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化学性损伤的现场救护 | 2011-12-8 8:54:00
化学物品强酸强碱对组织的损害与酸类、碱类的浓度、接触时间长短、接触量多少有关。强酸对组织的局部损害为强烈的刺激性腐蚀,不仅伤面被烧,且能向深层侵蚀。但由于局部组织细胞蛋白被凝结,从而能够阻止烧伤的继续发展。碱性物质更能渗透到组织深层,日后形成的瘢痕较深。常见的强酸有硫酸、硝酸、盐酸等,强碱有氢氧化钾等。
现场判断:
硫酸烧伤的伤口呈棕褐色,盐酸、石碳酸烧伤的伤口呈白色或灰黄色,硝酸烧伤的伤口呈黄色。烧伤局部疼痛剧烈,皮肤组织溃烂;如果酸、碱类通过口腔进入胃肠道,则口腔、食管、胃黏膜造成腐蚀、糜烂、溃疡出血、黏膜水肿,甚至发生食管壁穿孔和胃壁穿孔。严重烧伤病人可引起休克。
现场救护:
1、脱离现场,急救时迅速将残余化学物质清除干净。应脱去被污染、浸渍或燃烧的衣物。无论是何种化学物质致伤,最简单实用的方法就是用大量清水冲洗稀释,冲洗时间须在2小时以上。被少量强酸、碱烧伤,应立即用纸巾、毛巾等蘸吸,并用大量的流动清水冲洗烧伤局部,冲洗时间须在15分钟以上。
2、大量强酸、碱烧伤,应立即用大量的清水冲洗烧伤局部,冲洗时间须在2小时以上,冲洗时应将病人被污染的衣物脱去。
3、病人如能口服食品或药物,则可服用蛋清、牛奶、面糊、稠米汤,或服用氢氧化铝凝胶保护口腔、食管、胃黏膜。
4、如头、面、眼部被化学药品灼伤,须检查有无角膜烧伤,并予优先冲洗,在送医院途中仍应为病人冲洗受伤眼部。
5、很多化学物质不仅从创面吸收,还可因密闭空间从呼吸道吸入、消化道吞入,甚至通过健康皮肤粘膜吸收,使伤员中毒,其症状不一定立即表现出来。因此,不能因当时局部损伤不重而麻痹。如有全身中毒症状,应根据其性质和毒性及早预防,可先用大量高渗葡萄糖和维生素C静滴,施行给氧等治疗。
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