoma medication if necessary are important in prevention and management of complications.

A host of ocular surface reconstructive measures come into play in the late stage of chemical burns, of which limbal stem cell transplantation and the current availability of HOLOCLAR, approved by NICE for unilateral chemical burns are key interventions [ 12 ]. Wagoner M. Chemical injuries of the eye: Current concepts in pathophysiology and therapy. Surv Ophthalmol. Rinsing within 1 minute of the burn can reduce the risk of complications.

Flush the area for at least 20 minutes. Do not use a hard spray of water because it can damage the burned area. Have the person with the chemical burn remove the chemical if he or she is able.

Put on gloves to protect yourself from the chemical, if you need to remove it. As you flush the area, take off any clothing or jewellery that has the chemical on it. If the area still has a burning sensation after 20 minutes, flush the area again with flowing water for 10 to 15 minutes. Chemical burns not rinsed with water Some alkali burns are made worse if rinsed flushed with water.

Dry powders , such as dry lime, are brushed away first, because adding water can make a liquid that burns. After the powder is brushed away, flush with water for 20 minutes. Metal compounds are covered with mineral oil.