Beto itose (sima) Alkali Yaka hamwe no Gukomeretsa Ijisho ryumukungugu¶

Haba gusuka icyapa cya patio inyuma yumunsi wo kuwagatandatu nyuma ya saa sita, gushira amatafari yamatafari, gukoresha stucco cyangwa plaster, cyangwa gukwirakwiza lime yubuhinzi mu murima cyangwa mu kibuga cya siporo, gukorana na sima ya Portland, beto itose, amabuye ya masonry, lime hydrated, hamwe nigihe cyumye (okiside ya calcium, $ inyandiko {CaO} \() ** igaragaza uruhu n'amaso byangiza ibintu byubaka cyane, byangiza urugo. Mu gihe amazi avanze nifu ya sima ya Portland yumye (irimo ** 60 ku ijana kugeza kuri 65% oxyde ya calcium yuburemere bwa **), reaction ya hydratiya ya chimique ihindura ifu igisubizo cyuzuye kuri hydroxide ya calcium (\) inyandiko {Ca (OH)} _ 2 \() **, hamwe na hydroxide ya sodium (\) inyandiko {NaOH} \() ** na ** potasiyumu hydroxide (\) inyandiko) bikabije caustic ** $ inyandiko {pH ya 12.5 kugeza 14.0} $ **, urwego rumwe rwa pH nifungura amazi yamazi hamwe nogusukura ifuru.

Bitandukanye no gutwika amashyuza cyangwa acide-acide itera ako kanya ikaguhatira gusubiza inyuma ikiganza cyawe, ** beto itose ni insimburangingo, yicecekera ya tissue tissue : kubera ko alkaline calcium hydroxide yabanje kunanura imitsi yuruhu rwuruhu rwinshi mugihe isabune yibinure byuruhu mu isabune ( liquefactive necrosis **), umuntu apfukama muri beto itose yambara imyenda ya denim. kumasaha 2 kugeza 6 yambere **. Gusa nyuma yo kurangiza akazi no gukuramo ipantaro cyangwa inkweto mugihe cyo kurya, bavumbuye ko uruhu ruri hejuru y'amavi yabo, amajosi, cyangwa amaguru rwacitsemo ibice ** byimbitse, ibara ry'umuyugubwe-umukara cyangwa uruhu-rwera-urwego rwa gatatu rwuzuye-umubyimba wa chimique ** bisaba kubagwa no kubagwa uruhu. Kimwe na catastrophique ni ugusenyera umukungugu wa ** lime, plaster, cyangwa minisiteri itose mumaso , aho ion hydroxide yinjira muri cornea mumasegonda atarenze amasegonda 15 kugeza kuri 60 ** mugihe uduce duto twa lime yera twera cyane munsi yijisho ryimbere ( hejuru ya conjunctival fornix **), ikomeza gushonga mumaso nubwo isukuye mumazi isanzwe.

Aka gatabo karatanga intambwe-ku-ntambwe yo kwanduza umurima, "Amashanyarazi yumye Brush-Off Rule" kugirango yihute, protocole ya pH nyuma yo gukaraba, hamwe nubuhanga bwihuse bwo kuhira no guhumura amaso, byahujwe n’ikigo cy’Amerika gishinzwe umutekano n’ubuzima (OSHA), Ikigo cy’igihugu gishinzwe umutekano n’ubuzima (NIOSH / CDC) na Royal College of Ophthalmologistes.

Kora ubu¶

Niba wowe cyangwa undi muntu uri hafi ufite beto itose, minisiteri, grout, stucco, cyangwa ifu yumye yumye kuruhu rwabo, winjije mumyenda yabo cyangwa inkweto, cyangwa wamennye mumaso:

1. ** Kuri Lime YOSE, Sima, Mortar, cyangwa Plaster mumaso: Tangira koga mumasegonda 10 hanyuma uhanagure ijisho **:
2. ** Ntutegereze gutwara imodoka mubitaro mbere yo koza ijisho **: Alkali yinjira muri cornea yumuntu muri ** munsi yamasegonda 30 **. Ako kanya fata ijisho ryagutse ukoresheje intoki zawe hanyuma uhanagure ijisho ubudahwema n'amazi meza y'amazi meza ya robine, amazi yamacupa, cyangwa saline isanzwe (cyangwa ** Diphoterine ** igisubizo cya amphoteric niba kiri kurubuga) kuminota ** byibuze 30 kugeza 60 yuzuye **.
3. ** Kuraho lens ya contact ako kanya ** mugihe utangiye guhanagura.
4. ** Ihanagura uduce duto twa lime twafashwe munsi yijisho ryijisho **: Kuberako uduce twinshi twa lime, maromoro, cyangwa plaster twihishe imbere mubice byimbitse munsi yijisho ryimbere no hepfo hanyuma ugahita ushonga mumashya $ umwandiko {pH} 13 $ alkali kumasaha, kura umupfundikizo wo hepfo hanyuma uhindure umupfundikizo wumutwe hejuru yigitambaro cya pisine. gusya hamwe nuduto twa pamba utose mugihe ukomeje kuhira munzira igana ishami ryihutirwa (reba ibikomere by'amaso).
5. ** Koresha "Amashanyarazi Yumye Brush-Off" mbere yo gufungura amazi ya sima yumye cyangwa vuba vuba kuruhu **:
6. Niba amaboko yawe, ijosi, cyangwa imyenda byashizwe muri ** Ifu ya sima yumye, ivanze na minisiteri yumye, cyangwa igihe cyumye (okiside ya calcium, $ inyandiko {CaO} $) **, ** kwiyambura imyenda ivumbi hanyuma uhanagura buhoro buhoro cyangwa uzunguza ifu yumye ishoboka hamwe nigitambaro cyumye cyangwa mbere yohanagura mbere yo gukoresha amazi **.
7. Ongeramo akantu gato k'amazi (cyangwa ibyuya) mu buryo butaziguye ku gipimo cyinshi cyihuta cyumye gitera ubukana bwa ** exothermic hydration reaction ($ inyandiko {CaO} + inyandiko {H} _2 inyandiko {O} iburyo inyandiko {Ca (OH)} _ 2 + inyandiko {Ubushyuhe bukabije kugeza kuri} 150 ^ umuzenguruko inyandiko {C} / 300 ^ umuzingo 13 alkali imiti irashonga.
8. ** Kuraho ipantaro yuzuye beto, amasogisi, inkweto, gants, nimpeta ako kanya **:
9. Mugihe cya beto itose iranyerera mumavi ipantaro cyangwa isuka hejuru yinkweto zakazi kawe, ** reka guhita ukora **. Kuramo ipantaro itose, amasogisi, inkweto, reba, nimpeta zintoki ako kanya. Ntuzigere ukomeza gukora mumyenda isukuye "muminota 30 gusa kugirango urangize gukandagira icyapa."
10. ** Wuzuze uruhu n'amazi menshi atemba muminota 30 kugeza kuri 60 Yuzuye **:
11. Ifu yumye imaze guhanagurwa no gukuramo imyenda yatose ya beto ikuweho, oza uruhu munsi yumugezi ukomeye, uhoraho wamazi meza akonje cyangwa shitingi kuminota ** 30 kugeza kuri 60 ** kugeza igihe byose byoroshye, isabune yabuze kuruhu.
12. ** Koresha isabune yoroheje ya pH idafite aho ibogamiye cyangwa isukari nkeya ya acide ** (ntukigere ukarisha abrasive pumice scrubbers, ikuraho epidermis yacitse intege).
13. ** Icyiciro cya kabiri cyurugo rwa Vinegere Kwoza kuruhu rwuzuye / Urupapuro rwimbere (GUSA Nyuma yo Gukaraba Amazi Yuzuye) **:
14. Bitandukanye na acide ya sulfurike cyangwa lye (aho gusuka imbaraga zidafite aho zibogamiye kuri chimique mbisi bitera ubushyuhe bukabije bwa exothermic), dermatology yakazi hamwe nubuyobozi bwumutekano wubwubatsi (harimo na OSHA itanga amakuru yumutekano hamwe na sima protocole ya sima) menya ko ** nyuma yo koza sima yose igaragara kuruhu n'amazi atemba hamwe na acide ya acide ya vitamine 5%; 50:50 hamwe namazi ** (cyangwa buffer fosifate / amphoteric rinse) ifasha guhagarika intungamubiri za alkaline calcium hydroxide ion ($ inyandiko {pH} 13 $) ihambiriye imbere mumyanya yinyuma ya corneum, hanyuma ikurikirwa nandi mazi akonje. * (NTUKIGERE ushyira vinegere mumaso cyangwa ku bikomere byimbitse). *
15. ** Jya mu ishami ryihutirwa ryibitaro cyangwa gutwika ikigo cyuruhu rwijimye, Umukara, Umweru, cyangwa Uruhu **:
16. Kuberako beto itose itera ** umubyimba wuzuye wa liquefactive necrosis ** isa nuburiganya cyangwa gukomeretsa kumunsi wa 1, ikintu cyose cyatwitswe kumavi, shine, amaguru, cyangwa amaboko yerekana ** ibara ry'ubururu-ibara ry'umuyugubwe, ibishashara byera byera, ibisebe, cyangwa ibisebe ** bisaba kwisuzumisha mu bitaro, ntabwo byigeze byita ku mavuta ya antibiotique.

Ibikoresho byihutirwa, sima, na lime triage¶

flowchart TD
    Start["Guhura na beto itose, sima ya Portland, Mortar, Plaster, cyangwa Byihuse"] --> SiteCheck{"Kumenyekanisha kwabereye he?"}

    SiteCheck -->|Eye Splash: Lime Dust, Wet Mortar, Concrete,<br/>Plaster, or Whitewash in the Eye| EyeUrgent["BYIHUTIRWA NYAKURI (Cornea Yinjiye muri <30 Amasegonda) <br/> 1. Tangira koza n'amazi y'akazuyazi / saline HAMWE MU Masegonda 10 <br/> 2. Kuraho intumbero yo guhuza; fata ijisho ryagutse ufunguye kurwanya blpharospasm <br/> 3. Kuhira ubudasiba kuminota 30 kugeza kuri 60 Yuzuye <br/> 4. BIKORESHEJWE BIKURIKIRA IJISHO RY'AMASO: Kuramo ibipfundikizo byo hejuru & hepfo kugirango uhanagure <br/> buri kintu cyose cyera cyera cya lime / sima yafashwe kuva mubusambanyi <br/> 5. Ubwikorezi mu ishami ryihutirwa ryo kuhira Morgan Lens kugeza amarira pH = 7.0-7.4"]

    SiteCheck -->|Skin / Clothing Exposure:<br/>Hands, Knees, Shins, Ankles, or Arms| DryVsWet{"Imiti iri kuruhu Ifu Yumye cyangwa WET iranyerera?"}

    DryVsWet -->|Dry Powder: Dry Quicklime (CaO),<br/>Dry Portland Cement, or Dry Mortar Mix| BrushFirst["INTAMBWE 1 (ITEGEKO RY'IMBARAGA)"]

    DryVsWet -->|Wet Slurry: Wet Concrete, Mortar, Grout,<br/>Stucco, or Concrete-Soaked Pants/Boots| StripWet["INTAMBWE 1: Hagarika gukora ako kanya. Kuramo ipantaro yuzuye <br/> ipantaro, amasogisi, inkweto, gants, amasaha, nimpeta zintoki"]

    BrushFirst --> WaterFlush["INTAMBWE 2: Uruhu rwumwuzure hamwe n’amazi menshi akonje atemba ya MINUTES 30 kugeza kuri 60"]
    StripWet --> WaterFlush

    WaterFlush --> VinegarStep["INTAMBWE 3"]

    VinegarStep --> DepthEval{"Suzuma isura y'uruhu (Noneho no kumasaha 4-12): <br/> Hoba hariho ibara ry'umuyugubwe / ubururu / umukara ryirabura, kunanirwa kwera, <br/> kubyimba, cyangwa ububabare bukabije?"}

    DepthEval -->|Yes: Discoloration, Blisters, or Kneeling/Boot Burn| BurnUnit["JYA MU BITARO BITWARA CENTRE AKANYA"]
    DepthEval -->|No: Only mild dry redness ("Dermatite ya sima")| DermCare["Koresha amavuta adafite impumuro nziza; gukurikiranira hafi amasaha 24 <br/> (Shakisha ubuvuzi niba ibisebe bitinze, allergie ya chrome, cyangwa ububabare bikura)"]

Pathophysiologiya: Uburyo bukubye 4 bwa sima no kurimbura¶

Ni ukubera iki beto itose cyangwa lime byangiza cyane uruhu rwamaso n'amaso kuruta aside iringaniye? Uburyo bune butandukanye bwa chimique na physique butera umubiri icyarimwe:

1. Ubunyobwa bukabije ($ inyandiko {pH} 12.5 inyandiko {kugeza} 14.0 $) na Necrosis ya Liquefactive¶

Isima yumye ya Portland ikorwa no gushyushya hekeste n ibumba mu itanura kugirango ikore anhydrous ** calcium silicates ** na ** oxyde ya calcium (yihuta, $ Amazi ako kanya yongeyeho:

• ** Necrosis ya Liquefactive na Saponification **: Bitandukanye na acide zikomeye (ziteranya poroteyine zo hejuru zigahinduka umusemburo ukomeye wa eschar uhagarika acide yinjira cyane), ion ya hydroxide yubusa ($ inyandiko {OH} ^ - $) muri beto itose ** saponize acide yibinure mumyanya myunyungugu ya proteine ya vitamine.
• ** Impamvu Beton Yumva "Kunyerera cyangwa Isabune" kurutoki rwawe **: Iyo abakozi ba masonry bumva firime yoroshye, itanyerera, isabune yintoki zabo zambaye ubusa mugihe bakora kuri minisiteri itose, ** iyo firime iranyerera ntabwo ari isabune muri sima: ni urwego rwumukozi rwimbere rwamavuta yuruhu ruhinduka chimoni na pH 13 hydroxide ion **.

2. Ubushyuhe bwa Exothermic of Hydration (The Quicklime Thermal Burn)¶

Iyo ** yumye vuba (okiside ya calcium, $ inyandiko {CaO} \() ** cyangwa umukungugu wa sima muremure cyane uhura nu icyuya imbere yishati yishati, isogisi, cyangwa boot, cyangwa ugasukwa namazi make, reaction ya exothermic slaking reaction irekura ** 65.2 kilojoules kuri mole (\) 1,140 inyandiko {kilojoules ** kilo). Umubyimba mwinshi wumuvuduko wihuse wuzuye ibyuya kuruhu rwumukozi urashobora kugera kubushyuhe bwa ** $ 80 ^ umuzenguruko inyandiko {C} umwandiko {kugeza} 150 ^ umuzenguruko inyandiko {C} $ ($ 176 ^

3. Desgcation ya Hygroscopique (Dehydration ya selile)¶

Isima yumye kandi ikiza isukuye cyane ** hygroscopique **: kristaline calcium silicatike hydrate matrix ikuramo amazi mubintu byose ikoraho kugirango ikire kandi ikomere. Iyo sima itose cyangwa yumye yicaye kuruhu rwabantu, ikuramo amazi yimbere mungingo ya epidermal na dermal selile, yangiza kandi igabanya ingirabuzimafatizo mugihe yibanda kumazi ya alkaline.

4. Gukoresha imashini ya Abrasion + Chromium Hexavalent ($ inyandiko {Cr} ^ {6 +} $) Gukangurira¶

• ** Gusya n'umusenyi hamwe na ** Iyo beto itose yinjiye muri boot cyangwa ikanyunyuza mumavi ya denim jeans, buri ntambwe cyangwa ivi ihinduranya ikora nkumusenyi wuzuye, ** gusya mu buryo bwa mashini uburyo bwo kurinda stratum corneum barrière ** hanyuma ugafungura imiyoboro mito mito ya hydroxide ya pH 13 kugirango yuzure muri dermisi ndende.
• ** Chromium ya Hexavalent ($ inyandiko {Cr} ^ {6 +} \() Allergic Twandikire Dermatitis **: Ibikoresho fatizo bisanzwe hamwe nicyuma gisya ibyuma bisiga urugero rwa chromium ya hexavalent (\) inyandiko {Cr} ^ {6 +} $) ** muri sima ya Portland (keretse iyo itabangamiwe na ferrous sulfate igabanya abakozi, nkuko bisabwa mubumwe bwuburayi). Kumenyekanisha inshuro nyinshi, $ inyandiko {Cr} ^ {6 +} $ yinjira muruhu rwangiritse kuri alkali kugirango itere dermatite ikabije, idakira, ihindagurika **

Kugereranya sima, beto, Mortar, na Lime Hazards¶

Kwibira Byimbitse 1: Kuki gutwika beto itose bisa nk "" Ibikomere bitagira ingaruka "kumunsi wa 1 (Stage Clinical)¶

Imwe mu mitego iteje akaga mubuvuzi bwihutirwa ni uko ** umubyimba wuzuye (urwego rwa gatatu) alkali yaka kuri beto itose NTIBISA nkumuriro cyangwa gutwika umuriro mugihe umurwayi yabanje gukuramo ipantaro cyangwa inkweto **:

1. ** Amasaha 0 kugeza 4 (Icyiciro cy'isabune ya Numb) **:
2. Mugihe beto itose irimo kunyunyuza amavi yimyenda yumukozi cyangwa ikanyerera imbere yinkweto zabo, uruhu rwumva rushyushye cyane cyangwa rucuramye gato, hanyuma rukagenda ** numb ** kuko ion ya hydroxide ya pH 13 yangiza imitsi ya epidermal niveau. Niba umukozi yogeje muminota 15, gusa umutuku woroheje. Niba babiretse kumasaha 2 kugeza kuri 6, ubunini bwuzuye bwuzuye burakomeje.
3. ** Amasaha 4 kugeza 12 ("Umutego wijimye" Umutego wo Gusuzuma nabi) **:
4. Iyo umukozi akuyemo amajipo akomeye, yometse kuri beto cyangwa amasogisi saa kumi n'ebyiri za mugitondo, uruhu hejuru yivi ryabo cyangwa amaguru akenshi rusa nuwijimye wijimye wijimye, wijimye, ubururu bwijimye bwijimye, cyangwa umukara-umukara **, rimwe na rimwe uzengurutswe nimpeta yumutuku cyangwa ibisebe bitobito, cyangwa uruhu rwa ** rwapfuye-rwera, uruhu, uruhu **.
5. Abarwayi benshi batekereza: * "Nakomerekeje amavi kuva apfukamye kuri beto ikomeye umunsi wose," * hanyuma njya kuryama nyuma yo kwisiga amavuta yo kwisiga cyangwa amavuta ya antibiotique arenga kuri konti.
6. ** Mubyukuri, ako kantu kijimye cyangwa ibara ryijimye ni trombose imiyoboro yamaraso munsi yumubiri wapfuye rwose, saponified yuzuye umubyimba wuzuye.
7. ** Amasaha 12 kugeza 48 (Kanguka hamwe nububabare bukabije na Eschar Ulceration) **:
8. Ijoro ryose cyangwa bukeye bwaho, mugihe gutwika alkali bigera kumibabi yububabare bwimbitse mumyanya yo munsi yubutaka na periosteum, umurwayi akanguka afite ** ububabare bukabije, butwika, bubabaza cyane **, kubyimba, no kurira ibisebe bya nekrotique bitwikiriye isabune yumukara-umukara cyangwa umuhondo-wera.
9. ** Impamvu Ikigo Cyambere cyo Gutwika Ibintu **: Kubera ko imyambarire yimyambarire ihindagurika kumuriro wa beto yimbitse bifata ** ibyumweru 6 kugeza 12 byumweru ** kugirango ikureho tissue ya alkaline yapfuye hanyuma igasiga ibisebe byivi byivi bya hypertrophique hamwe namasezerano ahuriweho, ibigo byabashinzwe gutwika bikora ** hakiri kare kubagwa no kubaga uruhu rwinshi **, bigatuma umukozi akira mubyumweru 2 kugeza 3.

Kwibira cyane 2: Amaso ya Lime na Sima Amaso (Eversion ya Eyelid Double Eyvers & Limbal Stem Cell Rescue)¶

Mu buvuzi bw'amaso, ** kumeneka kwa lime (calcium oxyde cyangwa calcium hydroxide ya calcium), minisiteri itose, plaster, cyangwa beto bifatwa nkimwe mubintu byihutirwa byangiza ubuvuzi bwose **, bikaba bibi cyane kuruta kumena aside ya batiri.

1. Kuki Lime yashonga Cornea kandi igatera ubuhumyi buhoraho ("Ijisho ryera rya farashi")¶

• ** 15-Igice cya kabiri ** gusenya lens (itera cataracte yihuse) hamwe na trabecular meshwork (itera ** ikabije alkali glaucoma **).
• ** Limbal Stem Cell Ischaemia (Umutego "Ijisho ryera") **: Iparadizo, ijisho ryaka lime aho igice cyera cyijisho (sclera na conjunctiva kizengurutse cornea) gisa ** marble-yera kandi idafite amaraso ** ni ** mubyago byinshi byubuhumyi buhoraho ** kuruta ijisho risa numutuku uhoraho namaraso:
• Ijisho ritukura ryijimye riracyafite imiyoboro yamaraso nzima itunganya ** corneal limbus ** (impeta ya milimetero 1 kugeza kuri 2 ikikije inkombe ya cornea aho ingirabuzimafatizo zose ** ziba **).
• A ** yuzuye, farisari-yera sclera / limbus ** bivuze ko pH 13 alkali yegeranije rwose kandi isenya imiyoboro yamaraso igaburira ingirabuzimafatizo (** ischemia ** limbal ). Hatabayeho ingirangingo z'umubiri no gutanga amaraso, cornea ishonga ikoresheje imisemburo ya kolagenase ( sterile corneal ulceration na perforation ), cyangwa igahinduka neza kandi ikagira inkovu ( Roper-Hall / Dua Grade IV ocular gutwika **).

2. Intambwe-ku-ntambwe Umurima hamwe n'ibitaro byo gutabara amaso y'ibitaro¶

1. ** Guhita bikomeza Kuhira (Tangira kuri Scene mumasegonda 10) **:
2. Ntutakaze iminota 20 utwara ivuriro ryihutirwa rifite lime ikicaye mumaso. Koresha isoko yegereye amazi meza ako kanya: ** sitasiyo yijisho, kanseri ya Diphoterine, amazi yamacupa, amashanyarazi yubusitani kumuvuduko muke, igikoni cyo mu gikoni, cyangwa kwiyuhagira **.
3. Fata ijisho ukoresheje urutoki rwawe n'urutoki rwawe (ukanda ku magufwa ya orbital, * ntuzigere * ukanda ku jisho ubwaryo niba hakekwa ko hari igikomere cyinjira) hanyuma ukava mu mfuruka ya mazuru hanze ** ukomeza kuri ** byibuze iminota 30 kugeza kuri 60 **.
4. ** Nigute Ukora Hejuru Yijisho Ryakuweho Gukuraho Ibice Byakomeye byafashwe **:
5. ** Kuki amazi meza atemba birananirana iyo usimbutse iyi ntambwe **: Amashanyarazi ya lime, minisiteri, na sima ni ** gusa gushonga mumazi **. Ibibyimba byera byera bya calcium hydroxide bihunikwa muri ** isumba iyindi ya conjunctival fornix ** (umufuka wimbitse wa cul-de-sac hejuru munsi yijisho ryo hejuru) mugihe uwahohotewe yakubise ijisho rifunze kubabara. Nubwo wakoresha litiro 5 za saline imbere yijisho ryijisho, ayo mabuye yera yera yafashwe munsi yumupfundikizo wo hejuru akora nka ** gahoro gahoro pH 13 alkali depot **, ugahora usohora ion hydroxide kuri cornea kumasaha.
6. ** Intambwe ku yindi Tekinike yo guhanagura ijisho **:
   1. Kuramo ** ijisho ryo hepfo ** mugihe usaba uwahohotewe kureba * hejuru *, hanyuma ukoreshe ** usabye ipamba yometseho ipamba (Q-tip) ** cyangwa imfuruka ya padiri ya sterile itose kugirango uhanagure buhoro buhoro igikarabiro cyera cyangwa ibara rya sima risa mumufuka wo hepfo.
   2. Saba uwahohotewe kugirango ** urebe neza neza ibirenge byabo ** (byorohereza imitsi ya levator yumupfundikizo wo hejuru).
   3. Fata ** ijisho ryo hejuru ** witonze hagati y'urutoki rwawe n'urutoki rwawe, ukureho ijisho ryo hejuru hejuru gato hanyuma umanuke, shyira igiti cy'ipamba gitambitse mu buryo butambitse hejuru yigitereko cyo hagati cyijisho ryo hejuru (** hafi santimetero 1 / santimetero 0.4 hejuru y'umurongo wogosha **, kuruhande rwo hejuru hejuru yigitereko cyo hejuru hejuru yigitereko cyo hejuru.
   4. Fata umupfundikizo wo hejuru uhanamye hejuru y'urutoki ukoresheje urutoki rumwe mugihe ukoresheje ipamba ya kabiri ya ** itose ya swab ** kugirango uhanagure witonze buri kintu cyose cyera cyera cya lime cyangwa sima gifatanye na tarsal conjunctiva yijimye.
   5. Mu ishami ryihutirwa, abaganga bashiramo ibitonyanga byamaso (** proparacaine cyangwa tetracaine **), shyiramo ** Desmarres lid retractor ** kugirango ikore ** eversion ** yimbitse muri fornix yo hejuru, ivomerera hamwe na ** Morgan Lens ** yometse kuri ** 2 kugeza kuri 3 ya litiro ya Lactated Ringer cyangwa Saline isanzwe ya salitike ya EDTA ya salitike ya EDTA. impapuro za litmus ** iminota 30 nyuma yo guhagarika kuhira ** kugeza pH ikomeje kutagira aho ibogamiye kuri ** $ inyandiko {pH} 7.0 inyandiko {kugeza} 7.4 $ **.

Kugenzura Urutonde: Gukora neza hamwe na beto, Mortar, na Lime¶

• ** Wambare inkweto zidafite amazi ya Rubber hamwe namaguru yipantaro Yakuwe hejuru hejuru yinkweto (Ntabwo yigeze yinjizwa imbere) **: Gufata ipantaro yakazi imbere yinkweto zawe birema umuyoboro uyobora ibice byose bya beto itose neza neza hejuru yamaguru yawe namasogisi. Kuramo ipantaro idafite amazi * hejuru * hanze ya bote ya reberi ndende hanyuma ukande kuri cuff niba ugenda usuka cyane.
• ** Ntukigere upfukama kuri beto itose idafite amazi adafunze-Akagari ka Rubber Kneepad cyangwa Ikibaho cyo gupfukama **: Ifuro risanzwe cyangwa ifu yimyenda isanzwe unyunyuza amazi ya pH 13 ya sima muminota mike; burigihe ukoreshe ibishishwa bidafite amazi ya rubber ipfunyika ipantaro idafite amazi.
• ** Wambare Alkali-Irwanya Nitrile cyangwa Neoprene Gauntlet Gloves (Ntukigere ukora ipamba cyangwa uruhu rwo gukora) Komeza imbere ya gants yawe yumye rwose, kandi ntuzigere ukuramo uturindantoki n'intoki zipfundikijwe na sima.
• ** Bika indobo y'amazi meza yoza, Icupa rya Vinegere Yurugo Yumuryango, hamwe na Goggles z'umutekano zifunze Kuruhande rwa buri Mixer **: Gukaraba isuka ya beto itose mumaboko yawe cyangwa shine mumasegonda ** 60 ** ukurikirwa no kwoza vinegere mugufi kandi koza amazi meza birinda 100% gutwika beto.
• ** Buza Kuma Byihuse ($ inyandiko {CaO} \() cyangwa Hydrated Lime (\) inyandiko {Ca (OH)} _ 2 $) uhereye kumikino ya siporo yo kumurongo **: Ntuzigere ukoresha igihe cyihuta cyubuhinzi cyangwa lime ya masonry lime kugirango ugere kumurongo wumupira wamaguru, umupira wamaguru, cyangwa umupira wa baseball; iyo abakinyi banyerera kumurongo kumunsi wimvura cyangwa ibyuya, bahura nimpumyi za corneal lime yaka hamwe nubunini bwuzuye igikonjo / ikibero. Koresha gusa karubone ya calcium ya caustic ** $

Ibibazo bikunze kubazwa¶

Uyu munsi nasutse patio ya beto mugihe napfukamye ku gisate muri jeans yanjye. Mugihe nakuyemo ipantaro muri iri joro, uruhu hejuru y'amavi yanjye yombi ni umukara wijimye-umukara kandi wijimye, ufite ibisebe bike bikikije inkombe. Nakomerekeje amavi gusa, cyangwa iyi ni imiti yaka?¶

Ntabwo ari igikomere: wagize umubyimba mwinshi, wuzuye (urwego rwa gatatu) rwa alkaline ya chimique yaturutse kuri sima ya Portland itose (ifite pH ya 12.5 kugeza 14.0, ikomeye nkibisukura amazi meza), kandi ugomba kujya mubitaro byihutirwa byibitaro cyangwa ikigo cyaka umuriro muri iri joro. Kubera ko calcium hydroxide ishonga ibinure byuruhu ikoresheje necrosis ya liquefactique kandi ikananura imitsi yubuso hakiri kare, gutwika amavi ya beto bizwi cyane ko bitababaza kumanywa kandi bigahinduka umukara wijimye wijimye, ubururu-umukara, cyangwa ibishashara-byera nimugoroba nkuko imiyoboro yamaraso ya dermal iba yuzuye. Koza amavi yombi munsi y'amazi akonje muminota 30 ubungubu, upfundike neza wambaye neza wumye (ntukoreshe amavuta yamavuta), hanyuma ujye mubitaro kwivuza inzobere.

Ni ukubera iki ari byiza gukoresha vinegere yo mu rugo isukuye ku ruhu rwerekanwe na sima itose (nyuma yo gukaraba n'amazi), mugihe abashinzwe ubutabazi bavuga ko NTIBIGEZE gushyira vinegere kumuriro utunganya amazi (lye)?¶

Iyo umuntu asutse amavuta ya sodium hydroxide yibanze kuruhu rwabo, agasuka vinegere kumiti yibintu bitera imbaraga za acide-acide (itanga ubushyuhe) aside-fatizo ihita iteka igikomere kibisi. Hamwe na sima ya Portland itose kuruhu rudahwitse cyangwa rwarakaye cyane, ariko, WANJYE Banza ukarabe paste nyinshi ya sima munsi y'amazi menshi atemba muminota 15 kugeza kuri 20. Ndetse na nyuma yo koza amazi neza, ion ya microscopique calcium hydroxide ion ikomeza guhambirwa cyane kuri poroteyine za keratine imbere mu byobo by’uruhu rwo hanze (kugumisha uruhu pH hejuru ya 11 kugeza 12 kandi bigatera ibyiyumvo bidatinze). Muri make kwoza uruhu rwogejwe hamwe na vinegere yera yo murugo (5% acide acetike ivanze 50:50 n'amazi) byangiza neza ibyo bisigazwa bya alkaline bisubira kuruhu rusanzwe pH (5.5 kugeza 7.0) bidatanga ubushyuhe, hanyuma bigakurikirwa no kwoza amazi yanyuma. Ntuzigere ushyira vinegere mumaso cyangwa kubikomere byimbitse.

Kuki umuganga wamaso yakomeje guhumura ijisho ryumugabo wanjye isaha imwe mubitaro nubwo tumaze kwoza plaque murugo muminota 15?¶

Ibice bikomeye bya lime (calcium oxyde cyangwa calcium hydroxide ya calcium), plaster, na minisiteri ntibishobora gushonga mumazi kandi bigacumbika imbere mumifuka yiziritse munsi yijisho ryo hejuru no hepfo (fornices conjunctival). Ndetse nyuma yiminota 15 yubuso bwogejwe murugo, microscopique yera yera ya lime yafashwe munsi yijisho ryo hejuru ikomeza gushonga buhoro buhoro muri firime yamosozi, bigatuma pH yijisho isubira kumpumyi 12.5 cyangwa 13.0 ukimara guhagarika gusuka amazi. Mu bitaro, abaganga byihutirwa bacecekesha ijisho, bahindura umubiri (kabiri-burigihe) ijisho ryo hejuru hejuru ya retractor kugirango bakureho buri kintu cyose cyafashwe na lime grit grit, hanyuma bavomerera ubudahwema na litiro 2 kugeza kuri 3 za saline kugeza umurongo wa pH ushizwe mumaso nyuma yiminota 30 nyuma yo guhagarika kuhira byerekana ko amarira arira atagira aho abogamiye kuri pH 7.0 kugeza 7.4.

• Aka gatabo kagamije amakuru kandi ntigasimbuza isuzuma ryubuvuzi bwumwuga, ubuvuzi bwamaso bwihutirwa, cyangwa amahugurwa y'intoki. Turasaba cyane ko twakwiga amasomo yambere yubufasha bwemewe binyuze muri federasiyo mpuzamahanga ya Croix-Rouge n’umuryango utabara imbabare Croix-Rouge (IFRC), umuryango w’umuryango utabara imbabare Croix-Rouge, St John Ambulance, cyangwa umutanga w’umutekano wemewe.

Inkomoko yagenzuwe¶

• Ubuyobozi bushinzwe umutekano n’ubuzima (OSHA, Amerika): * Kurinda ibibazo byuruhu gukorana na Portland Cement (OSHA Guidance Document & Pocket Guide) *.
• Ikigo cy’igihugu gishinzwe umutekano n’ubuzima (NIOSH, Amerika) & Ibigo bishinzwe kurwanya no gukumira indwara (CDC): * NIOSH Pocket Guide y’ingaruka z’imiti: Portland Cement, Oxide ya Kalisiyumu (Quicklime), na Kalisiyumu Hydroxide (Hydrated Lime) *.
• Ishyirahamwe ryabanyamerika ryatwitse (ABA): * Igitabo Cyiza cyo Gutwika Ubuzima (ABLS) Igitabo gitanga: Ubuyobozi bwa Alkali, Sima, na Ocular Chemical Burns *.
• Umuyobozi w’ubuzima n’umutekano (HSE, Ubwongereza): * Urupapuro rwamakuru yubwubatsi CIS26: Sima (Alkali Burns na Hexavalent Chromium Dermatitis Gukumira) *.
• Royal College of Ophthalmologistes & American Academy of Ophthalmology (AAO): * Ubuyobozi bwihutirwa bwo gukomeretsa Acute Ocular Chemical (Alkali na Lime) *.

Kuyobora¶

• Acide Hydrofluoric, gukuramo ingese, hamwe n’imiti yaka inganda
• Gutwika bikabije no gutembera uruhu rwa chimique
• Gukomeretsa kw'amaso no kuhira amaso
• Igishyushye gishyushye, asfalt, hamwe na shitingi yatwitse (protocole yo gukuraho bitumen)
• Imibare yihutirwa ukurikije igihugu