Chemical burns: effect of prompt first aid

Chemical burns account for a relatively small proportion of the patients treated within a burn center; however, certain characteristics of these injuries, particularly in the initial stages of treatment, justify their separate consideration and review. Thirty-five patients were treated in the Baltimore Regional Burn Center from July 1976 through June 1980, with 14 different agents involved. The majority of injuries were work related; however, 20% were the result of assault. All patients received copious water lavage as primary therapy. In approximately one half of the patients this was begun as a first-aid measure at the scene of the accident. Compared to the group which did not receive lavage until admission to the hospital, the patients receiving appropriate first aid showed significantly less full-thickness injury and more than twofold shorter hospital stay, indicating the importance of public and industrial medical awareness of the role of immediate copious lavage. The problems of systemic toxicity with and specific therapy for certain agents is discussed with particular attention given to an unusual case involving cutaneous absorption of dichromate.