First Aid Interventions for Intentional Caustic Chemical Assaults in Adults and Children: A Scoping Review

There is limited evidence guiding optimal first aid management for caustic attacks, and this topic has not been systematically evaluated. We aimed to review the available literature to identify first aid treatments that demonstrate benefit. We searched MEDLINE, Embase, Cumulative Index to Nursing & Allied Health Literature, American Psychological Association PsycInfo, and Cochrane Library from inception through September 13, 2025. This scoping review was conducted in accordance with the methodological standards of the International Liaison Committee on Resuscitation Task Force Scoping Reviews, and reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist. We identified six studies that met the inclusion criteria: two prospective cohort studies, three case reports, and one case series. An alkali was used in two studies, an acid in three studies, and an unknown caustic in one study. Three studies had victims with skin and eye involvement, one had a victim with only skin involvement, and two had victims with only eye involvement. The decontaminants included water, water and soap, physiological solution or normal saline, and Diphoterine®. The various outcomes reported for post-decontamination skin exposure included scarring, need for surgical intervention and grafting, re-epithelialization time, vision, and evisceration for eye exposure. Available evidence, despite being limited and of low certainty, consistently supports immediate removal of contaminated clothing and copious irrigation with water as a biologically plausible and clinically accepted first aid intervention.