Document Detail


Complex chemical burns following a mass casualty chemical plant incident: How optimal planning and organisation can make a difference.
MedLine Citation:
PMID:  22356814     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Four employees at a chemical plant sustained extensive chemical burns following the explosion of a pipeline containing 100% sulphuric acid. We describe the management of these patients from the initial ED triage through to discharge from hospital in life and limb threatening chemical burns. METHODS: Four patients who sustained chemical burns to the torso and extremities are reviewed. Data was retrieved from patient case notes and operating theatre logbooks. RESULTS: Four patients sustained chemical burns during the blast and were immediately transferred to a local ED where a prompt referral was made to the burns service. All patients were male aged 25-59 years (mean 46.5). Burn size was 2-50% BSA (mean 22.5). Following RFDS transfer to the state burns service two patients required immediate excisional surgery. In these patients the chemical burn involved full thickness skin loss with extensive underlying muscle and neurovascular damage. One patient required immediate above knee amputation of one leg and fascial burn excision of the other. The other patient required fascial burn excision of both legs followed by Integra placement 24h later. Both patients had prolonged hospital stays due to the complex nature of their injuries requiring multiple trips to theatre and lengthy rehabilitation. The two patients with smaller burns had straightforward surgery and an unremarkable recovery. CONCLUSION: Early communication following this mass casualty incident allowed for organisation of tertiary services and early radical surgery which was life saving. Management lessons were learnt following this mass casualty chemical burn incident.
Authors:
Tomás B O'Neill; Jeremy Rawlins; Suzanne Rea; Fiona Wood
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-20
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  -     ISSN:  1879-1409     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.
Affiliation:
Burns Service of Western Australia, Royal Perth Hospital, Perth, Western Australia, Australia.
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