Skip to content

Phula Lotentha, Phula, ndi Zowotcha Zapulasitiki Zosungunuka (Protocol Yochotsa Bitumeni)

Manambala angozi amasiyana malinga ndi dziko. Tsambali limagwiritsa ntchito 911, nambala ya United States ndi Canada. Mayiko ena ambiri amagwiritsa ntchito 112, 999, kapena nambala ina. Pezani nambala ya dziko lanu.

Kuwotcha komwe kumachitika chifukwa phula losungunuka, phula lopaka misewu (phula), phula lamalasha, zomatira zosungunuka m'mafakitale, nsalu zosungunuka (nayiloni, poliyesitala, polypropylene), mfuti zamaguluta zotentha kwambiri, ndi shuga wowira kapena sera zimakhala zosiyana kwambiri ndi moto wamba - moto wamba kapena moto wamba. Pamene phula loyalidwa litulutsidwa pagalimoto yogawa pa \(140^\circ\text{C}\text{ to }205^\circ\text{C}\) (\(285^\circ\text{F}\text{ to }400^\circ\text{F}\)), kapena pamene denga layala 0{C3 rc3 bitumeni ^ \(2 rc3 ndi phula ^*\)2 mpaka }260^\circ\text{C}$ (\(450^\circ\text{F}\text{ to }500^\circ\text{F}\)), madzi okhuthala, owoneka bwino a hydrocarbon samawaza pakhungu ngati madzi otentha. M'malo mwake, ** imadzimanga yokha muzitsulo za tsitsi ndi epidermal ridges monga chofunda chotetezera, kutentha kutentha **, kupitiriza kuphika dermis, subcutaneous fat, and digital tendons kwa mphindi zingapo mutakhudzana.

Choopsa kwambiri kuposa kutentha koyambirira ndi zomwe ongoyimilira kapena okhudzidwa ndi mantha amachita m'masekondi 60 oyamba : kuyesa mwachibadwa kusenda, kukanda, kapena kung'amba phula lakuda lolimba kapena pulasitiki wosungunuka pakhungu. Chifukwa phula lozizilitsidwa ndi kusungunuka kwa polima kumakaniko mu epidermis ndi tsinde latsitsi, kukokera phula lolimba kapena nayiloni yosungunuka pakhungu louma ** kumang'amba khungu lonse lakhungu ndi khungu lomwe lili m'thupi, kutembenuza makulidwe ochiritsika kukhala chilonda chokhuthala chapakhungu chomwe chimafunikira kuyamwa. Bukuli limapereka ndondomeko yovomerezeka yadzidzidzi ya magawo awiri ( Phase 1: Pompopompo 20-Mphindi Yozizira Kutentha Kutentha kwa Madzi **, kutsatiridwa ndi ** Phase 2: Non-Toxic Lipophilic Emollient Dissolution pogwiritsa ntchito Mafuta a Mpendadzuwa, Mafuta a Ana, Butter, Mayonnaise, kapena Polymyxin-Bacitracin Ointed Association), British Burn Ointed Association * (BBA), National Institute for Occupational Safety and Health (NIOSH), ndi World Health Organization (WHO).

Chitani izi tsopano

Ngati inuyo kapena munthu wina wapafupi wanu mwathithiridwa kapena kuwotchedwa ndi phula, phula (phula), pulasitiki wosungunuka, guluu wosungunuka, zovala zopangidwa ndi phula, kapena sera yotentha:

  1. Sefukirani Tala kapena Pulasitiki Nthawi yomweyo ndi Madzi Othamanga Ozizira kwa Mphindi 15 mpaka 20 Zathunthu:
  2. OSATI kuwononga mphindi 2 zoyamba kufunafuna mafuta kapena kuyesa kupukuta phula. Ikani dzanja, mkono, mwendo, kapena nkhope yotenthedwa nthawi yomweyo pansi pa madzi ozizira apompopompo kapena paipi ya m'munda (\(15^\circ\text{C}\text{ to }20^\circ\text{C} / 59^\circ\text{6}\circ\text{F}\8{F}\) 15 mpaka 20 mphindi zotsatizana.
  3. Madzi ozizira amatulutsa mwachangu \(200^\circ\text{C}+\) kutentha kotentha kupyola pa phula, kulimbitsa phula lamadzimadzi kuti lisiye kufalikira, ndikuyimitsa kuphika kwakuya pamasekondi pang'ono. *(Musagwiritse ntchito madzi oundana kapena ayezi, zomwe zimayambitsa vasoconstriction kwambiri ndikuzama necrosis ya minofu).
  4. **OSATI KUYAMBIRA, Kutola, Kukwapula, Kapena Kukoka Tar, Asphalt, kapena Pulasitiki Wosungunuka Pakhungu **:
  5. Mukaziziritsidwa ndi madzi, siyani phula lakuda louma, guluu wotentha, kapena zovala za nayiloni zosungunuka ** zokhazikika pakhungu **.
  6. Ngati zovala zanyowetsedwa ndi phula lotentha kapena kusungunuka pabala, OSATI kukoka nsaluyo: kuziziritsa malo onse pansaluyo ndi madzi oyenda, kenaka gwiritsani ntchito sheya wa trauma kuti mudule nsalu yotayira, yosalumikizidwa m'mbali mwake.
  7. Pewani "Circumferential Tourniquet Trap" pa Zala, Zipatso, ndi Khosi:
  8. Pamene phula lotentha likazizira n’kukhala chinthu chakuda cholimba, chakuda chakuda chozungulira chala, pamkono, kapena pamkono, minofu yomwe yapsayo imayamba kutupa mofulumira. Ngati mphete yolimba ya phula yowuma imazungulira chala kapena dzanja, imakhala ngati ulendo womwe umachotsa kutuluka kwa magazi.
  9. Chotsani mphete zonse zachitsulo ndi mawotchi nthawi yomweyo mukuthamanga ndi madzi, ndipo ngati phula lolimba limapanga bande lathunthu la 360-degree kuzungulira chiwalo kapena manambala, yambani **lipophilic mafuta kufewetsa ** motsatira utali wautali nthawi yomweyo ndikunyamula mwachangu kupita kuchipinda chowotcha chipatala.
  10. Pa Tar kapena Asphalt M'maso kapena Kuphimba M'kamwa/Mphuno, Imbani 911/112/999 Pompopompo:
  11. Njira yoyamba: Ngati phula lotentha lawalira kumaso, kuziziritsani ndi madzi kwinaku mukuchotsa mphuno ndi kutsekula pakamwa kuti munthuyo apume.
  12. Maso: Tsukani maso opaka phula pang'onopang'ono ndi madzi ozizira kapena saline wosabala kwa mphindi 15 mpaka 20 kuti muchotse kutentha. **MUSAMAyese kuchotsa phula louma m'zikope kapena m'maso **; kuphimba maso ndi yopyapyala yopyapyala wopaka mafuta wosabala ophthalmic erythromycin/petrolatum mafuta ndi kupita kwa ophthalmologist mwadzidzidzi.
  13. ** Sungunulani Tar kapena Phula Mosawawa Pogwiritsa Ntchito Mafuta Otetezeka Omwe A Lipophilic Kapena Mafuta Othira Maantibayotiki ("Monga Amasungunuka Monga")**:
  14. Mutaziziritsa kwa mphindi 20 ndi madzi (komanso pakuwotcha pang'ono, kapena mu dipatimenti yodzidzimutsa chifukwa cha kutentha kwakukulu), sungunulani phula / phula lopangidwa ndi petroleum polipaka mowolowa manja ndi Mafuta a mpendadzuwa, Mineral Mafuta (Mafuta a Ana), White Petrolatum (Vaseline), Neosporin-Basirin (Polyporin) petrolatum base), Mafuta a Azitona, Mayonesi, kapena Batala Wosasungunuka, kuwasiya atakulungidwa kwa 30 mpaka mphindi 60 mpaka phula lakuda lisungunuke kukhala madzi ofewa omwe amapukuta mopanda mphamvu ndi yopyapyala yopyapyala.
  15. MUSAMAGWIRITSE NTCHITO Mafuta, Palafini, Mafuta a Dizilo, Turpentine, Acetone, Paint Thinner, kapena WD-40 pa Khungu Lowotchedwa:
  16. Ogwira ntchito zomanga ndi zofolera nthawi zambiri amasunga mafuta a dizilo, palafini, kapena zotsitsa mafuta a citrus/mafakitale pamagalimoto kuti aziyeretsa zida. Osathira zosungunulira zamakampani kapena mafuta pakhungu la munthu: zimayaka kwambiri pakhungu la munthu, zimayamwa mwachindunji kudzera m'matuza amtundu wa hydrocarbon (chiwindi, impso, ndi chiwopsezo cham'mafupa), ndipo zimatha kuyatsa moto.

Chifukwa Chake Kutentha kwa Padenga ndi Phula Kumapangitsa Kuwotcha Kwambiri Kuposa Madzi Owira

Madzi otentha sangapitirire \(100^\circ\text{C}\) (\(212^\circ\text{F}\)) panyanja ndipo amatuluka pakhungu pasanathe sekondi imodzi. Mosiyana, phula lopaka misewu limayikidwa pa \(140^\circ\text{C}\text{ to }205^\circ\text{C}\) (\(285^\circ\text{F}\text{ to }400^\circ\text{F}\)) ndipo phula la ketulo la denga limatenthedwa mpaka ku C \(23{23} }260^\circ\text{C}\) (\(450^\circ\text{F}\text{ to }500^\circ\text{F}\)), kuwirikiza **kuwirikiza kuwirikiza kawiri kutentha kwa madzi owira, ndi kutentha kwapadera kwapadera ndi kukhuthala kwakukulu komwe kumatsekera chisungunucho pakhungu. Chifukwa maselo a epidermal amafa mu masekondi osakwana 0.1 pa \(70^\circ\text{C}\) (\(158^\circ\text{F}\)), sekondi iliyonse ya kuchedwa isanalowetse kutentha kwa phula pansi pa madzi ozizira kumapangitsa kuti kutentha kulowe mozama mu reticular dermis ndi subcutaneous mafuta.

Kuwotcha kwadzidzidzi ndi tchati chochotsa phula

flowchart TD
    Start["Splash kapena Contact Burn ndi Hot Tar, Paving Asphalt (Bitumeni),<br/>Coal-Tar Pitch, Melted Plastic/Nayiloni, Hot Glue, kapena Sera Yotentha."] --> Phase1["MFUNDO 1: KUCHULUKA KWA NTCHITO YOMWEYO YOYAMBA (MISEKONDI 60 YOYAMBA)<br/>Sefukirani phula/pulasitiki & khungu lozungulira ndi madzi ozizira oyenda (15-20°C)<br/> mosalekeza kwa 15 mpaka 20 FULL MINUTES mpaka phula litalimba ndi kuzizira"]

    Phase1 --> NoPeel["LANGIZO WOFUNIKA: MUSASENDE, kusala, kupala, kapena kukoka<br/>phula lolimba, guluu wotentha, kapena zovala zosungunuka zosungunuka pakhungu<br/>Dulani zovala zotayirira zokha; chotsani mphete & mawotchi"]

    NoPeel --> TriageCheck{"Onani Kuopsa kwa Burn & Location:<br/>1. Nkhope, Maso, Njira ya Mpweya, Manja, Mapazi, Ziwalo Zakumaliseche, kapena Kulumikizana Kwakukulu?<br/>2. phula la 360-degree mozungulira chala/dzanja?<br/>3. Kutentha kwamoto> 5% TBSA (kapena kuwonetseredwa kwa Coal-Tar Pitch)?"}

    TriageCheck -->|Yes to Any High-Risk Feature| HospitalBurn["IYIMBANI 911 / 112 / 999 & KUTULUKA KUTI WOYOSERA CENTER<br/>• Pa Circumferential Tar Cast: Gawani/fewetsani phula motalika ndi<br/>wosabala petrolatum/Polymyxin-Bacitracin mafuta kuti mupewe digito ischemia<br/>• Pamaso a Flush Tarmic Splash:5 min. mafuta onunkhira"]

    TriageCheck -->|No: Localized Adherent Tar or Wax Burn| MaterialSplit{"Ndi zinthu ziti zomwe zimamatira pakhungu?"}

    MaterialSplit -->|Petroleum Bitumen: Road Asphalt, Roofing Tar,<br/>or Asphalt Sealant| OilDissolve["MFUNDO 2: LIPOPHILIC EMOLLIENT DISSOLUTION ('Monga Zimasungunuka Monga')<br/>1. Pakani mafuta opaka mpendadzuwa, Mafuta a Ana (Mineral Oil),<br/>Polysporin/Neosporin Ointment, Vaseline, Butter, kapena Mayonesi<br/>2. Phimbani ndi yopyapyala kwa 30-60 min (kapena usiku wonse chifukwa cha phula wandiweyani)<br/>3. Pang'onopang'ono pukutani phula lakuda la liquefied; ikaninso mpaka 100% yoyera<br/>(MUSAgwiritse ntchito mafuta, dizilo, palafini, acetone, kapena WD-40)"]

    MaterialSplit -->|Coal-Tar Pitch (Industrial Coke/Roofing Pitch)| CoalPitch["COAL-TAR PITCH PHOTOTOXICITY PROTOCOL<br/>Sungunulani ndi wosabala mchere wamafuta / petrolatum mafuta NDI<br/>chishango khungu mosamalitsa ku UV kuwala (muli polycyclic onunkhira<br/>ma hydrocarbon amene amayaka kwambiri UV phototoxic)"]

    MaterialSplit -->|Melted Plastic, Nylon/Polyester Fabric,<br/>Hot-Melt Glue Gun, or Candle Wax| PolymerRule["POLYMERA YOLIMBIKITSA / NTCHITO YA WAX <br/>• Sera ya Makandulo: Pewani ndi mafuta amwana/mafuta a azitona ndipo gudubuzani pang'onopang'ono<br/>• Pulasitiki Wosungunuka / Guluu Wotentha / Nayiloni: Mafuta achilengedwe MUSAsungunuke pulasitiki. kuwononga pansi pa analgesia"]

Physics ndi Pathophysiology of Adherent Thermal Burns

Chifukwa chiyani phula lotentha, pulasitiki wosungunuka, ndi caramel yowira kapena sera zimatenthetsa mopanda malire poyerekeza ndi malawi amoto kapena madzi otentha?

1. Kutentha, Viscosity, ndi "Insulating Thermal Blanket" Mphamvu

Mu kutentha kulikonse, kuya kwa minofu kufa (Jackson's Zone of Coagulation ndi Zone of Stasis) kumatsimikiziridwa ndi mitundu iwiri: Kutentha (\(T\)) ndi Kutalika kwa Kulumikizana (\(t\)).

  • Pa \(44^\circ\text{C}\) (\(111^\circ\text{F}\)), zimatengera 6 maola kuyambitsa epidermal necrosis.
  • Pa \(55^\circ\text{C}\) (\(131^\circ\text{F}\)), full epidermal necrosis imachitika mu masekondi 30.
  • Pa \(70^\circ\text{C}\) (\(158^\circ\text{F}\)), kufa kwa selo makulidwe athunthu kumachitika osakwana sekondi imodzi.
  • Pamene phula msewu phula (\(150^\circ\text{C}\text{ to }200^\circ\text{C}\)), phula denga (\(230^\circ\text{C}\text{ to }260^\circ\text{C}\)), melt ethylene polyethylene-VAIndustrial polyethylene guluu (\(170^\circ\text{C}\text{ to }210^\circ\text{C}\)), kapena polypropylene/nylon yosungunuka (\(160^\circ\text{C}\text{ to }260^\circ\text{C}\)) imagunda pakhungu la munthu:
  • Kunja kwa mamilimita 0.5 a dontho losungunula kumazizira pang'ono pokhudzana ndi mpweya ndi khungu, kupanga **yosatha kulowa, yotsekera kutumphuka kwakunja **.
  • Pansi pa phulalo, pakati pa phula kapena pulasitiki yosungunuka imakhala pamwamba pa \(100^\circ\text{C}\text{mpaka }180^\circ\text{C}\), kutulutsa mphamvu yotentha yosungidwa molunjika ku dermis kwa 3 mpaka mphindi 10 pokhapokha ngati madzi ozizira otuluka atsanulidwa panja kuti atulutse.

2. Kutsekereza Kwamakina: Chifukwa Chimene Kukoka Tala Woziziritsa Kumachotsa Dermis

Ngakhale madzi ali pa \(200^\circ\text{C}\), phula losungunuka kapena guluu wotentha amakhala ndi mphamvu yocheperapo pamwamba ndipo amalowa mkati mwa tinthu tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono tating'ono ta Epidermal pore** pa mkono kapena padzanja, kwinaku mukuphika ndikuphulitsa podutsana ndi dermo-epidermal:

  • Pamene phula limazizira pansi \(50^\circ\text{C}\) (\(122^\circ\text{F}\)), imakhazikika kukhala cholimba cholimba cha viscoelastic chomwe chimangiriridwa pamatsitsi masauzande ambiri ndi stratum corneum yakufa.
  • Pansi pa phula, kutentha kwalekanitsa epidermis ndi dermis (kupanga matuza).
  • Ngati wogwira ntchito kapena dokotala wosadziwa agwira m'mphepete mwa phula woziziritsidwa (kapena manja a nayiloni osungunuka) ndi mphamvu ndi kukoka, denga lonse la matuza a epidermis ndi papillary dermis pamwamba pake limang'ambika pansi pa phula, ndikuwonetsetsa zaiwisi zakuda, zotuluka magazi, kuwononga ma cell a capillary, kuwononga ma cell otupa. kuchiza kutentha popanda kumezanitsa khungu.

3. Bitumeni ya Petroleum (Asphalt) vs. Coal-Tar Pitch: A Critical Chemical Distinction

M’Chingerezi chatsiku ndi tsiku, anthu amagwiritsa ntchito mawu akuti “tar,” “asphalt,” “phula,” ndi “pitch” mosinthanasinthana, koma m’mankhwala a ntchito ndi toxicology amachokera ku magwero awiri osiyana:

  1. Aphalt / Bitumen ya Petroleum (95%+ ya Paving Road ndi Roofing Zamakono):
  2. Woyengedwa kuchokera ku heavy fractional distillation pansi pa mafuta amafuta osakhwima.
  3. Amakhala ndi ma molekyulu olemera kwambiri aliphatic ndi naphthenic asphaltenes ndi maltene.
  4. Kuvulala Kwamatenthedwe Konse: Bitumeni ya petroleum* si*** si mankhwala owononga poizoni; pamene kutentha kwake kuzimitsidwa ndi madzi, kwenikweni ndi ** wosabala ** (atatenthedwa pamwamba pa $ 200 ^ circ\text{C}$ mu ketulo) ndipo amasungunuka mosavuta mu zakudya zopanda polar kapena mafuta amankhwala (**mafuta a mpendadzuwa, mafuta amchere, petrolatum woyera, batala, kapena mayonesi **).
  5. Pitch ya malasha (Mauvuni a Coke Amakampani, Zoyala Zina za Panyanja/Mapaipi, ndi Pitch Yakale Yokhotakhota):
  6. Zochokera ku distillation yowononga ya malasha.
  7. Muli poizoni wambiri Polycyclic Aromatic Hydrocarbons (PAHs), phenols (cresols), ndi acridine/pyridine base.
  8. Thermal Burn + Severe UV Phototoxicity ("Pitch Smarts"): Kuphatikiza pa \(250^\circ\text{C}\) kutentha kwamoto, phula la malasha limapangitsa khungu la munthu komanso diso ku ultraviolet (UV-A) kuwala kwadzuwa. Ngati khungu kapena maso omwe ali ndi phula la malasha akhudzidwa ndi kuwala kwa dzuwa mkati kapena pambuyo pochotsedwa, kuwala kwa UV kumayambitsa ma PAHs kuti apange ma free radicals omwe amayambitsa agonizing phototoxic erythema, matuza, ndi keratitis. Odwala omwe akupsa ndi phula la malasha ayenera kutetezedwa ku kuwala kwa dzuwa ndi kuwala kwa UV mpaka kamvekedwe kalikonse katayimitsidwa.

Kuyerekeza Kwambiri kwa Adherent High-Temperature Burn Agents

Adherent Material & Source Kusungunuka Kwanthawi Zonse / Kutentha kwa Ntchito Kodi Mafuta Amasungunuka? Specific First Aid & Removal Protocol
** Phula Wopaka Pamsewu & Bitumen Yokhomerera** (Aphalt-sakanizani otentha, chosindikizira chotsekereza, ma mops/maketulo) \(140^\circ\text{C}\text{ to }260^\circ\text{C}\) (\(285^\circ\text{F}\text{ to }500^\circ\text{F}\)) YES (Kusungunuka mu ma triglycerides atali-chain & parafini yamadzimadzi/petrolatum) 1. Kuziziritsa ndi madzi oyenda 15 mpaka 20 min.
2. Sungunulani ndi Mafuta a Mpendadzuwa, Mafuta a Ana, Polysporin/Neosporin mafuta, Vaseline, Butter, kapena Mayonesi pa 30 mpaka 60+ min.
**3. Pukuta pang'onopang'ono **; onjezerani mafuta odzola mpaka phula lonse litatha.
Malasha-Tar Pitch & Creosote Pitch (Denga la mafakitale, ma elekitirodi osungunula aluminiyamu, zokutira zam'madzi / zogwiritsira ntchito) \(180^\circ\lemba{C}\lemba{ ku }260^\circ\text{C}\) (\(356^\circ\text{F}\text{ to }500^\circ\text{F}\)) YES (Kusungunuka mu mafuta amchere, petrolatum, ndi Polyethylene Glycol [PEG 400] ngati phenolic) 1. Kuziziritsa ndi madzi oyenda 15 mpaka 20 min.
2. Khalani oleza mtima KUPANDA KUWULA JUWA (amateteza kuyaka kwakukulu kwa PAH phototoxic).
3. Sungunulani ndi wosabala petrolatum/mineral mafuta (kapena PEG 400 ngati creosote/phenol zili zambiri).
Zomatira Mfuti za Glue za Hot-Melt (mfuti za guluu zapakhomo [zotentha kwambiri poyerekeza ndi zotentha kwambiri] ndi zopaka m'mafakitale EVA/polyamide guluu) Mfuti ya Low-Temp: \(120^\circ\text{C}\) (\(250^\circ\text{F}\)).
High-Temp / Industrial: \(195^\circ\text{C}\text{ to }215^\circ\text{C}\) (\(380^\circ\text{F}\text{ to }420^\circ\text{F}\)).		 MPAPANKHA AMAMASULA M'mphepete WOKHA (Polima ya pulasitiki ya EVA Yolimba samasungunuka m'mafuta, koma mafuta amapaka mawonekedwe a glue pakhungu) 1. Lowetsani chala m'madzi ozizira nthawi yomweyo kwa 15 mpaka 20 min ** (osagwedezeka kapena kupukuta guluu wosungunuka ndi chala chanu china chopanda kanthu, chomwe chimawotcha dzanja lachiwiri).
2. OSATI senda zomatira zolimba.** Zilowerereni madzi ofunda asopo + mafuta a azitona/petrolatum/Polysporin mafuta; pamene madzi a m'chithuza akachulukana kwa maola 12 mpaka 24, chepetsani m'mphepete mwake ndi lumo wosabala.
** Zovala & Pulasitiki Zosungunuka** (Nayiloni, Polyester, Polypropylene, Polyethylene, pulasitiki ya ABS) \(160^\circ\text{C}\text{ to }265^\circ\text{C}\) (\(320^\circ\text{F}\text{ to }510^\circ\text{F}\)) NO (Mapulasitiki opangidwa ndi Solidified sasungunuka m'mafuta apanyumba) 1. Ziziziritsani nthawi yomweyo ndi madzi oyenda 15 mpaka 20 min.
2. Dulani nsalu yotayirira kuzungulira poyaka ndi lumo; OSATI kukoka pulasitiki wosungunuka wosungunuka pakhungu.
3. Phimbani ndi wosabala petrolatum yopyapyala ndi kupita ku chipatala chowotchera chipatala kuti muchotsere maopaleshoni pochepetsa ululu.
Nkhandulo Yosungunula ya Makandulo, Paraffin, & Sera Yochotsa Tsitsi (Makandulo a mitsuko otayika, phula la batik, zotenthetsera sera zodzikongoletsera) \(60^\circ\text{C}\text{ to }150^\circ\text{C}\) (\(140^\circ\text{F}\text{ to }300^\circ\text{F}\), pamwamba ngati sera igwira moto) YES (Paraffin sera imafewa mu mineral/mwana mafuta ndi mafuta a azitona) 1. Kuziziritsa pansi pa madzi apampopi oyenda kwa mphindi 15 mpaka 20.
2. Pakani pang'onopang'ono Mafuta a Ana, Mafuta a Azitona, kapena Vaselini m'mphepete mwa sera woziziritsa kuti achotsere khungu; siyani sera iliyonse itakanidwa pakhungu laiwisi/matuza lokha kuti lichotsedwe kuchipatala.
Shuga Wowiritsa, Caramel, Tofi, & Maswiti A Kitchen a Napalm (Kupanga maswiti, kupaka shuga wa tanghulu, kupanikizana kotentha) \(150^\circ\lemba{C}\lemba{ ku}190^\circ\malemba{C}\) (\(300^\circ\text{F}\text{ to }375^\circ\text{F}\)) SOLUBLE WAMADZI (Amasungunuka m'madzi oyenda ozizira, osati mafuta) 1. Dzilowetseni nthawi yomweyo m'madzi ozizira kwa mphindi 20 mpaka 30 zonse: Mosiyana ndi phula kapena pulasitiki, galasi lolimba la shuga ** limasungunuka kwathunthu m'madzi oyenda ozizira ** pomwe madziwo amatulutsa kutentha. Osachotsa shuga wowuma pa zala zowuma.

Kuzama Kwambiri: Ndondomeko Yam'pang'onopang'ono Yachipatala Yochotsa Tar ndi Asphalt ("Monga Zimasungunuka Monga").

Mukamaliza Gawo loyamba (mphindi 15 mpaka 20 zamadzi oyenda ozizira mosalekeza) kuti phula likhale lozizira kwambiri pokhudza, kodi mayunitsi ndi oyankha oyamba amachotsa bwanji phula lakuda la phula popanda kung'amba khungu la millimeter imodzi?

1. Chemistry of Safe Lipophilic Solvents

Bitumeni ya petroleum imakhala ndi maunyolo omwe si a polar hydrocarbon omwe amalumikizidwa pamodzi ndi mphamvu za van der Waals. Madzi ndi a polar kwambiri ndipo sangadutse konse phula. Komabe, otetezeka, opanda poizoni opanda polar lipophilic mafuta ndi mafuta odzola amafalikira molunjika mu phula la phula, kuswa zomangira zapakati pa asphaltenes ndikutembenuza phula lakuda lolimba mwamwala kukhala madzi opyapyala abulauni pa kutentha kokwanira:

  1. Zosungunula Bitumen Zamzere Woyamba (Zotetezedwa 100% pa Dermis Yaiwisi Yowotchedwa):
  2. Mafuta a mpendadzuwa kapena Mafuta a Azitona: Kafukufuku wofalitsidwa wapakatikati (kuphatikiza ndondomeko zotengedwa ndi British Burn Association ndi European burnt centers) akuwonetsa kuti Mafuta a mpendadzuwa amtengo wamba wa chakudya amasungunula phula ndi phula la denga mwachangu komanso mwaukhondo kuposa pafupifupi zosungunulira zamalonda zilizonse mkati mwa 20 mpaka 40 mphindi*, pamtengo wocheperako komanso wapoizoni.
  3. Mafuta a Mineral (Parafini Yamadzimadzi / Mafuta Osanunkhira Ana): Amapezeka mosavuta mu pharmacy iliyonse ndi m'nyumba; kuthira pamiyala yopyapyala yoyalidwa pamwamba pa phula.
  4. Polymyxin-Bacitracin kapena Neomycin-Polymyxin-Bacitracin Ointment (Polysporin / Neosporin Ointment) kapena White Petrolatum (Vaseline): Amagwiritsa ntchito 100% white petrolatum hydrocarbon base yomwe imatulutsa phula pang'onopang'ono pomwe ikupereka antimicrobial burning prophylaxis prophylaxis. (Dziwani: Gwiritsani ntchito Mafuta, osati "Kirimu," popeza mafuta opaka m'madzi amakhala ndi zosungunulira zocheperako za petrolatum).
  5. Batala Wosasungunuka kapena Mayonesi: M'mafakitale kapena m'mphepete mwa msewu pomwe zida zothandizira zilibe mafuta a ana kapena mafuta a petrolatum, chakudya chamagulu batala wosasungunuka, margarine, kapena mayonesi (omwe ndi 75% mpaka 80% soya/canola mafuta opakidwa ndi dzira yolk bistucithi yothandiza kwambiri.)
  6. Malonda a Citrus-Peel D-Limonene / Polyoxyethylene Sorbitan (Tween-80 / De-Solv-It) Medical Burn Cleaners: Opangidwa makamaka osagwiritsa ntchito ionic / ester mankhwala opopera omwe ali m'zipatala zoyaka moto (osalowa m'malo mwa zodulira utoto za hardware).

2. Njira Yogwiritsira Ntchito Pang'onopang'ono ("Zilowerere, Pukutani, Bwerezani: Osakolopa").

  1. Sambani ndikuumitsa pang'onopang'ono khungu lozungulira mukamaliza kutsuka madzi ozizira kwa mphindi 20.
  2. Pakani 3-to-5-millimeter wandiweyani wosanjikiza wa Mafuta a mpendadzuwa, Mafuta a Ana, White Petrolatum, kapena Mafuta a Polysporin pamwamba ndi m'mbali mwa phula loziziritsidwa.
  3. ** Phimbani ndi yopyapyala yonyowa ndi mafuta ** ndikukulunga momasuka ndi bandeji kuti mafuta agwirizane ndi phula kwa 30 mpaka 60 mphindi.
  4. **Makololeni ndikupukuta pang'onopang'ono, osakolopa **: Pambuyo pa mphindi 30 mpaka 60, phula lolimba lakunja lidzakhala litasungunuka kukhala dothi lakuda lamafuta. Gwiritsani ntchito yopyapyala yofewa yonyowa ndi madzi ofunda kapena mafuta ochulukirapo kuti mufufute pang'onopang'ono **kupukuta phula lokhalo lomwe limatuluka ndi zero kukana **.
  5. Pakaninso zopaka zatsopano zamafuta/zodzola pa phula lokhuthala: Ngati phula lokhuthala likhalabe pakhungu la matuza, musalikakamize. Pakaninso mafuta osabala a petrolatum kapena maantibayotiki, valaninso bala, ndipo dikirani maola ena 4 mpaka 12 (kapena chipatala chiwotche chipatala chibwereze kuvala m'mawa wotsatira). Pakadutsa maola 12 mpaka 24 mutavala mafuta odzola, 100 peresenti ya phula yotsalayo imayandama momasuka kotero kuti adotolo azitha kuyang'ana kuya kwake komwe kumayaka.

3. Zadzidzidzi Zapadera za Anatomical: Maso, Nkhope, ndi Circumferential Finger Casts

  • Tala kapena Asphalt M'diso:
  • Yambani diso lotsegula ndi madzi apompopi ozizira kapena saline wosabala kwa mphindi 15 mpaka 20* kuti muziziritse phula ndi kutsuka phula.
  • MUSAMAyese kuchotsa phula louma pa diso, conjunctiva, kapena nsidze pogwiritsa ntchito ma tweezers kapena zowuma.
  • Mu dipatimenti yazadzidzidzi, akatswiri a maso amapaka wosabala ophthalmic erythromycin kapena mafuta odzola a bacitracin (mu mafuta osabala a mineral / white petrolatum ophthalmic base) mwachindunji mu thumba la conjunctival maola angapo aliwonse; mafuta osabala a ophthalmic amasungunula phula kuchokera ku cornea ndi nsidze kwa maola 12 mpaka 24 ndikuteteza cornea epithelium.
  • Circumferential Tar Cast pa zala, Dzanja, kapena Dzanja:
  • Wogwira ntchito akaponya m'chidebe cha phula lopanda kanthu kapena kudontheza pa chala kapena padzanja, phula loziziritsidwa limapanga chigoba cholimba chosasunthika. Pamene edema yoyaka imakula minofu yofewa mkati mwa chipolopolocho pa 1 mpaka maola atatu otsatirawa, kupanikizika kwa minofu kumaposa kuthamanga kwa mitsempha (**compartment syndrome / digital ischemia **).
  • Zochita Zadzidzidzi: Kwezani dzanja pamwamba pamlingo wamtima, nthawi yomweyo valani phula lonse lokhuthala Mafuta a mpendadzuwa, Mafuta a Mineral, kapena Mafuta a Petrolatum popita kuchipatala kuti chipolopolo cholimbacho chifewetseke kukhala phala, ndikuyang'ana nsonga ya capillary kudzaza ndi kumva mphindi 10 zilizonse. M'chipinda chowotcha, madokotala ochita opaleshoni amadula phula wofewa motalika (ndipo amachitira opaleshoni escharotomy ngati khungu lakuya kwambiri la eschar likulepheretsa kutuluka kwa magazi).

Deep Dive 2: Nsalu Zopanga Zosungunuka (Nayiloni, Polyester, Fleece) ndi "Tanghulu" Zowola Zagalasi la Shuga

1. Chifukwa Chake Zovala Zopanga Zimasungunuka Kukhala Pulasitiki Weld Pakhungu

Mosiyana ndi 100 peresenti yachilengedwe ** thonje, ubweya, bafuta, kapena silika** (yomwe imayaka phulusa lonyezimira ikayatsidwa ndi lawi lamoto osasungunuka), ulusi wopangidwa ndi petrochemical monga nayiloni, poliyesitala, polypropylene, acrylic, ndi spandex/elastane zimasungunuka pakati pa \(160^\circ\circ\text{C}rc2{C}rc2{C}C}text{C}rc\circ\6{C}C}\)6 (\(320^\circ\text{F}\text{ to }500^\circ\text{F}\)) kukhala pulasitiki yamadzimadzi yomata, yotubwikika yomwe imakhwinya mwamphamvu motsutsana ndi thupi la wovalayo:

  • Imani, Dulani, Perekani, ndi Kuzizira Kupyolera mu Nsalu: Ngati mathalauza a munthu wina, jekete la ubweya, kapena malaya a poliyesita agwira moto, zimitsani motowo nthawi yomweyo ndipo kuthirani zovala zosungunuka ndi madzi ozizira kwa mphindi 15 mpaka 20 MUSANAyese kuvula malo otenthedwawo.
  • Dulani Pozungulira, Osameta konse: Gwiritsani ntchito zida zometa zotchinga kuti mudule zovala zonse zotayirira, zosasungunuka pozungulira powotchera. **Siyani chilumba chilichonse cha nayiloni yosungunuka kapena poliyesitala yomwe imaphatikizidwa pakhungu mokhazikika **, iphimbeni ndi wosabala petrolatum yopyapyala kapena pulasitiki yoyera, ndikunyamula wodwalayo kupita kumalo oyaka moto m'chipatala komwe madokotala amatha kuwononga polima pansi pa intravenous analgesia kapena procedural sedation.

2. Mliri wa "Tanghulu" Wowotcha Shuga ndi Mliri Wotentha wa Kitchen Caramel

M'zaka zaposachedwa, mayunitsi a ana ndi akuluakulu padziko lonse lapansi anena kuti anthu akuwotcha kwambiri m'manja ndi kumaso chifukwa cha maswiti owiritsa a shuga ("Tanghulu" maphikidwe a zipatso za candied, caramel, ndi tofi) amatenthedwa mu makapu a microwave kapena miphika ya sitovu mpaka \(150^\circ\text{C}\)1{text\ci}\5{C}\(5{text{C}\)1{C} (\(300^\circ\text{F}\text{ to }350^\circ\text{F}\)):

  • Chifukwa Chake Kuwiritsa Shuga Kumagwira Ntchito Monga Kitchen Napalm: Madzi a Sucrose Osungunula amakhala ndi kutentha kwambiri (\(160^\circ\text{C}+\)) komanso kukhuthala kwakukulu komwe kumakwirira zala ndikuumira kukhala chigoba cha maswiti olimba, ngati galasi mkati mwamasekondi. Ngati mwana kapena wamkulu ayesa kugwedeza, kupukuta, kapena kusenda shuga wowuma ndi dzanja lake lina, shuga wosungunukayo amapita ku dzanja lachiwiri ndikung'amba khungu la matuza m'manja mwake nthawi imodzi.
  • Chifukwa Chake Madzi Othamanga Ozizira Ndiwo Ozizirira NDI Osungunulira Kuwotcha Shuga: Mosiyana ndi phula la petroleum (lomwe limafuna mafuta) kapena pulasitiki yosungunuka (yomwe imafuna kuchotsedwa kwa opaleshoni), **shuga wouma ndi caramel ndi 100 peresenti yosungunuka m'madzi **. Kugwira dzanja lokutidwa ndi shuga pansi pa mtsinje wofewa wa madzi apampopi ozizira kwa mphindi 20 mpaka 30 zonse nthawi imodzimodziyo kumachotsa kutentha kwa \(160^\circ\text{C}\) NDIKUsungunula chipolopolo cha maswiti owuma pakhungu popanda kung'amba epidermis.

Mndandanda wa Kupewa Kwapantchito ndi Kunyumba

  • **Valani 100% Heavy Cotton kapena Flame-Resistant (FR) Natural Fiber Clothing Pamene Mukugwira Ntchito Pakati pa Phula Lotentha Kapena Mabotolo a Padenga **: Musamavale poliyesitala, nayiloni, kapena malaya othamanga opangidwa ndi anthu ogwira ntchito yokonza kapena kufolera; Valani thalauza lalitali lolemera la denim lomwe limakokedwa kunja kwa nsapato zazikopa zazitali, magolovesi achikopa okhala ndi ma cuffs owoneka bwino, komanso chishango chakumaso chonse pamagalasi otetezera.
  • Ikani Galimoto Yomanga Iliyonse Ndi Zomangamanga Zokhala Ndi Mabotolo Awiri a Lita 1 a Mafuta a mpendadzuwa kapena Mafuta a Mineral ndi Ma Galoni 5 a Madzi Oziziritsa Kuthira: Sungani mafuta osungunula phula a lipophilic ndi mapaketi opaka mafuta a petrolatum opaka mkati mwa gulu laothandizira oyamba kuti asatenthedwe ndi mafuta ochapa kapena wothira mafuta.
  • Sungani Mtsuko wa Madzi Oziziritsa Pafupi ndi Mfuti ya Glue Yotentha Kwambiri kapena Mphika wa Shuga wa Chitofu: Mukamagwiritsa ntchito \(200^\circ\text{C}\) hot-melt glue gun kapena shuga wowira kunyumba, ikani mbale yaikulu yamadzi ozizira pa kauntala musanayatse kutentha kotero kuti dontho lililonse pa chala lingathe kuponyedwa m'madzi osachepera sekondi imodzi.

Mafunso omwe amafunsidwa pafupipafupi

Wantchito mnzanga adathiridwa pamkono ndi msewu wotentha phula mphindi 5 zapitazo. Wogwira ntchito wina akufuna kupukuta ndi chiguduli choviikidwa mumafuta a dizilo kapena WD-40 kuchokera mgalimoto. Ndiwalole?

Ayi: aletseni nthawi yomweyo. Osayika mafuta a dizilo, mafuta a petulo, palafini, WD-40, zotsukira mabuleki, zochepetsera utoto, kapena acetone pakhungu la munthu. Mafuta osungunulira m'mafakitalewa ndi ma hydrocarbon apoizoni omwe amachotsa ndikuwotcha dermis yomwe ili kale ndi matuza, kulowa mwachangu m'magazi kudzera pabala lotseguka lomwe lapsa kuti lipangitse poizoni, ndikupangitsa ngozi yoyaka moto. M'malo mwake, gwira dzanja la mnzanuyo pansi pa madzi ozizira kwa mphindi 15 mpaka 20 pompano kuti kutentha kusatenthe kwambiri. Pamene phula likazizira kwambiri, lipakani kwambiri ndi mafuta a mpendadzuwa, mafuta a masamba, mafuta a ana, batala, mayonesi, kapena mafuta a Neosporin / Polysporin, omwe amasungunula phula la petroleum bwinobwino popanda kuvulaza khungu.

Ndinawotcha chala changa chachikulu ndi mfuti ya glue yotentha kwambiri yotentha kwambiri ndipo mwachibadwa ndinakoka chingwe cha guluu wotentha ndi dzanja langa lina. Tsopano zala zazikulu ziwiri zonse zatenthedwa ndipo guluu wowuma akadali pa chithuza chosaphika. Kodi guluu lonselo ndingachotse bwanji?

Choyamba, gwirani zala zazikulu zonse pansi pa madzi apompopompo ozizira kwa mphindi 15 mpaka 20 kuti mutulutse kutentha kotsalira. OSATI kukoka kapena kunyamula guluu woumitsa wotsalayo wokhazikika pa chithuza chosaphika, chifukwa kuchikoka kumang'amba denga la chithuza ndikuwulula dermis yakuya. Mosiyana ndi phula la petroleum, guluu wolimba wa ethylene-vinyl acetate (EVA) ndi polymer yapulasitiki yomwe siyisungunuka kukhala madzi mumafuta; Komabe, kupaka guluu ndi chithuza mowolowa manja ndi Vaseline kapena Polysporin mafuta pansi pa bandeji kufewetsa zomangira zomatira pakhungu pomwe thupi lanu mwachibadwa limadziunjikira madzi mkati mwa chithuza pansi pake. Pamaola a 24 mpaka 48, guluuyo imakweza m'mphepete mwaulere kuti mutha kuidula popanda kupweteka, kapena dokotala wachipatala atha kuyichotsa bwinobwino.

Kodi nchifukwa ninji kuli kofunika kusiya phula PA khungu pamene mukuziziritsa ndi madzi kwa mphindi 20, m’malo mochotsa phula lotentha nthawi yomweyo ndi mpeni kapena ndodo?

Mkati mwa masekondi awiri kapena asanu mutagunda khungu lanu, phula la pansi la phula losungunuka kapena pulasitiki losungunuka lalowa kale m'mitsinje ya tsitsi lanu ndi matuza pamwamba pa epidermis. Mukayesa kukhwata kapena kusenda phulalo ndi ndodo, mpeni, kapena chiguduli pamphindi yoyamba, simungochotsa phulalo: mumameta ndi khungu lonse la epidermal lamoyo, ndikusiya bala laiwisi, lomwe likutuluka magazi. Kuthira phula ndi madzi ozizira othamanga kumatulutsa kutentha kupyola mu phula lopyapyala mkati mwa masekondi, kulimbitsa phula pamalo ake, ndikusunga 100 peresenti ya khungu lanu kuti phula lithe kusungunuka pang'onopang'ono ndi mafuta mphindi 20 pambuyo pake.

Bukhuli ndi lofuna kudziwa zambiri ndipo sililowa m'malo mwachipatala cha akatswiri pamalo ovomerezeka. Chifukwa kutentha kwakukulu kungayambitse kutupa kwa mpweya, kugwedezeka kwa hypovolemic, ndi matenda, tikukulimbikitsani kuti mutenge maphunziro ovomerezeka a chithandizo choyamba kudzera ku International Federation of Red Cross and Red Crescent Societies (IFRC), gulu lanu la Red Cross, St John Ambulance, kapena wopereka maphunziro ovomerezeka kwanuko.

Magwero afufuzidwa

  • American Burn Association (ABA): *Advanced Burn Life Support (ABLS) Buku Lopereka: Kuvulala Kwapadera Kwamoto, Kuwotcha Tar ndi Asphalt *.
  • Bungwe la British Burn Association (BBA) & NHS Burn Networks: * Malangizo Ogwiritsira Ntchito Zachipatala pa Thandizo Loyamba ndi Kuchotsa Zowonongeka kwa Bitumen (Tar / Asphalt) Kuwotcha (Mafuta a mpendadzuwa ndi Malamulo a Paraffin amadzimadzi) *.
  • National Institute for Occupational Safety and Health (NIOSH, United States) & Centers for Disease Control and Prevention (CDC): * Ndemanga ya Ngozi: Zotsatira Zaumoyo za Kuwonetsedwa kwa Ntchito ku Asphalt ndi 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.

Maupangiri ogwirizana