Puhi Pa'i Pa'u (Cement) Alkali a me ka Eha Maka Lehu Lime¶

Inā e ninini ana i ka pā pā hale ma ka ʻauinalā Pōʻaono, e hoʻomoe ana i ka pāpaʻi pōhaku, e hoʻopili ana i ka stucco a i ʻole ka hamo, a i ʻole e hohola i ka lime mahiʻai ma waena o kahi māla a i ʻole ke kahua haʻuki, e hana ana me Portland cement, wet concrete, masonry mortar, hydrated lime, and dry quicklime (calcium oxide, \(\text{CaO}\)) hoʻomaʻemaʻe i ka ʻili o ka ʻili. nā pōʻino i ke kūkulu ʻana a me ka hoʻomaikaʻi ʻana i ka hale. ʻO ka manawa e hui ʻia ai ka wai i loko o ka pauka sima Portland maloʻo (ʻo ia ka 60 pākēneka a hiki i ka 65 pākēneka calcium oxide ma ke kaupaona ʻana), ʻo ka hopena hydration kemika e hoʻololi i ka pauka i loko o kahi hopena saturated o calcium hydroxide (\(\text{Ca(OH)}_2\)), me sodium hydroxide (\(\text{NaOH}\)) a me \(**text{NaOH}\)) and ** a hiki i kahi \(\text{pH o 12.5 a i 14.0}\), ka pae pH like me ka mea wehe wai a me ka mea holoi umu.

ʻAʻole like me ka wela wela a i ʻole ka pāpaʻi ʻana i ka wai a i ʻole ka pāpaʻi ʻana i ka ʻili a hoʻopaʻa koke iā ʻoe e huki i kou lima i hope, ** ʻo ke konima pulu he mea hoʻoheheʻe i ka ʻiʻo hoʻoheheʻe ʻole**: no ka mea, ʻo ka alkaline calcium hydroxide e hoʻopau mua i nā hopena o ka ʻili i ka wā e hoʻoheheʻe ai i nā momona o ka ʻili i kopa (liquefactive necrosis), he kanaka e kukuli i ka lole ʻū, ka lepo lepo a hoʻopaʻa ʻia i ka denim pulu. kāmaʻa, manaʻo pinepine ** ʻaʻohe ʻeha no nā hola 2 a 6 mua **. Ma hope wale nō o ka hoʻopau ʻana i ka hana a me ka wehe ʻana i ko lākou puʻupuʻu a i ʻole nā ​​kāmaʻa i ka wā ʻaina ahiahi, ʻike lākou ua hoʻoheheʻe ʻia ka ʻili ma ko lākou mau ʻāʻī, nā ʻūhā, a me nā kuʻekuʻe wāwae paha i loko o kahi hohonu, poni-ʻeleʻele a i ʻole ʻili-keʻokeʻo ʻekolu-degere piha-mānoanoa ** e koi ana i ka ʻokiʻoki a me ka mānoanoa o ka ʻili grafting. ʻO ka pōʻino like ka paʻipaʻi ʻana o ka lehu lime, plaster, a i ʻole ka hamo pulu i loko o ka maka, kahi i komo ai nā ion hydroxide i loko o ka ʻāʻī ma ** emi iho ma mua o 15 a 60 kekona ʻoiai ʻo nā ʻāpana lime keʻokeʻo paʻa e waiho hohonu ma lalo o ka lihilihi luna (**ka conjunctival fornix kiʻekiʻe **), e hoʻomau ana i ka hoʻoheheʻe ʻana i ka maka i waho me ka ʻole o ka wai maʻamau. kahili maʻemaʻe.

Hāʻawi kēia alakaʻi holoʻokoʻa i ka hoʻomaʻemaʻe ʻana i kēlā me kēia pae, ka "Dry Powder Brush-Off Rule" no ka lime wikiwiki, nā protocol buffering pH ma hope o ka holoi ʻana, a me nā ʻenehana ocular irrigation a me ka hoʻololi ʻana i ka eyelid e pili ana me ka United States Occupational Safety and Health Administration (OSHA), ka National Institute for Occupational Safety and Health (NIOSH/ABAH) Ke Kulanui o Ophthalmologists.

E hana i kēia i kēia manawa¶

Inā loaʻa iā ʻoe a i ʻole kekahi mea kokoke i ka ʻili pulu, ka pahū, ka lepo, ka stucco, a i ʻole ka pauka lime maloʻo ma ko lākou ʻili, i pulu i loko o ko lākou ʻaʻahu a i ʻole nā kāmaʻa, a i ʻole ʻia i ko lākou mau maka:

1. No KEKAHI Lime, Cement, Mortar, a i ʻole Plaster i ka Maka: E hoʻomaka i ka hoʻoheheʻe ʻana i loko o 10 kekona a hoʻohuli i ka ʻili maka:
2. Mai kali e kaʻa i ka haukapila ma mua o ka holoi ʻana i ka maka: Komo ka alkali i loko o ke kino o ke kanaka i ma lalo o 30 kekona. E paʻa koke i nā lihilihi me kou mau manamana lima a holoi i ka maka me kahi kahe mālie o ka wai paipu ʻoluʻolu, ka ʻōmole wai, a i ʻole ka paʻakai maʻamau maʻamau (a i ʻole Diphoterine amphoteric solution inā ma ke kahua) no ka ** ka liʻiliʻi o 30 a 60 mau minuke piha**.
3. Wehe koke i nā lens pili ke hoʻomaka ʻoe e holoi.
4. ** Holoi i nā ʻāpana lime paʻa paʻa i paʻa mai lalo o nā lihilihi**: No ka mea e hūnā ana nā ʻōpala paʻa o ka lime, ka pahū, a i ʻole ka hamo i loko o nā ʻāpana hohonu ma lalo o ka lihilihi o luna a lalo a hoʻoheheʻe mālie i loko o ka \(\text{pH } 13\) alkali no nā hola, e huki i ka poʻi lalo i lalo a ** hoʻohuli i ka lihilihi o luna a i ʻole ka pulupulu e hiki ke hoʻopakele i ka lihilihi o luna a i ʻole ka pulupulu. holoi i nā ʻāpana keʻokeʻo a pau o ka ʻōpala i paʻa me kahi ʻōpuʻu pulupulu pulu ʻoiai e hoʻomau ana i ka wai ma ke ala i ke keʻena pilikia (e nānā ʻeha maka).
5. E hoʻopili i ka "Dry Powder Brush-Off Rule" MAMUA o ka hoʻā ʻana i ka wai no ka sima maloʻo a i ʻole ka lime ma ka ʻili:
6. Inā uhi ʻia kou mau lima, ʻāʻī, a i ʻole nā lole i ** ʻO ka pauka sima maloʻo, hui ʻia i ka mortar maloʻo, a i ʻole ka lime maloʻo (calcium oxide, \(\text{CaO}\))**, e wehe i nā lole lepo lepo a HULU mālie a lulu i ka pauda maloʻo me ka lole maloʻo a i ʻole ka pulupulu palupalu ma mua o ka hoʻohana ʻana i ka wai.
7. ʻO ka hoʻohui ʻana i kahi kahe liʻiliʻi o ka wai (a i ʻole ka hou) ma luna o kahi ʻāpana mānoanoa o ka lime maloʻo e hoʻoulu i ka **exothermic hydration reaction (\(\text{CaO} + \text{H}_2\text{O} \rightarrow \text{Ca(OH)}_2 + \text{Intense Heat up to } 150^\circ\text{0}}\) hoʻomoʻa i kou ʻili i ka manawa hoʻokahi e hoʻoheheʻe ʻia ka pH 13 alkali.
8. Wehe koke i na Pulu Paa, Socks, Kamaa Pua, Mīkina Lima, a me ke apo:
9. ʻO ka manawa e pāpaʻi ʻia ai ke koʻi pulu ma kou mau kuli pālule a i ʻole e kahe ana ma luna o kou mau kāmaʻa hana, ** hoʻōki koke i ka hana**. Wehe koke i ka pants pulu, nā pūkuʻu, nā kāmaʻa, ka wati, a me nā apo manamana lima. Mai hoʻomau i ka hana ʻana i nā lole i hoʻoheheʻe ʻia "no 30 mau minuke wale nō e hoʻopau i ka troweling i ka papa."
10. Hoʻopiha i ka ʻili me ka wai holo nui no 30 a 60 mau minuke piha:
11. Ke holoi ʻia ka pauda maloʻo a wehe ʻia nā lole pulu i hoʻomoʻa ʻia i ke kopa, e holoi i ka ʻili ma lalo o kahi kahe ikaika a mau o ka wai hoʻoheheʻe a i ʻole ka hose no 30 a 60 mau minuke a hiki i ka nalo ʻana o ka ʻili i ka ʻili.
12. E hoʻohana i ka kopa wai pH-kūʻole a i ʻole ka ʻakika liʻiliʻi (ʻaʻole loa e hoʻomaʻamaʻa i nā ʻōpala pumice abrasive, kahi e ʻoki ai i ka epidermis nāwaliwali).
13. Waila ʻAi ʻAi ʻAi ʻAi ʻAlua Koho ma ka ʻili Intact/Superficial (WALE MA hope o ka holoi wai ʻana):
14. ʻAʻole like me ka wai sulfuric acid concentrated a i ʻole lye (kahi e ninini ai i kahi neutralizer ikaika ma luna o ke kemika maka e hoʻonui ai i ka wela exothermic), ʻoihana dermatology a me nā alakaʻi palekana hana (me ka OSHA concrete safety bulletins a me ke kuni-center cement protocols) e hoʻomaopopo ʻo ** ma hope o ka holoi ʻana i ka sima i ʻike ʻia mai ka ʻili me ka wai kahe me ka wai kahe no 15 a i ʻole 20 mau minuke. ** hoʻoheheʻe ʻia ka vīnega keʻokeʻo hale (5 pākēneka acetic acid) i hoʻoheheʻe ʻia i ka 50:50 me ka wai** (a i ʻole buffered phosphate/amphoteric rinse) kōkua i ka hoʻopau ʻana i nā iona calcium hydroxide alkaline paʻakikī (\(\text{pH } 13\)) i hoʻopaʻa ʻia i loko o ka stratum corneum pores o waho, a ukali ʻia e kahi holoi wai anuanu. (ʻAʻole loa e hoʻokomo i ka vīnega i loko o nā maka a i ʻole ma luna o nā ʻeha maka hohonu).
15. E hele i kahi 'Oihana Ho'opi'i Haukapila a i 'ole Burn Center no kekahi 'ili poni, 'ele'ele, ke'oke'o, a i 'ole ka 'ili i pona:
16. No ka mea, ke kumu o ke kaila pulu ka necrosis liquefactive piha mānoanoa he palahalaha a ʻeha paha i ka lā 1, ʻo ke ahi ʻana o ke ahi ma nā kuli, nā ʻūhā, nā kuʻekuʻe wāwae, a i ʻole nā lima e hōʻike ana i ka ** ʻeleʻele poni-hina, ʻeleʻele keʻokeʻo keʻokeʻo, ʻāhu, a i ʻole ka maʻi ʻulaʻula** pono e nānā koke i ka mālama ʻana i ke ahi me ka lāʻau lāʻau lapaʻau.

ʻO ke kōpaʻa ulia pōpilikia, sima, a me ka palapala hoʻoheheʻe lime triage¶

flowchart TD
    Start["ʻO ka ʻike ʻia ʻana i ka Pulu Paʻa, Portland Cement, Mortar, Plaster, a i ʻole Quicklime"] --> SiteCheck{"Ma hea i puka mai ai ka ʻike?"}

    SiteCheck -->|Eye Splash: Lime Dust, Wet Mortar, Concrete,<br/>Plaster, or Whitewash in the Eye| EyeUrgent["KAHIKI OCULAR OIAIO (Koʻi ʻia ka Cornea i loko o <30 kekona)<br/>1. E hoʻomaka i ka holoi ʻana me ka wai mehana/paʻakai i loko o 10 KEkona<br/>2. Wehe i nā leka pili; e paʻa i ka lihilihi me ka blepharospasm<br/>3. E hoʻohāinu mau no 30 a 60 mau minuke piha<br/>4. Hana i ka lihilihi maka pālua: E hoʻohuli i ka poʻi luna a me lalo no ka holoi ʻana i waho<br/>nā kiko keʻokeʻo paʻa paʻa o ka lime i paʻa ʻia e nā ʻōpala mai nā fornices<br/>5. ʻO ka lawe ʻana i ka Oihana Hoʻopilikia no Morgan Lens irrigation a hiki i ka waimaka pH = 7.0-7.4"]

    SiteCheck -->|Skin / Clothing Exposure:<br/>Hands, Knees, Shins, Ankles, or Arms| DryVsWet{"ʻO ka pauka DRY a i ʻole WET slurry ka kemika ma ka ʻili?"}

    DryVsWet -->|Dry Powder: Dry Quicklime (CaO),<br/>Dry Portland Cement, or Dry Mortar Mix| BrushFirst["KA HANA 1 (RULE POWDER DRY): Wehe i nā lole lepo lepo & BRUSH OFF<br/>ka pauda maloʻo a pau me kahi kāwele maloʻo/palapala MAMUA o ka hoʻohui ʻana i ka wai<br/>(Hoʻopaʻa i ka wela 150 ° C exothermic hydration wela ma ka ʻili sweaty)"]

    DryVsWet -->|Wet Slurry: Wet Concrete, Mortar, Grout,<br/>Stucco, or Concrete-Soaked Pants/Boots| StripWet["KANAWAI 1: E hooki koke i ka hana. Wehe i nā pālule<br/>palu, nā pūkini, nā kamaa, nā mīkina lima, nā wati, a me nā apo manamana."]

    BrushFirst --> WaterFlush["KANAWAI 2: E hoʻokahe i ka ʻili me ka wai anuanu nui no 30 a 60 mau minuke a hiki i ka pau ʻana o ka ʻili a me ke kopa (saponified fat)"]
    StripWet --> WaterFlush

    WaterFlush --> VinegarStep["KaʻAnuʻu 3 (Ka ʻili wale nō - ʻAʻole loa nā maka): Ma hope o 15-20 min o ka hoʻoheheʻe ʻana i ka wai,<br/>holo pōkole i ka ʻili i ʻike ʻia i ka sima me ka dilute home wīnega keʻokeʻo<br/>(5% acetic acid i hui pū ʻia me 1:1 me ka wai) e hoʻopaʻa i ke koena pH 13 alkali,<br/>a laila holoi me ka wai kahe no kekahi 15-20 mau minuke."]

    VinegarStep --> DepthEval{"E nānā i ke ʻano o ka ʻili (I kēia manawa a ma nā hola 4-12):<br/>He poni poni/uliuli/ʻeleʻele, ʻeleʻele keʻokeʻo, ʻeleʻele, a i ʻole ʻeha ʻeha hohonu?"}

    DepthEval -->|Yes: Discoloration, Blisters, or Kneeling/Boot Burn| BurnUnit["E HELE KOE I KA HOSPITAL BURN CENTER<br/>Pūkū pulu ke kumu leo 3rd-degree full-thickness liquefactive necrosis<br/>e koi ana i ka wehe mua ʻana o ka tangential a me ka grafting ili."]
    DepthEval -->|No: Only mild dry redness ("Dermatitis sima")| DermCare["E hoʻopili i ka cream emollient ʻala ʻole; e nānā pono i nā hola 24<br/>(E ʻimi i ka mālama kino inā loaʻa nā maʻi maʻi lohi, chrome allergy, a i ʻole ka ʻeha)"]

ʻO Pathophysiology: Ka 4-Fold Mechanism of Cement and Lime Destruction¶

No ke aha i ʻoi aku ka luku ʻana i ka ʻili a me nā maka o ke kanaka ma mua o ka ʻakika o ka pae like? ʻEhā mau hana kemika a me ke kino e hoʻouka i ke kino i ka manawa like:

1. Alkalinity Loa (\(\text{pH} 12.5\text{ a i }14.0\)) a me Liquefactive Necrosis¶

Hana ʻia ʻo Dry Portland sima ma ka hoʻomehana ʻana i ka limestone a me ka pālolo i loko o kahi kiln e hana i ka anhydrous calcium silicates a me calcium oxide (quicklime, \(\text{CaO}\)), me ka trace ** sodium oxide (\(\text{Na}_2\text{O}\))** a me potassium oxide (\(\text{O}\)2). Hoʻohui ʻia ka wai koke:

• Liquefactive Necrosis and Saponification: ʻAʻole like me nā ʻakika ikaika (nāna e hoʻohui i nā protein o ka ʻili i loko o kahi ʻōpala eschar paʻakikī e ālai ana i ke komo ʻana o ka waika hohonu), nā ion hydroxide manuahi (\(\text{OH}^-\)) i loko o ka pāpaʻi pulu ** hoʻoheheʻe i nā ʻakika momona i loko o nā membrane cell kanaka** (e hoʻohuli ana i kou ʻili iho i nā lipids i loko o ka wai protein kopa.
• No ke aha i manaʻo ai ka Paʻa "Paheʻe a Kopa" ma kou mau manamana lima: Ke ʻike ka poʻe masonry i kahi kiʻiʻoniʻoni paheʻe, paheʻe, kopa ma ko lākou mau manamana lima ʻaʻole e hoʻopā i ka hamo pulu, **ʻo kēlā kiʻi paheʻe ʻaʻole ia he kopa i loko o ka sima: ʻo ia ka ʻili o waho o ka momona o ka ʻili i hoʻololi ʻia i kemika ** 13 kopa wai.

2. ʻO ka wela o ka hoʻoheheʻe ʻia (The Quicklime Thermal Burn)¶

I ka wā e pili ai ka ** ʻeleʻele maloʻo (calcium oxide, \(\text{CaO}\))** a i ʻole ka lepo sima kiʻekiʻe me ka hou i loko o ke koʻi pālule, sock, a i ʻole ka pahu, a i ʻole ka pipi ʻia me kahi wai liʻiliʻi, e hoʻokuʻu ka hopena exothermic slaking i **65.2 kilojoules no ka mole (\(1,140\text{\) kilojoule) o ka wela o ka kilojoule. Hiki i kahi papa mānoanoa o ka lime maloʻo i pulu ʻia me ka hou ma ka ʻili o ka mea hana ke hiki i ka mahana o \(80^\circ\text{C}\text{ a i }150^\circ\text{C}\)$ (\(176^\circ\text{F}\text{ a i }302^\circ\text{F}\)), e hana ana i ke ahi wela pH1 ma luna pono o ka wela.

3. Hygroscopic Desiccation (Cellular Dehydration)¶

ʻO ka sima maloʻo a me ka hoʻōla ʻana he mea ikaika loa hygroscopic: ʻo kona crystalline calcium silicate hydrate matrix e omo ikaika i ka wai mai nā mea a pau āna e hoʻopā ai i mea e ola ai a paʻakikī. Ke kau ʻia ka sima maloʻo a maloʻo paha ma ka ʻili o ke kanaka, huki ia i ka wai intracellular ma waho o ka epidermal a me nā pūnaewele dermal, e hoʻomaloʻo a hoʻoemi i ka ʻiʻo i ka wā e noʻonoʻo ana i ka wai pore alkaline.

4. Hoʻopili ʻia ʻana o ka Mechanical Aggregate Abrasion + Hexavalent Chromium (\(\text{Cr}^{6+}\)) Sensitization¶

• Sand and Aggregate Grinding: Hoʻopiha ʻia ke kōpaʻa pulu a me ka pahū me ke one quartz ʻoi a me ka hōʻuluʻulu pōhaku. Ke komo ka pulupulu pulu i loko o ka kāmaʻa a i ʻole i nā kuli o ka denim jeans, e like ana kēlā me kēia ʻanuʻu a i ʻole nā ​​kuli e like me ka pepa koʻikoʻi, e wili me ka mīkini i ka pale stratum corneum pale a wehe pololei i nā micro-channels no ka pH 13 calcium hydroxide e kahe pololei i ka dermis hohonu.
• Hexavalent Chromium (\(\text{Cr}^{6+}\)) Allergic Contact Dermatitis: Ke waiho nei na mea maka maoli a me na mea wili kiln kila i ka nui o ka wai hiki ke hooheheeia hexavalent chromium (\(\text{Cr}^{6+}\)) ma Portland cement (koe ke hooleia e ka ferrous sulfate reducing agents, e like me ka pono). Ma nā hōʻike pinepine ʻana, komo ʻo \(\text{Cr}^{6+}\) i ka ʻili i hoʻopōʻino ʻia i ka alkali no ka hoʻoulu ʻana i ka ʻeha nui, ka maʻi maʻi, ka ʻāʻī allergic cement dermatitis ("bricklayer's itch") a me ke kī ʻana " chrome ulcers."

Hoʻohālikelike i nā mea ʻino o ka sima, ka pāpaʻa, ka lepo, a me ka lime¶

Deep Dive 1: No ke aha e like ai ke kuni ʻana o ka pulu pulu me he "Hōʻino ʻole" ma ka lā 1 (Clinical Stging)¶

ʻO kekahi o nā pahele pōʻino loa i ka lāʻau lapaʻau pilikia ʻo ia ** ʻaʻole like me ka lapalapa ahi a i ʻole ka ʻā ʻana o ka mea maʻi i ka wā e wehe mua ai ka mea maʻi i ko lākou puʻuwai a i ʻole nā kāmaʻa**:

1. Nā hola 0 a i 4 (Ka Hana Kopa Numb):
2. ʻOiai e pulu ana ka pāpaʻi pulu ma nā kuli o ka lole lole o ka mea hana a i ʻole ka hū ʻana i loko o ko lākou mau kāmaʻa, ʻike ʻia ka ʻili me ka ʻoluʻolu a me ka ʻeha iki paha, a laila hele ʻo ** ʻūlū ** ʻoiai ka pH 13 hydroxide ions e hoʻopau i nā hopena o ke aʻalolo epidermal. Inā holoi ka mea hana i loko o 15 mau minuke, hiki mai ka ʻulaʻula haʻahaʻa wale nō. Inā waiho lākou no 2 a 6 mau hola, ke hoʻomaka nei ka liquefaction piha-mānoanoa.
3. Hula 4 a hiki i ka 12 (The "Purple Bruise" Misdiagnosis Trap):
4. Ke wehe ka mea hana i ko lakou mau paani oolea a i ole kopa i ka hora 6:00 PM, ike pinepine ka ili ma luna o ko lakou mau kuli a me na ku'ekue wawae ** poni poni, violace, uliuli polū, a 'ele'ele-'ele'ele**, i kekahi manawa i ho'opuni 'ia e ke apo 'ula'ula a pāpa'u paha, a i 'ole he wahi o keokeo-ke'oke'o, 'ili, 'ele'ele**.
5. Manaʻo ka poʻe maʻi he nui: * "Ua ʻeha wale au i koʻu mau kuli mai ke kukuli ʻana i ka lāʻau paʻa paʻa i ka lā a pau," a hele i kahi moe ma hope o ka hoʻokomo ʻana i ka wai a i ʻole ka ʻaila poni antibiotic.
6. ** ʻO ka ʻoiaʻiʻo, ʻo kēlā ʻāpana poni ʻeleʻele a i ʻole keʻokeʻo he thrombosed nā kīʻaha koko subdermal ma lalo o kahi dermis i make loa, saponified full-thickness dermis.** No ka paʻa ʻana o ka calcium hydroxide paʻa i loko o nā follicles lauoho a me nā dermis liquefied, ** hoʻomau ka ʻai ʻana i ke ahi i loko o ka momona subcutaneous i ka pō holoʻokoʻa** ke hiamoe ka mea maʻi.
7. Hula 12 a i 48 (E ala ana me ka Eha Hohonu Ko'iko'i a me ka Ulceration Eschar):
8. I ka pō a i ʻole kakahiaka aʻe, i ka hiki ʻana o ke kuni alkali i nā ʻeha ʻeha hohonu i loko o ka ʻiʻo subcutaneous a me ka periosteum, ala ka mea maʻi me ka ** ʻeha nui, wela, ʻeha ʻeha **, pehu, a me ka uē ʻana i nā ʻeha necrotic i uhi ʻia e kahi eschar hina-ʻeleʻele a melemele-keʻokeʻo.
9. No ke aha he mea nui ke kuhikuhi ʻana o Early Burn Center: No ka hoʻololi ʻana o ka ʻaʻahu conservative i ke kuni ʻana i ke ahi hohonu, e lawe ʻia 6 a 12 mau pule e hoʻopau ai i ka ʻiʻo alkaline make a waiho i nā ʻeha o ke kuli hypertrophic a me nā ʻaelike hui, hana nā kikowaena kuni kūikawā ** ʻokiʻoki mua a me ka grafting ʻili mānoanoa**, hoʻōla ka mea hana i 3 mau pule.

Deep Dive 2: Lime and Cement Eye Splashes (The Double Eyelid Eversion & Limbal Stem Cell Rescue)¶

I loko o ka ophthalmology, ka paʻipaʻi ocular o ka lime (calcium oxide a calcium hydroxide), ka paʻakai pulu, ka plaster, a i ʻole ke koʻikoʻi i manaʻo ʻia kekahi o nā pilikia pōʻino loa o nā lāʻau lapaʻau a pau, ʻoi aku ka ʻino ma mua o ka paʻi ʻana o ka waika pākaukau.

1. No ke aha e hoohehee ai ka Lime i ke Kone a me ka Makapo mau ("Porcelain White Eye")¶

• 15-Second Penetration: ʻOiai e pāpaʻi ana ka waikawa e hoʻoheheʻe i nā protein ma luna o ka epithelium corneal a hoʻolōʻihi i ko lākou komo ʻana, ʻo nā ion alkaline hydroxide (\(\text{OH}^-\)) e hoʻoheheʻe i nā membrane cell o ka epithelium corneal i sekona, e hoʻoheheʻe i ka glycosaminoglycan ground substance o ka corneanterior stroma straight 15 a 60 kekona**, e luku ana i ka lens (no ka ho'omaka 'ana i ka ma'i cataracts wikiwiki) a me ka trabecular meshwork (e ho'oulu ai i ka secondary alkali glaucoma).
• Limbal Stem Cell Ischaemia (The "White Eye" Trap): ʻO ka mea hoʻohālikelike, he maka i puhi ʻia i ka lime kahi e nānā ai ka ʻāpana keʻokeʻo o ka maka (ka sclera a me ka conjunctiva a puni ka cornea) keʻokeʻo-keʻokeʻo a me ke koko ʻole ** ʻoi aku ka nui o ka pilikia o ka makapō mau loa ma mua o ka maka ʻulaʻula a me ke koko koko:
• He mau aʻa koko e ola ana ka maka ʻulaʻula ʻulaʻula e paʻa ana i ka korneal limbus (ke apo 1-a-2-millimeter a puni ka lihi o ka cornea kahi e noho ai nā ** limbal epithelial stem cell **).
• ʻO ka blanched, porcelain-white sclera/limbus ʻo ia ka pH 13 alkali ua hui pū ʻia a luku i nā kīʻaha koko e hānai ana i nā pūnaʻi limbal stem (limbal ischemia). Me ka loaʻa ʻole o ka limbal stem cell a me ka hāʻawi koko, hoʻoheheʻe ʻia ka cornea ma o nā enzyme collagenase (sterile corneal ulceration and perforation), a i ʻole e lilo i opaque mau loa a ʻulaʻula (Roper-Hall / Dua Grade IV ocular burn).

2. Kaʻanaʻa-i-Step Field a me ka Halemai maka hoopakele Protocol¶

1. Ka Hoʻomaʻamaʻa Hoʻomau Koke (E hoʻomaka i ka Scene i loko o 10 kekona):
2. Mai lilo i 20 mau minuke e holo ana i kahi keʻena mālama koʻikoʻi me ka lime e noho mau ana i ka maka. E hoʻohana koke i ke kumu wai maʻemaʻe kokoke loa: kahi hoʻomaʻemaʻe maka, ka pahu Diphoterine, ka wai ʻōmole, ka paipu kīhāpai ma ke kaomi haʻahaʻa, ka mea hoʻoheheʻe kīhini, a i ʻole ka ʻauʻau.
3. E hoʻokaʻawale i nā lihilihi me kou manamana nui a me kou manamana lima kuhikuhi (e ʻomi i ka ʻaoʻao orbital iwi, *ʻaʻole loa e kaomi i ka ʻōpoʻe maka inā manaʻo ʻia kekahi ʻeha komo) a hoʻomaʻemaʻe mai ka ** kihi ihu i waho ** mau no ** ma kahi o 30 a 60 mau minuke **.
4. Pehea e hana ai i ka Upper Eyelid Eversion no ka wehe ʻana i nā ʻāpana lime paʻa i hoʻopaʻa ʻia:
5. No ke aha e hiki ʻole ai ka hoʻoheheʻe ʻana i ka wai maʻemaʻe inā ʻaʻole ʻoe i kēia ʻanuʻu: ʻO ka lime plaster, mortar, a me ka sima ʻaʻole hiki ke hoʻoheheʻe ʻia i ka wai**. Hoʻopili ʻia nā ʻōpala keʻokeʻo paʻa o ka calcium hydroxide i loko o ka superior conjunctival fornix (ka ʻeke hohonu cul-de-sac kiʻekiʻe ma lalo o ka lihilihi luna) ke ʻomi ka mea i hoʻopaʻa ʻia i ko lākou mau lihilihi i pani ʻia i ka ʻeha. ʻOiai inā e holo ana ʻoe i 5 lita o ka paʻakai ma mua o ka maka o ka maka, ʻo kēlā mau ʻiliʻili lime keʻokeʻo i hoʻopaʻa ʻia ma lalo o ka poʻi o luna e hana ma ke ʻano he ** hoʻokuʻu lohi pH 13 alkali depot**, e hoʻolei mau ana i nā ion hydroxide ma luna o ka cornea no nā hola.
6. ** ʻO ka ʻenehana hoʻomaʻemaʻe ʻana i kēlā me kēia ʻanuʻu **:
   1. Huki i ka ** lihilihi haʻahaʻa** i lalo i ka wā e noi ana i ka mea i pepehi ʻia e nānā i luna, a hoʻohana i ka mea hoʻopili pulupulu i hoʻomoʻa ʻia (Q-tip) a i ʻole ke kihi o kahi paʻi pulu maʻemaʻe maʻemaʻe e kahili mālie i ka ʻili keʻokeʻo a i ʻole ka paʻi sima hina i waho o ka ʻeke poʻi lalo.
   2. E noi i ka mea i pepehi ʻia e ** nānā pololei i lalo i ko lākou mau wāwae** (e hoʻomaha ai i ka ʻiʻo levator o ka poʻi luna).
   3. E hoʻopaʻa mālie i ka maka maka o luna ma waena o kou manamana nui a me kou manamana lima kuhikuhi, e huki iki i ka lihilihi luna i mua a i lalo, e kau i ke kumu o ka pulupulu pulupulu ma ka ʻaoʻao ma ka ʻaoʻao waena o ka ʻili maka o luna (ma kahi o 1 kenimika / 0.4 ʻīniha ma luna o ka laina lihilihi, ma ka ʻaoʻao o luna o ka puʻupuʻu ʻoʻoleʻa i loko o ka ʻōpala o luna), a pii i luna e like me ka lihilihi o ka ʻili o ka maka. waho.
   4. E hoʻopaʻa i ka poʻi luna luna ma ka lae me ka manamana lima me ka hoʻohana ʻana i ka lua ** pulupulu pulupulu pulu** e holoi mālie i nā ʻāpana keʻokeʻo a ʻike ʻia o ka lime a i ʻole ka sima i paʻa i ka conjunctiva tarsal ʻulaʻula.
   5. I loko o ke keʻena pilikia, hoʻokomo nā kauka i nā kulu maka anesthetic (proparacaine a i ʻole tetracaine), e hoʻokomo i kahi Desmarres lid retractor e hana double eversion hohonu i loko o ka fornix kiʻekiʻe, e hoʻoinu me kahi Morgan Lens i hoʻopili ʻia me **2 a i 3 Litera o ka Lactated Ringer's topical solution chelcifiedmedium i hoʻohui ʻia. plaques), a nānā i ke kiʻiʻoniʻoni waimaka me ka pepa litmus 30 minuke ma hope o ka hoʻomaha ʻana i ka wai a hiki i ka paʻa ʻole o ka pH ma \(\text{pH } 7.0\text{ a i }7.4\).

Papa Hoʻopaʻa Kāohi: Ke hana pono nei me ka Paʻa, Moka, a me ka Lime¶

• E hoʻohana i nā kāmaʻa Rubber Waterproof me nā wāwae Pant i huki ʻia ma luna o nā kāmaʻa (ʻAʻole i hoʻopaʻa ʻia i loko): ʻO ka hoʻopaʻa ʻana i nā pālule hana i loko o kou mau kāmaʻa e hana i kahi leʻaleʻa e alakaʻi ana i kēlā me kēia pāpaʻi ʻana o ka lepo lepo pololei a puni kou mau kuʻekuʻe wāwae a me kou mau wāwae. Huki i nā pālule ʻaʻole wai ma luna o waho o nā kāmaʻa ʻeleʻele kiʻekiʻe a hoʻopaʻa i ka puʻupuʻu inā e au i ka wai hohonu.
• Mai kukuli ma luna o ka paʻa pulu me ka ʻole o nā kuʻekuʻi lima pani paʻa i ka wai a i ʻole kahi papa kukuli: ʻO ka ʻūhā maʻamau a i ʻole ka lole lole e hoʻoheheʻe ʻia me ka pH 13 wai sima i nā minuke; e hoʻohana mau i nā ʻūhā ʻōpala wai ʻole ma luna o nā pālule wai.
• E hoʻohana i nā mīkina lima lima ʻo Alkali-Resistant Nitrile a i ʻole Neoprene Gauntlet (ʻAʻole loa i ka pulupulu a i ʻole nā ​​mīkina lima hana ʻili): Hoʻomoʻa ka pulupulu a me nā mīkina lima ʻili i ka wai sima alkaline a paʻa i kou mau puʻupuʻu i ka lā a pau. E maloʻo loa ka loko o kou mau mīkina lima, a mai wehe i ka mīkina lima me nā manamana lima i uhi ʻia.
• E mālama i kahi Bākeke wai holoi maʻemaʻe, he ʻōmole winika keʻokeʻo o ka hale, a me nā makaʻala palekana i hoʻopaʻa ʻia ma ka ʻaoʻao o kēlā me kēia huila: ʻo ka holoi ʻana i kahi pāpaʻi paʻa lepo mai kou mau lima a i ʻole ka ʻāʻī i loko o 60 kekona a ukali ʻia me ka holoi ʻana i ka vīnega hoʻoheheʻe pōkole a me ka holoi wai maʻemaʻe e pale ai i ka 100 pakeneka o ke ahi.
• Kāʻe i ka Dry Quicklime (\(\text{CaO}\)) a i ʻole Hydrated Lime (\(\text{Ca(OH)}_2\)) mai ka Sports Field Line Marking: Mai hoʻohana i ka lime mahiʻai a i ʻole ka lime hydrated masonry no ka hoʻopaʻa ʻana i nā laina ma ke kahua pōpeku, pōpeku, a i ʻole ke kahua baseball; i ka wā e paheʻe ai nā mea pāʻani i ka laina i ka lā ua a i ʻole ka wela, e ʻeha lākou i ka ʻā ʻana o ka lime corneal a me ka ʻāʻā piha o ka ʻāʻī / ʻūhā. E hoʻohana wale i ka ʻo ka calcium lepo (\(\text{CaCO}_3\) / paʻakai limestone pulverized, \(\text{pH} 8\text{ a i }9\)) aiʻole ka pena pāʻani.

Nīnau pinepine¶

Ua ninini au i kahi patio i kēia lā i ke kukuli ʻana ma luna o ka pā i loko o koʻu jeans. I koʻu wehe ʻana i koʻu pālule i kēia pō, ʻo ka ʻili ma luna o koʻu mau ʻāʻī ʻelua he poni ʻeleʻele-ʻeleʻele a ʻeleʻele hoʻi, me nā ʻōpala liʻiliʻi a puni nā kihi. Ua ʻeha wale au i koʻu mau kuli, a i ʻole he puhi kemika kēia?¶

ʻAʻole ia he ʻeha: ua loaʻa iā ʻoe kahi wela kemika hohonu a piha-mānoanoa (degere ʻekolu) mai ka sima Portland mākū (ʻo ia ka pH o 12.5 a 14.0, ʻoi aku ka ikaika e like me ka hoʻomaʻemaʻe wai hoʻomaʻemaʻe wai), a pono ʻoe e hele i ke keʻena pilikia o ka haukapila a i ʻole ke kikowaena ahi i kēia pō. Ma muli o ka hoʻoheheʻe ʻana o ka calcium hydroxide i nā momona o ka ʻili ma o ka liquefactive necrosis a hoʻopau i nā aʻalolo o ka ʻili i ka wā mua, ʻaʻole ʻeha ka ʻeha o ke kukuli ʻana i ke ahi i ka lā a lilo i poni ʻeleʻele, uliuli-ʻeleʻele, a i ʻole keʻokeʻo keʻokeʻo i ke ahiahi i ka wā e ʻoki ai nā kīʻaha koko lalo. E holoi i nā kuli ʻelua ma lalo o ka wai anuanu no 30 mau minuke i kēia manawa, e uhi maloʻo me kahi lole maloʻo maʻemaʻe (ʻaʻole e kau i ka poni momona), a hele i ka haukapila no ka mālama ʻana i ke kuni.

No ke aha e palekana ai ka hoʻohana ʻana i ka vīnega wai hoʻoheheʻe ʻia ma ka ʻili i ʻike ʻia i ka sima pulu (ma hope o ka holoi ʻana me ka wai), ke ʻōlelo nei nā alakaʻi kōkua mua ʻAʻole loa e kau i ka vīnega ma kahi wai hoʻomaʻemaʻe wai (lye) kuni?¶

Ke hoʻokahe kekahi i ka wai sodium hydroxide lye ma luna o ko lākou ʻili, me ka ninini ʻana i ka vīneka ma luna o ke kemika paʻa e hoʻoulu koke i ka hopena exothermic (hana wela) acid-base e hoʻomoʻa i ka ʻeha maka. Me ka pulu sima Portland ma ka ʻili paʻa a i ʻole ka ʻili i hoʻonāukiuki ʻia, akā, holoi mua ʻoe i ka paʻi sima nui ma lalo o ka wai kahe nui no 15 a 20 mau minuke. ʻOiai ma hope o ka holoi ʻana i ka wai, ua paʻa paʻa nā ion calcium hydroxide microscopic i nā protein keratin i loko o nā pores o waho o ka ʻili (e mālama ana i ka pH o ka ʻili ma luna o 11 a 12 a me ka hoʻomau ʻana i ka manaʻo slimy). Holoi pōkole i ka ʻili i holoi ʻia me ka vīnega keʻokeʻo hale (5% acetic acid diluted 50:50 me ka wai) hoʻopaʻa palekana i kēlā mau koena alkaline i hoʻi i ka pH maʻamau o ka ʻili (5.5 a 7.0) me ka ʻole o ka wela, a laila ukali ʻia e ka holoi wai hope. Mai hoʻokomo i ka vīneka i loko o nā maka a i ʻole i nā ʻeha maka.

No ke aha i hoʻomaʻamaʻa mau ai ke kauka maka i ka maka o kaʻu kāne no hoʻokahi hola ma ka haukapila ʻoiai ua holoi mua mākou i ka lime plaster ma ka home no 15 mau minuke?¶

ʻAʻole hiki ke hoʻoheheʻe ʻia nā ʻāpana paʻa o ka lime (calcium oxide a i ʻole calcium hydroxide), plaster, a me ka mortar i loko o ka wai a komo i loko o nā ʻeke i pelu ʻia ma lalo o nā lihilihi luna a lalo (nā conjunctival fornices). ʻOiai ma hope o 15 mau minuke o ka holoi ʻana i ka ʻili ma ka home, e hoʻoheheʻe mālie nā ʻōpala keʻokeʻo microscopic i paʻa ma lalo o ka lihilihi luna i loko o ke kiʻi waimaka, e hoʻihoʻi i ka pH o ka maka i kahi 12.5 a i ʻole 13.0 makapō ke hoʻōki ʻoe i ka ninini ʻana i ka wai. I loko o ka halema'i, ho'opau nā kauka pilikia i ka maka, ho'ohuli kino (double-evert) i ka lihilihi luna ma luna o ka retractor e holoi i nā kiko lime pa'a pa'a a pau, a e ho'oinu mau me 2 a 3 lita o ka pa'akai a hiki i ka litmus pH strip i kau 'ia ma ka maka 30 minuke ma hope o ka pau 'ana o ka wai.

• ʻO kēia alakaʻi no ka ʻike ʻike a ʻaʻole ia e pani i ka loiloi olakino ʻoihana, mālama ophthalmology pilikia, a i ʻole ka hoʻomaʻamaʻa lima. Paipai ikaika mākou i ka lawe ʻana i kahi papa hana kōkua mua ma o ka International Federation of Red Cross and Red Crescent Societies (IFRC), kāu hui Red Cross National, St John Ambulance, a i ʻole kahi mea lawelawe palekana hana.*

Nānā ʻia nā kumu¶

• ʻO ka hoʻoponopono palekana a me ke ola olakino (OSHA, United States): Ka pale ʻana i nā pilikia ʻili mai ka hana ʻana me Portland Cement (OSHA Guidance Document & Pocket Guide).
• National Institute for Occupational Safety and Health (NIOSH, United States) & Centers for Disease Control and Prevention (CDC): NIOSH Pocket Guide to Chemical Hazards: Portland Cement, Calcium Oxide (Quicklime), and Calcium Hydroxide (Hydrated Lime).
• American Burn Association (ABA): Advanced Burn Life Support (ABLS) Provider Manual: Hooponopono i ka Alkali, Cement, a me Ocular Chemical Burns.
• Luna Ho'okele Ola a me ka Maluhia (HSE, United Kingdom): Pepa 'Ikepili Ho'okumu CIS26: Cement (Alkali Burns and Hexavalent Chromium Dermatitis Prevention).
• Royal College of Ophthalmologists & American Academy of Ophthalmology (AAO): Hoʻoponopono ulia pōpilikia o Acute Ocular Chemical (Alkali a Lime) nā ʻeha.

Nā alakaʻi pili¶

• ʻO ka waika Hydrofluoric, ka wehe ʻana i ka ʻōpala, a me ke ahi kemika ʻoihana
• Puhi nui a me ka ʻili kemika
• ʻO nā ʻeha maka a me ka hoʻoinu ʻana i ka maka
• ʻO ke kā wela, ka asphalt, a me ke ahi i hoʻoheheʻe ʻia (bitumen removal protocol)
• Nā helu pilikia ma ka ʻāina