Chemical Skin Injury by Howard I. Maibach & Alan H. Hall

Author:Howard I. Maibach & Alan H. Hall
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

Dilution (dilution is a method of obtaining a final solution with a concentration lower than the starting concentration) which is a minor effect, but always existing when adding water on a skin chemical splash.

Most facilities utilize either plumbed or self-contained (non-plumbed) decontamination equipment, with potable water (water suitable for drinking) being the most common flushing fluid [197].

The ANSI/ISEA Z358.1-2009 Standard [197] defines flushing fluid as:

“Potable water, preserved water, buffered saline solution, or other medically acceptable solution manufactured and labeled in accordance with government regulations.”

The ANSI/ISEA Standard is a performance standard which also specifies flow rates and duration for skin and eye decontamination [198]. There is also a provision for Personal Wash Units which have the capacity to provide immediate flushing fluid [197]. Similar recommendations can also be found in the European Standards (European Committee for Standardization NF EN 15154–1; 2006).

A significant concern has been raised about water rinsing. This is the “wash-in” effect, where it has been demonstrated at least for some chemical substances that water rinsing may actually increase skin penetration, potentially making them more available to cause systemic toxicity [154]. This topic is discussed more fully in Sect. 4.6.1.

Psychosocial consequences are frequently overlooked in patients with chemical skin injuries, especially those due to deliberate chemical assaults which often involve the head, face, eyes, and neck [199]. Such patients may have increased anxiety levels, depression, social anxiety, social avoidance, and decreased quality of life [199].

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