Managing the blue man: multiple traumas involving a paint-carrying truck

This report describes the difficulty in evaluating a patient with multiple traumas because he was covered with paint poured from a truck in a car accident. Cleansing with paint thinner and isotonic saline solution was necessary.

A 29-year-old male patient was admitted to the emergency department following the collision of his car with a paint-carrying truck. His head, face, neck and hands were covered with a cyan-blue oil paint, and bloody "paint mud" covered all frontal and occipital areas of the scalp. Abdominal guarding was identified. A rapid cleansing with normal saline solution (0.9% NaCl) was attempted in order to expose the lesions of the patient, but it had no effect on the drying paint. The patient's scalp, face and neck were cleaned with paint thinner (60% toluene). The patient was then diagnosed as having a maxillofacial fracture and underwent surgery for open reduction and rigid fixation by plastic and reconstructive surgeons. Thinner was not used for the eyes for fear of further chemical injury. Normal saline removed corneal and conjunctival paint remnants but proved ineffective for cleansing of the eyelids and eyelashes.

Removal of the paint from the skin and the eyes was a prerequisite for the evaluation of the underlying structures. It is difficult to find a cleansing material that can be used effectively and safely in different parts of the body.