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Treatment:

  • Seek medical help immediately.
  • If the chemical exposure was on the skin or the eyes, cleansing of the skin or eyes with large amounts of water for at least 15 minutes. If the exposure on the skin results in chemical burn see chemical burns part I, II.
  • If the patient swallowed the chemical substance immediately give the person water or milk, unless told not to by a medical care provider. Don’t give water or milk if the patient is vomiting, having convulsions, or other symptoms that make it hard for the patient to swallow. Don’t make the patient throw up unless told to do so by a physician.
  • If the chemical is inhaled move the patient immediately away from that area to an area where there is fresh air.

Prevention:

Certain protective measures can be followed to prevent exposure to toxic levels of chlorine.

  • Protective masks and good ventilation for those working with the chemical will help avoid inhalation while working with the chemical.
  • Face shield and eye protection with breathing protection will help protect the eyes.
  • Protective clothing and insulating gloves will help protect the skin.
  • Proper handling of the chlorine containing substance.
  • Keeping all bleaching materials out of the reach of children in well secured containers.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Chlorine is a chemical compound that is found in a liquid and a gaseous form. The liquid is colorless to amber colored and the gas is greenish-yellow in color.

Chlorine is used in water purification because it prevents bacteria from growing. It is found in swimming pool water. Chlorine is used as a disinfecting agent in mild cleaners and some bleach products. It is also used in industrial products such as industrial plastic production and other industrial and consumer products.

Chlorine poisoning occurs when a person swallows it or inhales it. Chlorine reacts with water inside and outside the body to form acids which are extremely poisonous.

Symptoms:

The symptoms will depend on the part of the body affected.

  • Respiratory: may include cough, sore throat, a choking sensation, breathing difficulty, upper airway irritation and burns to mucous membranes and lungs, pulmonary edema (fluid filling the lung), inflammation of the sinuses and lungs, and lung infection.
  • Blood: change in the acidity of the blood.
  • Eyes: watering of the eyes, pain and burning sensation in the eyes, redness, burns, loss of vision.
  • Skin: when the skin comes in contact with chlorine it may lead to, irritation, pain, redness, burning sensation, frost bite, skin burns (see chemical burns part I, II).
  • Heart and blood vessels: collapse, possible arrhythmias (abnormal conduction), decrease in blood pressure.
  • Gastrointestinal: nausea and vomiting, severe abdominal pain, burns to the food pipe, vomiting blood or blood in the stool.
  • Nervous system: headache, dizziness, decrease consciousness level, coma.
  • Kidney: it may lead to kidney damage.
  • Liver: it may lead to liver damage.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Hyperbaric oxygen therapy is a non invasive mode of medical treatment in which the patient is entirely enclosed in a pressure chamber filled with oxygen at a pressure greater than one atmosphere.

It is a painless procedure that can be carried out in either in a monoplace chamber where only one patient is in the chamber, or a multiplace chamber where the patient along with someone else are inside the chamber. The chamber is pressurized with 100% pure oxygen.

Topical hyperbaric oxygen therapy technique includes delivering 100% oxygen directly to an open, moist wound at a pressure slightly higher than atmospheric pressure through special devices. The patients may be trained and can use these devices at home.

There are many conditions that may benefit from hyperbaric oxygen therapy such as sores and gangrene that will not heal or that are related to diabetes, decompression sickness, osteomyelitis, severe anemia and others. Healing wounds and burn victims can benefit from this treatment with its effect on body tissues and wound healing.

In severe thermal burns tissue damage will happen leading to hypoxia (insufficient supply of oxygen) and tissue death. Tissue damage may progress due to the failure of the surrounding tissue to supply borderline cells with oxygen and nutrients necessary to sustain viability. Hypoxia will prevent normal wound healing. HBOT will accelerate wound healing by providing the oxygen needed to stimulate and support wound healing.

Burned patients have increased susceptibility to infection due to the loss of skin which acts as a barrier to bacterial invasion. HBOT can be useful in treating some of these infections. It can act by enhancing leukocyte and macrophage activity, potentiating the effects of antibiotics and act directly on anaerobic bacteria.

Hyperbaric oxygen therapy is also used in the treatment of smoke inhalation. Carbon monoxide has a high affinity to hemoglobin and when it is inhaled it will bind to hemoglobin forming a compound called carboxyhemoglobin (COHb), this will lead to hypoxia and decrease oxygen delivery to tissues. Hyperbaric oxygen decreases the half life of carboxyhemoglobin and fasten the disassociation of carbon monoxide from hemoglobin making hemoglobin available for oxygen.

Side effects may include:

  • Ear and sinus barotraumas.
  • Myopia.
  • Aggravation of congestive heart failure.
  • Oxygen seizures.
  • Pulmonary barotraumas

.

The Hyperbaric oxygen therapy course will vary depending on the condition, severity and the response of the patient to therapy.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Airway Suction:

Smoke inhalation injuries may lead to edema (swelling) of the lining of the airway, this may lead to the accumulation of secretions in the airways, these secretions need to be cleared as they may increase the risk of infection and increase the risk that these secretions may be aspirated leading to inflammation of the lungs and pneumonia.

Nasotracheal suctioning is done by inserting a suction catheter through the nasal passages and pharynx into the trachea in order aspirate these secretions.

Bronchodilators:

They are drugs that may be useful in smoke inhalation injuries; these drugs cause bronchial smooth muscle relaxation leading to dilatation and an increase in the diameter of the airways which in turn will improve respiration.

Chest physiotherapy:

It is one of the methods used in the treatment of smoke inhalation injury to aid in the removal of secretions from the bronchial tree; it is gravity assisted bronchial drainage. There are multiple positions in which the patient can be placed for postural drainage.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Pennsylvania Professional Firefighters Association Camp:

Pennsylvania
The PPFFA camp provides a place where burn survivors can unite with each other, share their stories, play and have fun in a caring and safe environment. It’s opened to burn survivors between the age of 6 and 17.

For mor information see the website

Email: DSchmidt@ppffa.org
West Penn Hospital summer Burn Camp:

Pennsylvania
This camp is one of the programs of the West Penn Hospital Burn Trauma Center. This camp is held each June for children ages 7-17 who have been patients in West Penn’s Burn Center. This camp will provide an environment for children who were burned to have fun and be carefree for a week. This supportive environment will also help these children in raising their self-esteem knowing that there are others who have gone through the same thing. This camp also provides therapeutic services to the campers.

For more information see the Website.

Email: slewis3@wpahs.org

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  • Speech and language therapists and pathologists: they help the patient with swallowing issues, they can help with vocal cord issues, and communication needs (if the patient can’t speak) and they can help teach the patient with a tracheotomy how to speak.
  • Respiratory therapist: they manage and administer oxygen, breathing treatments and other respiratory needs. If the patient’s injury is severe; the patient might need breathing assistance with the aid of mechanical ventilator (see mechanical ventilator part I, II).
  • Dietitian: the dietitian develops a nutrition plan for the patient to promote wound healing and minimize weight loss, (see nutrition and burn).
  • Psychologist or psychiatrist: their duty is to provide counseling and support to patients with psychiatric issues or psychological distress as a result of the burn injury.
  • Social workers: they offer help with practical concerns, benefits, financial and social issues, supportive counseling in the hospital and planning of discharge from the hospital. They also help identify helpful services in the community.
  • Child life specialists: they help children and their families. Their goal is to maintain a child’s development, emotional wellbeing, and the ability to cope with the illness, procedures, dressing changes and the stress associated with wound care. It is done through play, self expression and other forms of age appropriate therapy.
  • Pharmacist: they dispense and monitor the medication given to the patient and provide any information needed about their use and their side effects.
  • Case managers and discharge planners: they help with funding the services and equipments of the patient. They make sure that there is a smooth transition from the hospital to a home or to a rehabilitation center.
  • Ward clerk: involved in organizing the admission and discharge papers and direct phone calls to the patient.
  • Chaplains: they can help with the religious and spiritual needs of the patient and the family.
  • Translators: can be provided if needed by the patient or the family.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Taking care of a burned patient in a hospital requires a team effort. This team is called the burn team which is a group of people with different specialties who work together to help the patient and his/her family.
The members of the burn team with some variation from one hospital to another include:

  • The patient: you are the key member of the burn team, when you are admitted you may meet different members of the team. Each team member plays an important role in your recovery. As your condition improves, you will become more independent and will help set goals for your care. Make sure to ask the team about any concern that you have. Communication and understanding are very important.
  • Family: your family is an important member of the team. They should not hesitate to ask the team about any question or voice any concern they might have. Family plays an important role in providing the encouragement and emotional support that the patient needs. They will be taught how to deal with and handle situations they might face in the burn center or at home.
  • Burn surgeons and other specialty surgeons: a burn surgeon is a surgeon who is specialized and trained in burn care, wound care, skin grafting and plastic surgery. The burn surgeon who is monitoring wounds, healing, and signs of infection is the team leader who gets help from the other specialists and staff as needed. There are other specialty surgeons who may also be involved in the team such as plastic surgeons, orthopedic surgeons, ophthalmic surgeons, vascular surgeons and others.
  • Trauma intensive care doctors: these physicians are specially trained to care for the needs of critically ill adults. They work with the burn surgeons and other specialties.
  • Pediatric intensive care doctors: they are specially trained to care for the needs of critically ill pediatric patients. They work with the burn surgeon and other specialties.
  • Medical physicians: depending upon the injury, other physicians may be consulted to help the team with the care needed for the patient, these physicians may include: internists, ophthalmologists, nephrologists, cardiologists and other specialties.
  • Nurses: the nurse will be with you for the longest period of time each day; the nurse is skilled in burn care. Patient and family cooperation will help facilitate the nurse when caring for the patient. Nursing staff may include: registered nurses, licensed practical nurses, clinical nurse educators, nurse assistants and others. The staff is usually directed by a burn center nurse manager.
  • Physical therapists: they are involved in exercises to help improve joint movement, strengthen muscles and improve general function. Physical therapy is important to prevent contracture and restricted movement. The physical therapist will work with you on an exercise program. He/she may develop a home exercise program as well as follow up with the patient after discharge.
  • Occupational therapists: they are involved in evaluating and assessing the functional abilities and what equipment is required by the patient. They make splints to help prevent and/or reduce contractures, among other responsibilities are teaching the patient how to accomplish activities of daily living and to provide a program for splinting and exercises.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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Western Pennsylvania Hospital — Burn Trauma Center
4800 Friendship Ave.
Pittsburgh, PA 15224-1722 United States
412-578-5274

Mercy Hospital of Pittsburgh
1400 Locust St.
Pittsburgh, PA 15219 United States
412-232-8111

St. Christopher’s Hospital for Children — Pediatric Burn Center
Erie Ave. at Front St.
Philadelphia, PA 19134 United States
215-427-5000

Crozer-Chester Medical Center — Nathan Speare Regional Burn Treatment Ctr.
One Medical Center Blvd.
Upland, PA 19013 United States
610-447-2800

Temple University Hospital — Temple Burn Center
Broad & Ontario Streets Philadelphia, PA 19140 United States 215-707-2876

Lehigh Valley Hospital Burn Center
PO Box 689
Allentown, PA 18105-1556 United States
610-402-8734

St. Agnes Medical Center
1900 S. Broad St.
Philadelphia, PA 19145-2304 United States
215-339-4100