Chemical and Electrical Injuries
Next week, we're going to be welcoming Krissie Stiles as our fabulous guest blogger. Krissie's specialty is burns and plastics and while writing the blog with her, it prompted some questions about what to do if the injury is due to chemicals or electricity, rather than thermal.
So, that’s a really interesting question and one we haven’t really looked into before even though it’s really relevant to our environment, whether you’re cleaning on a Superyacht or working on a vessel carrying something quite toxic!
Chemicals
Chemical burns or injuries can be caused by acid, alkaline or caustic chemicals. They can be very damaging and need immediate medical attention. You will need to raise the alarm as soon as you suspect a chemical incident so that everyone is aware. It may mean certain safety protocols are triggered.
As with every first aid scenario, safety is paramount and you MUST
make sure it is safe for you to approach the casualty. Be very wary of gases that could be inhaled, liquids or powder that could make contact with you too - if possible, ask the casualty to move away from the source to a safer area.
- Use gloves or something protective to cover your hands.
- Try to carefully remove the chemical and any contaminated clothing without contaminating yourself or the area you’re in.
- The aim is to remove the chemical and clothing from contact with the skin and eyes, but being careful not to touch or spread it.
- Carefully cutting clothing off is more effective than pulling it over the casualty’s head and body.
- If the chemical is dry, pat it with a dry towel and gently brush it off the skin. Then rinse with lots of water.
- If the chemical is wet, rinse the affected area with as much clean water as possible.
- Rinse the affected area continuously with clean water as soon as possible.
- Try to make sure the water runs off the affected area without pooling on the skin or in the eyes.
- Only use water. Don’t rub or wipe the affected area.
Your vessel should have ‘Data Sheets’ for any chemicals used onboard. They may be called something different, but they contain crucial information about the different chemicals, how they act and react, and any special treatments that are needed. Make a point of finding out where this information is kept so that you can access it quickly in an emergency.
Any chemical burns or injuries must be assessed in hospital so you would need to plan for a medevac or to come ashore as soon as possible.
Once the casualty gets to hospital, treatment will include more washing, to make sure the substance is completely removed. Then cleaning and dressing the burn or injury and managing pain. Dressing will need to be checked and changed regularly until the burn has completely healed, in order to prevent infection.
Minor injuries that only affect the outer layer of skin, or a small section of the underlying layer of tissue normally heal well and leave minimal scarring. As with superficial or partial thickness thermal burns, good ongoing burn care can make a big difference.
More severe burns may need referral to a specialist burns unit where an entire medical team including occupational therapists, physiotherapists and mental health professionals work together to support recovery. Treatment could include skin grafts and the more severe or deeper burns can take months or years to heal. In the worst cases it can leave significant scar tissue, plus issues like sight loss and reduced or restricted movement.
Electrical
Electrical injuries happen when high-energy current travels through the body due to contact with an electrical source. Injuries occur due to either the flow of current through the body, arc flash, or from clothing that catches fire.
Most body tissues, except bone, conduct electricity very well and the highly developed human nervous system is very sensitive to even small electrical currents. Skeletal muscle and peripheral nerve tissue are particularly susceptible to injury. Some casualties show little sign of external injury, but extensive muscle and nerve injury internally.
One of the unique aspects of electrical injuries are that there should be an entrance and exit wound. The electric current injures the tissues where it enters, but also where it exits. So these wounds may look fairly innocuous, but the damage caused by the current as it tracks through the tissues from the entrance to the exit, through the body, can be extensive.
Low voltage currents passing through the body have well defined, but normally reversible physiological effects including muscle contraction, respiratory paralysis and ventricular fibrillation.
At higher voltages, strong muscular contractions can actually cause fractures and/or dislocations and throw the victim away from the electrical circuit. This in itself can cause traumatic injuries.
Some currents will ‘freeze’ the casualty, making them unable to let go of or move away from the electrical current, leading to a frightening and painful struggle, even for short periods.
- As with every first aid scenario, safety is paramount and you
MUST make sure it is safe for you to approach the casualty.
- Turn off the power source and if you do need to recover the casualty, you may need to wait for specialist equipment.
- For lower voltage incidents, you can consider using something non conductive, such as a wooden pole, to move the casualty from the source.
- Check the airway and breathing - as electrical damage to the brainstem can cause respiratory arrest and you may need to start CPR.
- Likewise, the current may cause the casualty’s heart to stop beating normally, and you may need to carry out CPR.
- Electrical burns can be cooled with water, but it will only really make a difference to the entry and exit wounds, it won’t help the internal damage.
- Have handy, or attach a defibrillator if you have one. Then you can activate it quickly if needed.
All electrical injuries or burns, however minor they may seem, need urgent assessment in hospital so you would need to plan for a medevac or to come ashore as soon as possible.
We hope you’ve taken away a couple of new points from this slightly more in depth look at chemical and electrical injuries, compared to standard burns. As always, please feel free to get in touch if you have any ‘burning’ questions! (Sorry, we couldn't resist that one!)
Finally, we have a few blogs on related topics that you might find interesting, and the links below are for anyone (and their families) affected by burns.
https://www.redsquaremedical.com/and-it-burns-burns-burns
https://www.redsquaremedical.com/lightning-strikes-at-sea
- Changing Faces provides support for people whose condition or injury affects their appearance
- Victim Support
provides help and advice to victims and witnesses of crimes
- Katie Piper Foundation provides specific help for victims and families of acid attacks and other burns
This is super useful and a must read for all working at sea - go on share it!
We are big fans of free resources and information sharing. Good quality, evidence based first aid and medical care information should be available to everyone and we provide it in a number of different ways:
Annual updates - this lets you know what has changed in the last year with the regulations and new techniques.
Salt Water Solutions
- this is a monthly learning resource that helps you stay on top of your knowledge and skillset
STCW validation - This is done every 6 months and is your way of telling us whether your STCW First Aid and Medical Care training is actually useful and relevant to life onboard your ship.
Worse Things Happen at Sea! - a monthly resource that hones in on something current and pertinent to the maritime industry.
Just click on the images below to sign up for one or all of them!!