A chemical burn happens when an acid, alkali or other industrial agent damages the skin, and the injury continues until the chemical is removed. Alkalis often go deeper than acids, so early, long irrigation with water is the key treatment.
Key symptoms
- Burning pain, redness and blisters
- Skin that looks gray, white or black
- Eye pain and blurred vision if splashed
- Cough or breathlessness if fumes were inhaled
What you find on exam
- Scene safety and personal protective equipment; identify the chemical
- Size and depth of the burn; deeper than it first looks
- Eyes, mouth and airway
- Signs of systemic toxicity, such as with hydrofluoric acid
Tests
- Safety data sheet and poison control for the specific agent
- Skin pH after irrigation
- Calcium, magnesium and ECG for hydrofluoric acid
- Electrolytes and kidney function for large burns
Treatment basics
- Remove contaminated clothing and jewelry
- Brush off dry powder, then irrigate with large amounts of water for at least 20 minutes
- Irrigate the eyes continuously with saline or water
- Calcium gluconate gel for hydrofluoric acid burns
- Cover with dry dressings, give pain relief and refer to a burn center
Red flags
- Hydrofluoric acid exposure
- Eye involvement
- Breathing symptoms or a large burn area
Practice it in Making Synapses
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Related guides
Sources: NASEMSO National Model EMS Clinical Guidelines; National EMS Education Standards (2021). Written by Making Synapses. Making Synapses is not affiliated with these organizations.