Ka Wela, Asphalt, a me ke ahi i hooheheeia (Bitumen Removal Protocol)¶

ʻOkoʻa loa ke ʻano o ke kuni ʻana e ka pā hale hoʻoheheʻe ʻia, ka asphalt paving alanui (bitumen), ka pahu lanahu, nā mea hoʻoheheʻe wela hoʻoheheʻe ʻoihana, nā lole synthetic hehee (nylon, polyester, polypropylene), nā pū hoʻoheheʻe kiʻekiʻe, a me ka paila kō a i ʻole ka wax ʻokoʻa loa ke ʻano mai ka lapalapa maʻamau a i ʻole ka wai wela. I ka wā e hoʻokuʻu ʻia ai ka asphalt paving mai kahi kaʻa hoʻolaha ma \(140^\circ\text{C}\text{ a i }205^\circ\text{C}\) (\(285^\circ\text{F}\text{ a i }400^\circ\text{F}\)), a i ʻole i ka wā i hoʻomehana ʻia ai ka bitumen o ka hale i ka $23{0}^23{0} }260^\circ\text{C}$ (\(450^\circ\text{F}\text{ a i }500^\circ\text{F}\))**, ʻaʻole paʻi ka wai hydrocarbon mānoanoa me ka ʻili e like me ka wai paila. Akā, ** hoʻopili iā ia iho i loko o nā follicles lauoho a me nā kuamoʻo epidermal ma ke ʻano he insulating, pale wela **, e hoʻomau i ka kuke ʻana i ka dermis lalo, ka momona subcutaneous, a me nā tendon kikohoʻe no kekahi mau minuke ma hope o ka hoʻopili ʻana.

ʻOi aku ka pōʻino ma mua o ka wela mua ka mea a ka poʻe e kū ana a i ʻole ka poʻe i hoʻopilikia ʻia e hana i loko o 60 kekona mua: hoʻāʻo maoli e ** ʻili, ʻohi, a ʻohi paha i ka pā ʻeleʻele paʻakikī a i ʻole ka plastik hehee mai ka ʻili**. Ma muli o ka hui ʻana o ka tar maloʻo a me ka polymer hehee i loko o ka epidermis i poha a me nā kumu lauoho, e huki ana i ka tar paʻa a i ʻole ka naylon hehee mai ka ʻili maloʻo ** e ʻoki pono i ka epidermal ola a me ka papa dermal mai ka ʻiʻo**, e hoʻololi ana i kahi wela ʻāpana-mānoanoa hiki ke hoʻōla i kahi ʻeha ʻeleʻele piha. Hāʻawi kēia alakaʻi i ka protocol ulia pōpilikia ʻelua manawa (Phase 1: Koke 20-Minute Cool Running Water Heat Extraction, a ukali ʻia e **Phase 2: Non-Toxic Lipophilic Emollient Dissolution me ka hoʻohana ʻana i ka ʻaila Sunflower, Baby Oil, Butter, Mayonnaise, a i ʻole Polymyxin-Bacitracin Ointment **) aligned (BB the American Association), Burn the American Association. no ka Occupational Safety and Health (NIOSH), a me ka World Health Organization (WHO).

E hana i kēia i kēia manawa¶

Inā ʻoe a i ʻole kekahi mea kokoke i pipi ʻia a puhi ʻia paha e ke kākā wela o ka hale, ka asphalt (bitumen) alanui, ka plastik hoʻoheheʻe ʻia, ke kāpili wela wela, nā lole synthetic hehee, a i ʻole ka wax wela:

1. Hoʻokahe koke i ka Tar a i ʻole Plastic me ka wai e holo ana no 15 a 20 mau minuke piha:
2. Mai hoʻopau i nā minuke 2 mua e ʻimi ai i ka ʻaila a i ʻole e hoʻāʻo e holoi i ke kākā. E kau koke i ka lima, lima, wāwae, a i ʻole ke alo i puhi ʻia ma lalo o ke kahawai ikaika o ka wai hoʻoheheʻe kahe ʻana a i ʻole ka paipu kīhāpai ($15^\circ\text{C}\text{ to }20^\circ\text{C} / 59^{\circ\text{F}\text}} to ** 20 mau minuke mau**.
3. Wehe koke ka wai maʻalili i ka \(200^\circ\text{C}+\) i waho o ka wela wela ma loko o ka papa pā, hoʻopaʻa i ka bitumen wai no laila e pau ka laha ʻana, a hoʻopau i ka hana kuke ʻili hohonu i loko o kekona. (Mai hoʻohana i ka hau a i ʻole ka wai hau, ka mea e hoʻoulu ai i ka vasoconstriction koʻikoʻi a hoʻomāhuahua i ka necrosis o ka ʻiʻo).
4. ʻAʻole i ʻili, ʻohi, ʻohi, a huki paha i ka pā paʻa, asphalt, a i ʻole nā ​​​​palapala hehee mai ka ʻili:
5. Ma hope o ka hoʻomaʻalili ʻana i ka wai, e waiho i ke kākā ʻeleʻele paʻakikī, ke kolu wela, a i ʻole ka lole nylon hehee ** i paʻa loa ma ka ʻili**.
6. Inā pulu ka lole i ke kā wela a hoʻoheheʻe ʻia paha i loko o ka ʻeha, mai huki i ka lole: e hoʻolili i ka ʻāpana holoʻokoʻa ma o ka wai kahe, a laila e hoʻohana i nā ʻāpana ʻeha e ʻoki i ka lole ʻaʻole i hoʻopili ʻia a puni nā kihi.
7. E pale i ka "Circumferential Tourniquet Trap" ma nā manamana lima, nā lima lima, a me ka ʻāʻī:
8. I ka wā e maʻalili ai ke kā wela i loko o kahi ʻeleʻele ʻeleʻele ʻeleʻele paʻa pōhaku a puni ka manamana lima, lima lima a lima paha, e hoʻomaka koke ka pehu ʻana o ka ʻiʻo i puhi ʻia ma lalo. Inā hoʻopuni piha ke apo paʻa o ke kākā paʻa i ka manamana lima a i ʻole ka pulima lima, e hana ʻo ia me he tourniquet e ʻoki ana i ke kahe o ke koko.
9. E hoʻoneʻe koke i nā apo metala a me nā wati i ka wā e hoʻomaʻemaʻe ʻia me ka wai, a inā hoʻokumu ʻia ke kākā paʻa i kahi kaula piha 360-degere a puni kahi lālā a i ʻole huahelu, e hoʻomaka i ka lipophilic oil softening ma ke axis longitudinal i kēia manawa a lawe koke i kahi ʻāpana kuni o ka haukapila.
10. No ka Tar a i ʻole Asphalt ma nā maka a i ʻole ka uhi ʻana i ka waha/nā puka ihu, e kelepona iā 911 / 112 / 999 koke:
11. Ea mua: Inā pipi ka maka wela ma ka maka, e hooluolu me ka wai me ka wehe wale i ka puka ihu a me ka hamama o ka waha i hiki i ke kanaka ke hanu.
12. Nā Maka: E holoi mālie i nā maka i kāpī ʻia me ka wai anuanu a i ʻole ka paʻakai sterile no 15 a 20 mau minuke e wehe i ka wela. Mai ho'āʻo e ʻohi i ka tar paʻakiki mai ka lihilihi a i ʻole ka ʻāʻī; uhi i nā maka me ka gauze sterile i lubricated me ka sterile ophthalmic erythromycin/petrolatum ointment a lawe aku i kahi ophthalmologist pilikia.
13. E hoʻoheheʻe i ka Tar a i ʻole Asphalt me ​​ka ʻeha ʻole me ka hoʻohana ʻana i nā ʻaila Lipophilic palekana a i ʻole ka ʻaila Antibiotic ("Like Dissolves Like"):
14. Ma hope o ka hoʻoluʻu ʻana no 20 mau minuke me ka wai (a no nā kuni liʻiliʻi wale nō, a i ʻole ma ke keʻena pilikia no nā kuni nui aʻe), e hoʻoheheʻe i ka petroleum-based tar/bitumen ma ka uhi ʻana iā ia me ka Sunflower Oil, Mineral Oil (Baby Oil), White Petrolatum (Vaseline), Neosporin/Polysporin-Bacitrola Aila ʻOlive, Mayonnaise, a i ʻole ** ʻAiʻa Paʻa ʻole **, waiho ʻia i ʻōwili ʻia no 30 a 60 mau minuke a hiki i ka hoʻoheheʻe ʻana o ka ʻeleʻele i loko o kahi wai palupalu e holoi pono ai me ka gauze pulu.
15. ʻAʻole hoʻohana i ka Gasoline, Kerosene, Diesel Fuel, Turpentine, Acetone, Paint Thinner, a i ʻole WD-40 ma ka ʻili i puhi ʻia:
16. Hoʻomau pinepine ka poʻe paving a me ka hale i ka wahie diesel, kerosene, a i ʻole citrus/industrial degreasers ma nā kaʻa e hoʻomaʻemaʻe i nā mea hana. Mai ninini i nā mea hoʻoheheʻe ʻenehana a i ʻole wahie ma luna o ka ʻili o ke kanaka: hoʻoulu lākou i ke ahi kemika nui ma luna o ka wela wela, e hoʻomoʻa pololei i nā dermis poha ʻia e hoʻoulu ai i ka ʻona hydrocarbon systemic (ke ake, ka puʻupaʻa, a me ka momona iwi), a hiki ke ʻā i ke ahi uila.

ʻO ka hoʻāʻo ʻana o ka puhi ahi a me ka palapala holo bitumen¶

flowchart TD
    Start["Pāpaʻi a Hoʻopā paha me ka Wela Tar, Paving Asphalt (Bitumen),<br/>Coal-Tar Pitch, Heheʻe Plastic/Nylon, Hoʻopili Wela, a i ʻole Wax Wela."] --> Phase1["PĀNĀ 1: KA HOʻOPIʻI KOKE WEHE (MUA 60 KEkona)<br/>Hoʻopiha i ka tar/plastic & puni ka ʻili me ka wai e kahe ana (15-20°C)<br/> mau no 15 a 20 FULL MINUTES a hiki i ka paʻakikī a me ke anu."]

    Phase1 --> NoPeel["RULE NUI: Mai ʻili, ʻohi, ʻokiʻoki, a huki paha<br/>ka paʻa paʻa, kelu wela, a i ʻole nā lole synthetic i hoʻoheheʻe ʻia mai ka ʻili<br/>E ʻoki i nā lole i hoʻopaʻa ʻole ʻia; wehe i na apo & wati"]

    NoPeel --> TriageCheck{"E nānā i ka ʻino a me ka wahi o ke kuni:<br/>1. Maka, Maka, Alanui, Lima, Waewae, Genital, a i 'ole ka Hui Nui?<br/>2. Ka pōʻai 360-degere kā hoʻolei ʻia a puni ka manamana lima?<br/>3. ʻO ka nui o ke ahi ma kahi o 5% TBSA (a i ʻole ka hōʻike ʻana o ka Coal-Tar Pitch)?"}

    TriageCheck -->|Yes to Any High-Risk Feature| HospitalBurn["CALL 911 / 112 / 999 & TRANSPORT TO BURN CENTER<br/>• No ka Circumferential Tar Cast: Hoʻokaʻawale / hoʻomāmā i ka tar longitudinally me<br/>sterile petrolatum/Polymyxin-Bacitracin hinu e pale ai i ka ischemia digital<br/>• No ka Eye Tar Splash: Flushline 15 min."]

    TriageCheck -->|No: Localized Adherent Tar or Wax Burn| MaterialSplit{"ʻO wai ka mea pili i paʻa i ka ʻili?"}

    MaterialSplit -->|Petroleum Bitumen: Road Asphalt, Roofing Tar,<br/>or Asphalt Sealant| OilDissolve["PĀNĀ 2: KA LILIPOPHILIC EMOLLIENT DISSOLUTION ('Like Dissolves Like')<br/>1. E noi i ka papa mānoanoa o ka ʻaila Sunflower, ka ʻaila pēpē (Mineral Oil),<br/>Polysporin/Neosporin Ointment, Vaseline, Butter, a i ʻole Mayonnaise<br/>2. E uhi me ka gauze no 30-60 min (a i ʻole i ka pō no ke kā mānoanoa)<br/>3. E holoi mālie i ka bitumen ʻeleʻele liquefied; e noi hou a hiki i ka 100% maʻemaʻe<br/>(ʻAʻole e hoʻohana i ka ʻaila, diesel, kerosene, acetone, a i ʻole WD-40)"]

    MaterialSplit -->|Coal-Tar Pitch (Industrial Coke/Roofing Pitch)| CoalPitch["COAL-TAR PITCH PHOTOTOXICITY PROTOCOL<br/>E hoʻoheheʻe ʻia me ka ʻaila mineral sterile / petrolatum ʻaila A me<br/>pale pale i ka ʻili mai ka lā o UV (loaʻa nā polycyclic aromatic<br/>hydrocarbons e hoʻoulu ai i nā wela UV phototoxic nui)"]

    MaterialSplit -->|Melted Plastic, Nylon/Polyester Fabric,<br/>Hot-Melt Glue Gun, or Candle Wax| PolymerRule["SOLIDIFIED POLYMER / WAX PROTOCOL<br/>• Candle Wax: E hoʻoluliluli me ka ʻaila pēpē/ʻaila ʻoliva a ʻōwili mālie ʻia<br/>• Plastic hehee / Hot Glue / Nylon: ʻAʻole e hoʻoheheʻe ka ʻaila organik. analgesia"]

Physics and Pathophysiology of Adherent Thermal Burns¶

No ke aha e hoʻopā nui ʻia ai ke kākā wela, ka plastic i hoʻoheheʻe ʻia, a me ka caramel paila a i ʻole ka wax i ke ahi hohonu like ʻole me ka lapalapa ahi a i ʻole ka wai wela?

1. Ka Mahana, Viscosity, a me ka hopena "Insulating Thermal Blanket".¶

Ma kekahi wela wela, ua hoʻoholo ʻia ka hohonu o ka make ʻana o ka ʻiʻo (Jackson's Zone of Coagulation and Zone of Stasis) e nā mea hoʻololi ʻelua: Temperature (\(T\)) a me Duration of Contact (\(t\)).

• Ma \(44^\circ\text{C}\) (\(111^\circ\text{F}\)), he 6 mau hola** ke kumu o ka epidermal necrosis.
• Ma \(55^\circ\text{C}\) (\(131^\circ\text{F}\)), hiki mai ka necrosis epidermal piha iloko o 30 kekona.
• Ma \(70^\circ\text{C}\) (\(158^\circ\text{F}\)), hiki mai ka make ana o ke keena manoanoa piha iloko o ** emi iho malalo o 1 kekona**.
• Ke hooheheeia alanui asphalt (\(150^\circ\text{C}\text{ a i }200^\circ\text{C}\)), o ka bitumen o ka hale (\(230^\circ\text{C}\text{ a i }260^\circ\text{C}\)), ethylene-vinyl acetateamide (Evinyl acetateamide) o ka hale hana. (\(170^\circ\text{C}\text{ i }210^\circ\text{C}\)), ai'ole ** polypropylene/nylon i hooheheeia (\(160^\circ\text{C}\text{ a i }260^\circ\text{C}\))** pili i ka ili kanaka:
• ʻO ka 0.5 millimeters o waho o ka kulu hoʻoheheʻe ʻia e maʻalili iki i ka hoʻopili ʻana me ka ea a me ka ʻili, e hana i kahi ** impermeable, insulating outer crust**.
• Ma lalo o kēlā ʻāʻī, ʻo ke kumu o ka pā a i ʻole ka mea i hoʻoheheʻe ʻia e noho ma luna o \(100^\circ\text{C}\text{ a i }180^\circ\text{C}\), e hoʻokuʻu pololei ana i ka ikehu wela i mālama ʻia i lalo i loko o ka dermis no 3 a 10 minuke ke ʻole e ninini koke ʻia ka wai anuanu ma waho e hoʻokuʻu i ka wela.

2. Hoʻopili Mechanical: No ke aha e huki ai i ke kalo i hoʻoluʻu ʻia mai ka Dermis¶

ʻOiai ʻo ka wai ma \(200^\circ\text{C}\), ʻo ka bitumen hoʻoheheʻe ʻia a i ʻole ke kolu wela he haʻahaʻa ka ʻili o ka ʻili a kahe i loko o kēlā me kēia microscopic epidermal ridge, sweat pore, a me vellus hair follicle ma ka lima a i ʻole ka lima, ʻoiai e hoʻomoʻa ana a pohū i ka hui dermo-epidermal ma lalo:

• I ka wā e maʻalili ai ka pā ma lalo o \(50^\circ\text{C}\) (\(122^\circ\text{F}\)), ua paʻa ia i loko o kahi paʻa viscoelastic paʻa i hoʻopaʻa ʻia i nā kaukani lauoho a me ka stratum corneum make.
• Ma lalo o ke kā, ua hoʻokaʻawale ka wela i ka epidermis mai ka dermis (ka hoʻokumu ʻana i ka blister).
• Inā hopu kekahi limahana a kauka ʻike ʻole paha i ka ʻaoʻao o ka pā maloʻo (a i ʻole ka lima nylon i hoʻoheheʻe ʻia) me ka ikaika a huki, ** ʻo ka hale holoʻokoʻa o ka epidermis poha a me ka dermis papillary luna e haehae ʻia i paʻa i ka ʻaoʻao lalo o ke kā**, e hōʻike ana i ka maka, e kahe ana ke koko, e hoʻopau i nā moena dermal capillary e pono ai. ho'ōla i ke kuni me ka ʻole o ka ʻili ʻili.

3. Petroleum Bitumen (Asphalt) vs. Coal-Tar Pitch: He Koʻikoʻi Kemika¶

Ma ka ʻōlelo Pelekania i kēlā me kēia lā, hoʻohana ka poʻe i nā huaʻōlelo "tar," "asphalt," "bitumen," a me "pitch", akā i ka lāʻau lapaʻau ʻoihana a me ka toxicology hele mai lākou mai nā kumu like ʻole:

1. Petroleum Asphalt / Bitumen (95%+ o ka Paʻa Alanui a me ka Hale Paʻa Hou):
2. Hoʻomaʻemaʻe ʻia mai ka hoʻoheheʻe haʻahaʻa haʻahaʻa lalo o ʻaila ʻaila maʻemaʻe.
3. Loaʻa i nā aliphatic a me naphthenic kiʻekiʻe-molecular-weight asphaltenes a me maltines.
4. Maʻemaʻe Thermal & Mechanical Injury: ʻO ka bitumen Petroleum ʻaʻole ** he mea make kemika; i ka wā e kinai ʻia ai kona wela me ka wai, ʻo ia ka sterile (ua hoʻomehana ʻia ma luna o \(200^\circ\text{C}\) i loko o ka ipu hao) a hiki ke hoʻoheheʻe ʻia i loko o ka ʻaila meaʻai ʻole polar a i ʻole nā ​​​​ʻaila lāʻau lapaʻau (ʻaila sunflower, ʻaila mineral, petrolatum keʻokeʻo, pata, a i ʻole mayonnaise).
5. Lānahu-Tar Pitch (Industrial Coke Ovens, Kekahi Paipai Moana/Pipe Pitch, a me Older Flat-Roofing Pitch):
6. Loaʻa mai ka distillation hoʻopōʻino o lāhuhi.
7. Loaʻa i nā kiʻekiʻe o nā mea ʻawaʻawa Polycyclic Aromatic Hydrocarbons (PAHs), phenols (cresols), a me acridine/pyridine base.
8. Thermal Burn + Severe UV Phototoxicity ("Pitch Smarts"): Ma waho aʻe o ke ahi wela he \(250^\circ\text{C}\), hoʻonanea ka lanahu-tar pitch i ka ʻili kanaka a me ke koʻa o ka maka i ka ultraviolet (UV-A) ka lā. Inā ʻike ʻia ka ʻili a i ʻole nā ​​maka i haumia i ka ʻili lanahu-tar i ka lā o waho i ka wā a ma hope paha o ka wehe ʻana, hoʻāla nā kukui UV i nā PAH e hoʻohua i nā radical manuahi e hoʻoulu ai i ka ** agonizing phototoxic erythema, blistering, a me keratitis**. Pono e mālama ʻia nā poʻe maʻi me ke kuni ʻana o ka lānahu mai ka lā a me ke kukui UV a hiki i ka pau ʻana o kēlā me kēia ʻāpana o ka pitch.

Hoʻohālikelike kumu o nā mea hoʻoheheʻe wela kiʻekiʻe¶

Ka Luʻu Hohonu: ʻAi ʻAi-Mai-Step Clinical Protocol no ka Wehe ʻana i ka Tar a me ka Asphalt ("Like Dissolves Like")¶

Ke hoʻopau ʻoe i ka Phase 1 (15 a 20 mau minuke o ka wai e kahe mau ana) no laila e anuanu loa ke kā i ka hoʻopā ʻana, pehea e wehe ai nā ʻāpana puhi a me nā mea pane mua i ka ʻōpala bitumen ʻeleʻele me ka ʻole o ka haehae ʻana i hoʻokahi millimeter o ka ʻili?

1. Ka Kemika o na Lipophilic Solvents Palekana¶

ʻO ka bitumen Petroleum he mau kaulahao hydrocarbon non-polar i paʻa pū ʻia e nā pūʻali van der Waals. He polar ikaika ka wai a ʻaʻole hiki ke komo i ka bitumen. Eia nō naʻe, ʻo ka ʻaila lipophilic non-polar a me ka hamo** palekana, ʻona ʻole, hoʻoheheʻe pololei ʻia i loko o ka matrix bitumen, e wāwahi ana i nā paʻa intermolecular ma waena o nā asphaltenes a e hoʻohuli hou i ka pā ʻeleʻele paʻa pōhaku i loko o kahi wai ʻeleʻele ʻeleʻele ʻeleʻele i ka wela lumi.

1. Nā Laʻau Lapa mua a me nā mea hoʻoheheʻe ʻawaʻawa o ka hale (100% palekana ma nā Dermis i puhi ʻia):
2. ** ʻAila Sunflower a i ʻole ʻAila ʻOlive**: Ua hoʻopuka ʻia nā haʻawina kikowaena kuni (me nā kuʻina i hāpai ʻia e ka British Burn Association a me nā kikowaena kuni ʻEulopa) e hōʻike ana ʻo ** ʻAila Sunflower maʻemaʻe i ka meaʻai maʻemaʻe** e hoʻoheheʻe i ka asphalt a me ka bitumen hale i ʻoi aku ka wikiwiki a ʻoi aku ka maʻemaʻe ma mua o nā mea hoʻoheheʻe lapaʻau pāʻoihana i loko o 20 a 40 mau minuke, me ka liʻiliʻi o ke kumukūʻai.
3. Aila Mineral (Paraffin wai / Aila ʻAla ʻAla ʻole): Loaʻa maʻalahi i kēlā me kēia lāʻau lapaʻau a me nā hale; ninini ʻia ma luna o nā paʻi gauze i waiho ʻia ma luna o ke kā.
4. Polymyxin-Bacitracin a i ʻole Neomycin-Polymyxin-Bacitracin Ointment (Polysporin / Neosporin Ointment) a i ʻole White Petrolatum (Vaseline): Hoʻohana i kahi kumu hydrocarbon petrolatum keʻokeʻo 100% e hoʻoheheʻe mau ana i ka tar me ka hāʻawi ʻana i ka pale antimicrobial ma lalo o ke kino. *(E hoʻomaopopo: E hoʻohana i ka Ointment, ʻaʻole "Cream," no ka mea, ʻoi aku ka liʻiliʻi o ka petrolatum solvent i loko o ka wai.
5. Ka Paʻakai ʻAʻole Paʻa ʻole a i ʻole Mayonnaise: Ma nā hanana ulia pōpilikia ʻoihana a i ʻole ma ka ʻaoʻao o ke alanui kahi i loaʻa ʻole ai i ka pahu kōkua mua ka aila pēpē a i ʻole ka ʻaila hinu, ka meaʻai ** ka pata paʻakai ʻole, ka margarine, a i ʻole ka mayonnaise** (ʻo ia ka 75% a i ka 80% soybean/canola oil i hoʻoheheʻe ʻia me ka hua manu lecithins disolver maikaʻi loa.
6. **Citrus-Peel D-Limonene / Polyoxyethylene Sorbitan (Tween-80 / De-Solv-It) Mea Hoʻomaʻemaʻe Hoʻomaʻemaʻe Lapaʻau Lapaʻau **: ʻO nā lāʻau lapaʻau non-ionic surfactant/ester i hoʻopaʻa ʻia i loko o nā keʻena kuni ʻoihana (ʻaʻole e hoʻololi i nā mea pena pena hale kūʻai lako lako).

2. ʻĀpana noiʻi ʻanuʻu ("Soak, Wipe, Repeat: Never Scrub")¶

1. E holoi a hoʻomaloʻo mālie i ka ʻili a puni ma hope o ka pau ʻana o ka ʻili wai anuanu 20 mau minuke.
2. E kau i kahi papa mānoanoa 3-a-5-millimeter o ** ʻAila Sunflower, ʻAila Baby, White Petrolatum, a i ʻole Polysporin Ointment** ma luna o ka ʻili holoʻokoʻa a me nā kihi o ka pā maloʻo.
3. Uhi ʻia me ka gauze sterile i hoʻomoʻa ʻia i ka ʻaila a ʻōwili ʻia me kahi kāʻei e hoʻopaʻa ʻia ai ka ʻaila me ka pā no 30 a 60 mau minuke.
4. Wehe a holoi mālie, ʻaʻole holoi ʻia: Ma hope o 30 a 60 mau minuke, ua heheʻe ka papa o waho o ke kākā paʻa i loko o kahi lepo ʻaila ʻeleʻele. E hoʻohana i ka gauze sterile palupalu i pulu ʻia me ka wai mahana a i ʻole ka ʻaila hou aʻe no ka ** holoi ʻoluʻolu i ke kākā wai i puka mai me ka pale ʻole **.
5. E hoʻopili hou i ka ʻaila/ʻaila hou no ka ʻili mānoanoa paʻakikī: Inā paʻa ka ʻiʻo mānoanoa o ke kā i ka ʻili poha, mai hoʻokuʻu iā ia. E hoʻopili hou i kahi papa momona o ka petrolatum sterile a i ʻole ka ʻaila lāʻau antibiotic, e kāhiko hou i ka ʻeha, a kali i kahi 4 a 12 mau hola (a i ʻole e ʻae ke keʻena kuni o ka haukapila e hana hou i ka lole i ke kakahiaka aʻe). I loko o 12 a 24 mau hola ma lalo o ka ʻaʻahu ʻaila poni, e lana kaʻawale loa ka 100 pākēneka o ke kala i koe i hiki i ke kauka ke nānā i ka hohonu o ke kuni kumu.

3. Nā Kūikawā Anatomical Kūikawā: Nā Maka, Maka, a me nā manamana lima pōʻai¶

• Tar a i ʻole Asphalt i ka Maka:
• E holoi koke i ka maka hāmama me ka wai piʻi maloʻo a i ʻole ka paʻakai maʻamau maʻamau no 15 a 20 mau minuke no ka hoʻomaʻalili ʻana i ka bitumen a holoi ʻia i ka ʻōpala.
• Mai ho'āʻo e ʻohi i ka tar paʻakiki mai ke koʻo, conjunctiva, a i ʻole nā maka maka me nā tweezers a i ʻole nā pulu maloʻo.
• Ma ke keʻena pilikia, hoʻohana ka poʻe ophthalmologists sterile ophthalmic erythromycin a i ʻole ka ʻaila bacitracin (i loko o kahi ʻaila mineral sterile / keʻokeʻo petrolatum ophthalmic base) pololei i loko o ka ʻeke conjunctival i kēlā me kēia mau hola; ʻO ka ʻaila ophthalmic sterile e hoʻoheheʻe me ka ʻeha ʻole i ka tar mai ka cornea a me nā maka ma luna o 12 a 24 mau hola ʻoiai e pale ana i ka epithelium corneal.
• Ka Poʻe Kaʻa Poʻe ma nā manamana lima, lima, a lima paha:
• Ke hoʻokuʻu ka mea hana i ka lima ʻole i loko o ka bākeke pā wela a i ʻole ka pāpaʻi ʻana i 360-degere a puni ka manamana lima a i ʻole ka pulima lima, ua lilo ka pā i hoʻoluʻu ʻia i pūpū ʻoʻoleʻa paʻa ʻole. I ka pehu ʻana o ka edema kuni i ka ʻiʻo palupalu i loko o kēlā pūpū i nā hola 1 a hiki i 3 e hiki mai ana, ua ʻoi aku ke kaomi o ka ʻiʻo ma mua o ke kaomi arterial perfusion (compartment syndrome / digital ischemia).
• Aila Kūpilikiʻi: E hoʻokiʻekiʻe i ka lima ma luna o ke kiʻekiʻe o ka puʻuwai, e hoʻokomo koke i ke kākā holoʻokoʻa i loko o ka mānoanoa ** ʻAila Sunflower, Mineral Oil, a i ʻole Petrolatum Ointment** i ke ala e hele ai i ka haukapila no laila e palupalu ka pūpū ʻaʻa i loko o kahi paʻi paʻa, a nānā i ka hoʻopiha hou ʻana o ka manamana lima a me ka ʻike i kēlā me kēia 10 mau minuke. I loko o ka ʻāpana kuni, hoʻokaʻawale ka poʻe kaukō i ke kākā i hoʻopalupalu ʻia me ka lōʻihi (a hana i kahi escharotomy ʻokiʻoki inā e hoʻopaʻa ana ka eschar ʻili mānoanoa i ke kahe koko).

Hohonu Luu 2: Hooheheeia Mea Hana lole (Nylon, Polyester, Fleece) a me "Tanghulu" Sugar Glass Scalds¶

1. No ke aha e hehee ai ka lole synthetic i loko o ka wili plastik ma ka ʻili¶

ʻAʻole e like me ka 100 pakeneka maoli ** pulu, hulu hipa, olonā, a i ʻole kilika** (e hoʻoheheʻe ʻia i loko o ka lehu palupalu ke ʻike ʻia i ka lapalapa me ka hoʻoheheʻe ʻole ʻia), hoʻoheheʻe ʻia nā fiber petrochemical synthetic e like me nylon, polyester, polypropylene, acrylic, a me spandex/elastane hehee ma waena o \(160^\circ\text{C}\text {^}\) (\(320^\circ\text{F}\text{ a hiki i }500^\circ\text{F}\)) i loko o ka wai ehuehue, paʻa paʻa i ke kino o ka mea hoʻohana:

• Stop, Drop, Roll, and Cool Through the Fabric: Inā wela ka pants track synthetic, ʻaʻahu huluhulu, a i ʻole ka pālule polyester i ke ahi, e kinai koke i ke ahi a ** hoʻopiha i nā lole i hoʻoheheʻe ʻia me ka wai anuanu no 15 a 20 mau minuke MAMUA o ka hoʻāʻo ʻana e wehe i ka wahi i puhi ʻia**.
• E ʻoki a puni, ʻaʻole e ʻili: E hoʻohana i nā ʻāpana ʻāʻī ʻōpala e ʻoki i nā lole i hoʻoheheʻe ʻole ʻia a puni ka ʻāpana o ke ahi. E waiho i kekahi mokupuni o ka nylon hehee a i ole polyester i hookui pono ia iloko o ka ili, e uhi ia me ka gauze petrolatum sterile a i ole i ka pepa palaki ma'ema'e, a e lawe aku i ka mea ma'i i ke keena kuni o ka halemai kahi e hiki ai i na kauka ke hoopau i ka polymer ma lalo o ka analgesia intravenous a i 'ole ka hana ho'omaha.

2. ʻO ka "Tanghulu" Boiling Sugar and Caramel Kitchen Burn Epidemic¶

I loko o nā makahiki i hala iho nei, ua hōʻike ʻia ka piʻi ʻana o ke kuni ʻana o nā keiki a me nā mākua ma ka honua holoʻokoʻa i ke kuni ʻana o ka lima hohonu a me ka maka ma muli o ka ** hoʻolapalapa kōpaʻa syrups ("Tanghulu" candied fruit recipes, homemade caramel, and toffee)** i hoʻomoʻa ʻia i loko o nā kīʻaha microwave a i ʻole nā ipu kapuahi i \(150^\circ\text{C}\text{ to }175^\text{to }175^\circ\text{0}\)circ\text i }350^\circ\text{F}$):

• No ke aha e hana ai ka paila kōpaʻa e like me ka Napalm kīhini: Loaʻa i ka molten sucrose syrup ka wela loa (\(160^\circ\text{C}+\)) a me ka viscosity kiʻekiʻe e ʻaʻahu ai i nā manamana lima a paʻa i loko o kahi pūpū kukui e like me ke aniani i loko o kekona. Inā ho'āʻo ke keiki a makua paha e luliluli, holoi, a ʻili paha i ke kō paʻakikī me ko lākou lima ʻē aʻe, e hoʻoili ke kō i hoʻoheheʻe ʻia i ka lima ʻelua a ʻokiʻoki i ka ʻili poha mai nā lima ʻelua i ka manawa like.
• No ke aha ka wai maʻalili a me ka mea hoʻoheheʻe no ke kuni ʻana i ke kō: ʻAʻole like me ka petroleum tar (ʻo ia ka mea e pono ai ka aila) a i ʻole ka plastic i hoʻoheheʻe ʻia (e pono ai ke wehe ʻia ʻana), ** ʻo ke kō a me ka caramel he 100% hiki ke hoʻoheheʻe ʻia i ka wai**. ʻO ka paʻa ʻana i ka lima i uhi ʻia i ke kō ma lalo o ke kahawai ʻoluʻolu o ka wai piʻi anuanu no 20 a 30 mau minuke holoʻokoʻa i ka manawa like e unuhi i ka wela \(160^\circ\text{C}\) A hoʻoheheʻe ʻia ka ʻili lole paʻakiki ma waho o ka ʻili i poha ʻole me ka haehae ʻole o ka epidermis.

Wahi hana a me ka papa inoa pale home¶

• E hoʻohana i ka pulupulu kaumaha 100% a i ʻole ke ahi-pale (FR) ʻaʻahu kūlohelohe i ka wā e hana ana a puni ka asphalt wela a i ʻole nā ipu hale hale: Mai ʻaʻahu i nā pālule pālule polyester, nylon, a i ʻole synthetic ma luna o ka paving a i ʻole ka hale o ka hale; e komo i nā pālule denim koʻikoʻi lōʻihi i huki ʻia ma waho o nā kāmaʻa ʻili kiʻekiʻe, nā mīkina lima ʻili me nā puʻupuʻu paʻa, a me kahi pale maka piha ma luna o nā aniani palekana.
• E hoʻopaʻa i kēlā me kēia Kaʻa Kaʻa Paʻa a me ʻelua ʻOmole 1-Liter o ka ʻaila Sunflower a i ʻole ka ʻaila Minerale a me 5 Galani o ka wai hoʻoluʻu ʻona: E mālama pono i ka ʻaila lipophilic bitumen-dissolving a me nā ʻeke ʻaila poni sterile i loko o ka pahu kōkua mua o ka poʻe no laila ʻaʻohe mea hana e hoʻowalewale ʻia e holoi i ka mea hoʻoheheʻe me ka lāʻau.
• E mālama i kahi kīʻaha wai anuanu ma ka ʻaoʻao o kekahi pū kiʻekiʻe kiʻekiʻe a i ʻole ka ipu kōpaʻa umu: I ka wā e hoʻohana ai i ka pū kelu wela he \(200^\circ\text{C}\) a i ʻole ka paila kōpaʻa ma ka home, e kau i kekahi pola nui o ka wai piʻi anuanu ma luna pono o ka pā ma mua o ka hoʻā ʻana i ka wela i hiki ke hoʻoheheʻe ʻia kekahi kulu ma ka manamana lima i loko o ka wai ma lalo o 1 kekona.

Nīnau pinepine¶

Ua paʻi ʻia koʻu hoa hana ma ka lima me ka asphalt alanui wela 5 mau minuke aku nei. Makemake kekahi ohua e holoi iā ia me kahi lole i hoʻoluhi ʻia i ka wahie diesel a i ʻole WD-40 mai ke kaʻa. Pono au e ʻae iā lākou?¶

ʻAʻole: kāpae koke iā lākou. Mai hoʻokomo i ka wahie diesel, ka ʻaila, ka ʻaila, WD-40, ka mea hoʻomaʻemaʻe kaʻa, ka mea lahilahi pena, a i ʻole ka acetone ma luna o ka ʻili kanaka i puhi ʻia. ʻO kēlā mau mea hoʻoheheʻe ʻoihana a me nā wahie he hydrocarbons ʻawaʻawa e wehe a hoʻopau i nā kemika i nā dermis i pohu mua ʻia, e komo wikiwiki i loko o ke kahe koko ma o ka ʻeha wela e hoʻomaka ai ka make ʻana o ka ʻōnaehana, a e hoʻopilikia i ke ahi. Akā, e hoʻopaʻa i ka lima o kāu hoa hana ma lalo o ka wai e kahe ana no kahi 15 a 20 mau minuke i kēia manawa e hoʻōki i ka wela mai ka hohonu. Ke anu loa ka asphalt, e uhi mānoanoa me ka aila puaa maʻemaʻe, ka aila mea kanu, ka aila pēpē, ka pata, ka mayonnaise, a i ʻole ka ʻaila Neosporin/Polysporin, kahi e hoʻoheheʻe ai i ka ʻaila ʻaila me ka ʻeha ʻole me ka ʻole o ka pōʻino i ka ʻili.

Puhi au i koʻu manamana lima me ka pu kiʻekiʻe wela wela hoʻoheheʻe craft glue a huki ʻia i ke kaula o ke kāpili wela me koʻu lima ʻē aʻe. I kēia manawa, ua puhi ʻia nā manamana lima ʻelua a ua paʻa mau kahi ʻāpana o ke kāpili paʻakikī i kahi ʻōpala maka. Pehea wau e wehe ai i ke koena o ke kāpili?¶

ʻO ka mua, e hoʻopaʻa i nā manamana lima ʻelua ma lalo o ka wai hoʻoheheʻe ʻoluʻolu no 15 a 20 mau minuke e huki i ke koena wela. Mai huki a ʻohi paha i ke koena paʻa paʻa i paʻa i ka ʻōpala maka, no ka mea, ʻo ka huki ʻana ia mea e ʻāhae loa ai ke kaupaku o ka ʻōhū a ʻike ʻia ka dermis hohonu. ʻAʻole like me ka petroleum tar, ʻo ka ethylene-vinyl acetate (EVA) paʻa hoʻoheheʻe wela he polymer plastik ʻaʻole e hoʻoheheʻe ʻia i loko o ka wai i loko o ka ʻaila; akā naʻe, ʻo ka uhi ʻana i ke kolu a me ka pohū me ka ʻaila Vaseline a i ʻole Polysporin ma lalo o kahi kāʻei e hoʻopalupalu i ka paʻa paʻa ʻili-ʻoiai ʻo kou kino e hōʻiliʻili maoli i ka wai i loko o ka ʻōpala ma lalo. Ma luna o 24 a 48 mau hola, e hoʻokiʻekiʻe ʻia ke kāpili ma nā ʻaoʻao i hiki iā ʻoe ke ʻoki me ka ʻeha ʻole, a i ʻole hiki i ke kauka ma ke keʻena mālama koʻikoʻi ke wehe iā ia me ka palekana.

No ke aha he mea nui ka waiho ʻana i ka ʻili i ka ʻili i ka wā e hoʻoluʻu ai me ka wai no 20 mau minuke, ma mua o ka ʻoki koke ʻana i ka pā wela me ka pahi a lāʻau paha?¶

I loko o 2 a 5 kekona o ka paʻi ʻana i kou ʻili, ua hoʻopili ʻia ka papa lalo o ka pā i hoʻoheheʻe ʻia a i ʻole ka plastic i hoʻoheheʻe ʻia i loko o kou lauoho lauoho a pohū i ka papa luna o kou epidermis. Inā ho'āʻo ʻoe e ʻohi a ʻili paha i ka ʻili me ka lāʻau, ka pahi, a i ʻole ka ʻōpala i ka minuke mua, ʻaʻole ʻoe e wehe wale i ka pā: ʻoki ʻoki ʻoe i ka ʻili epidermal ola holoʻokoʻa me ia, e waiho ana i kahi ʻeha mānoanoa o ke koko. ʻO ka hoʻokahe ʻia ʻana o ke kā me ka wai kahe e hoʻoheheʻe ʻia ka wela ma o ka ʻili liʻiliʻi i loko o nā kekona, hoʻopaʻa i ke kākā ma kahi, a mālama i ka 100 pakeneka o kou ʻili i lalo i hiki ke hoʻoheheʻe mālie ʻia ke kā me ka ʻaila 20 mau minuke ma hope.

• ʻO kēia alakaʻi no ka ʻike ʻike a ʻaʻole ia e pani i ka mālama lapaʻau ʻoihana ma kahi kikowaena kuni i hōʻoia ʻia. No ka mea, hiki i nā wela wela ke hoʻoulu i ka pehu ʻana o ke ea, hypovolemic shock, a me ka maʻi, paipai mākou e lawe i kahi papa kōkua mua i ʻae ʻia ma o ka International Federation of Red Cross and Red Crescent Societies (IFRC), kou ʻahahui Red Cross, St John Ambulance, a i ʻole kahi mea hoʻolako aʻo kūloko.*

Nānā ʻia nā kumu¶

• American Burn Association (ABA): Advanced Burn Life Support (ABLS) Mea Hoʻolako Manual: Nā ʻEha Puhi Kūikawā, Tar a me nā Puhi Asphalt.
• ʻO ka British Burn Association (BBA) & NHS Burn Networks: * Nā Kūlana Hoʻomaʻamaʻa Clinical no ke kōkua mua a me ka wehe ʻana i ka emollient o ka bitumen (Tar / Asphalt) Burns (Sunflower Oil and Liquid Paraffin Protocols)*.
• National Institute for Occupational Safety and Health (NIOSH, United States) & Centers for Disease Control and Prevention (CDC): Nā Hoʻolāʻau Hazard: Nā Hana Ola o ka Hoʻolaha Hana i ka Asphalt and Coal-Tar Pitch.
• World Health Organization (WHO) & International Society for Burn Injuries (ISBI): ISBI Practice Guidelines for Burn Care: First Aid Cooling and Adherent Agent Management.

Nā alakaʻi pili¶

• ʻO ke kuni, ka wela, a me ke ahi wela ke kōkua mua
• Puhi nui a me ka ʻili kemika
• ʻO ke kuni ʻana o ke ahi alkali a me nā ʻeha maka lime
• ʻO ka waika Hydrofluoric, ka wehe ʻana i ka ʻōpala, a me ke ahi kemika ʻoihana
• ʻO nā ʻeha maka a me ka hoʻoinu ʻana i ka maka
• Nā helu pilikia ma ka ʻāina