I-Concrete emanzi (i-Cement) i-Alkali itshiswa kunye nokulimala kothuli lwe-Lime¶

Nokuba ugalela isilabhu sepatio yangasemva kwemini ngoMgqibelo, ubeka udaka lwezitena, ugalela istucco okanye udaka, okanye usasaze ikalika yezolimo kwibala okanye kwibala lezemidlalo, ukusebenza nge-Portland isamente, ikhonkrithi emanzi, udaka lwemasonry, ikalika enehydrated, kunye ne-quicklime eyomileyo (icalcium oxide, \(\text{CaO}\))* iveza eyona ntsholongwane iyingozi emehlweni ukwakhiwa nokuphuculwa kwekhaya. Umzuzu wamanzi uxutywe kwi-powder ye-samente eyomileyo yasePortland (equlethe ** i-60 ipesenti ukuya kwi-65 ipesenti ye-calcium oxide ngobunzima *), i-chemical hydration reaction iguqula i-powder ibe yisisombululo esigcweleyo se-calcium hydroxide ($\text{Ca(OH)}_2 \()**, kunye ne ** i-sodium hydroxide (\)\text{NaOH}) i-hydroxide ye-potassium, i-$ hydroxide, i-$ , i-$ hydroxide, i-$ . ialkalinity yekhonkrithi emanzi ukuya kuthi ga kwi-caustic ekrakra \(\text{pH ye-12.5 ukuya kwi-14.0}\), uluhlu lwe-pH olufanayo njengesivuli se-drain yolwelo kunye nesicoci se-oveni.

Ngokungafaniyo nokutsha kwe-thermal okanye ukutshiza kwe-acid-acid ehlaba kwangoko kwaye ikunyanzele ukuba ubuyisele isandla sakho emva, ikhonkrithi emanzi yinto efihlakeleyo, isinyibiliki sezicubu ezithe cwaka: kuba ialkaline calcium hydroxide iqala yenza i-alkaline calcium hydroxide ithobe iziphelo zemithambo-luvo yolusu ngelixa ithambisa amanqatha esikhumba kwisepha (liquefactive necrosis), umntu oguqe ngamadolo, oguqa ngamadolo rhoqo okanye aguqe ngamadolo. batshiza phantsi phezulu kwiibhutsi zabo zokusebenza, bahlala beziva ** iintlungu eziziro kwiiyure ezi-2 ukuya kwezi-6 zokuqala**. Kuphela emva kokugqiba umsebenzi kunye nokukhulula ibhulukhwe okanye iibhutsi zabo ngexesha lesidlo sakusihlwa bafumanisa ukuba ulusu kwii-kneecaps zabo, i-shins, okanye i-ankle lunyibilikisiwe lwaba ngu- *ubunzulu, obumfusa-omnyama okanye omhlophe-omhlophe okwesithathu-iqondo lesithathu eligcweleyo lokutshisa imichiza yokutshisa ** efuna ukuchithwa kotyando kunye nokwahlula-ukutyeba kwesikhumba. Intlekele elinganayo kukuchaphaza kwe uthuli lwekalika, udaka, okanye udaka olumanzi kwiliso, apho ii-ion zehydroxide zingena kwikhonea nge-ngaphantsi kwe-15 ukuya kwimizuzwana engama-60 ngelixa amasuntswana ekalika aqinileyo aqinileyo ehlala nzulu ngaphantsi kwejwabu lenkophe eliphezulu (i-conjunctival ephezulu yeliso ngaphandle kokuba i-fornix yesiqhelo iqhubeleka nonwebu lwamanzi), Ujijelwe ngaphakathi ngaphakathi kwaye utshayela wacoceka.

Esi sikhokelo esibanzi sinika inyathelo-nge-nyathelo lokucoca intsimi, "i-Dry Powder Brush-Off Rule" ye-quicklime, i-pH ye-buffering protocols emva kokuhlamba, kunye nokunkcenkceshela okungxamisekileyo kwe-ocular kunye nobuchule be-eyelid-eversion ehambelana ne-United States yoKhuseleko lwezeMisebenzi kunye noLawulo lwezeMpilo (OSHA), iNational Institute for Occupational Safety / Ukhuseleko lwe-UK kunye neMpilo (i-CDC) yaseMelika (HSE), kunye neKholeji yaseRoyal of Ophthalmologists.

Yenza oku ngoku¶

Ukuba wena okanye umntu osondeleyo unekhonkrithi emanzi, udaka, i-grout, i-stucco, okanye i-lime powder eyomileyo eluswini, efakwe kwiimpahla zabo okanye kwiibhutsi, okanye efafazwe emehlweni abo:

1. Ngayo nayiphi na ikalika, isamente, udaka, okanye iPlasta elisesweni: Qalisa ukugungxuza ngemizuzwana eli-10 kwaye ujike inkophe:
2. Sukulinda ukuba uqhube ukuya esibhedlele phambi kokuba uhlambe iliso: Ialkali ingena kwikhonea yomntungaphantsi kwemizuzwana engama-30. Ngoko nangoko bamba iinkophe zivuleke kakhulu ngeminwe yakho kwaye ugungxule iliso ngokuqhubekayo ngomjelo othambileyo wamanzi etephu adikidiki, amanzi asebhotileni, okanye ityuwa eqhelekileyo engenazintsholongwane (okanye iDiphoterine isisombululo se-amphoteric ukuba sikwisiza) kangange ubuncinane bemizuzu engama-30 ukuya kuma-60 epheleleyo.
3. Susa iilensi zoqhagamshelwano ngoko nangoko njengokuba uqala ukugungxula.
4. Tshayela iziqwenga zekalika eziqinileyo ezivaleleke ngaphantsi kweenkophe: Ngenxa yokuba iimvuthuluka eziqinileyo zekalika, udaka, okanye udaka zifihla ngaphakathi kwimiphetho enzulu ngaphantsi kweenkophe ezingaphezulu nezisezantsi kwaye zinyibilike kancinane zibe yi-alkali entsha ye-\(\text{pH } 13\) yealkali kangangeeyure, tsala isiciko esisezantsi ezantsi kwaye *flip (rhoqo) uhlangulo olungaphezulu lwekhuko lekhuko phezu kwesikhuseli somqhaphu susa onke amachaphaza amhlophe egrit evalelekileyo enomqhaphu omanzi ngelixa uqhubeka nokunkcenkceshela kwindlela eya kwisebe likaxakeka (bona ukwenzakala kwamehlo).
5. Sebenzisa i-"Dry Powder Brush-Off Rule" PHAMBI Kokuvula Amanzi eSamente eyomileyo okanye i-Quicklime kwiSkin:
6. Ukuba iingalo zakho, intamo, okanye iingubo zakho zifakwe kwi- ** Umgubo we-samente oYOMILEYO, umxube wodaka olomileyo, okanye i-quicklime eyomileyo (i-calcium oxide, i-$\text{CaO} $)**, ** khulula iimpahla ezinothuli kwaye uGQUBE ngobunono okanye uvuthulule umgubo obomileyo ngokusemandleni ngelaphu elomileyo okanye ibrashi ethambileyo PHAMBI kokusebenzisa amanzi **.
7. Ukongeza intwana yamanzi (okanye ukubila) ngokuthe ngqo kumaleko ashinyeneyo we quicklime eyomileyo ibangela ubundlobongela exothermic hydration reaction (\(\text{CaO} + \text{H}_2\text{O} \rightarrow \text{Ca(OH)}_2 +\text{Ubushushu obuqatha ukuya kuthi ga kwi} 150^\circ} 300^\circ\text{F}\)) epheka ulusu lwakho ngokushushu ngaxeshanye kanye ipH 13 alkali iyinyibilikisa ngokwekhemikhali.
8. Khulula ibhulukhwe ekhonkrithi, iikawusi, iibhutsi, iigloves, kunye neringi ngoko nangoko:
9. Lo mzuzu ikhonkrithi emanzi itshiza emadolweni ebhulukhwe okanye ichilele phezu kweebhutsi zakho zokusebenza, yeka ukusebenza kwangoko. Khulula ibhulukhwe emanzi, iikawusi, iibhutsi, iwotshi, neringi zeminwe ngoko nangoko. Ungaze uqhubeke usebenza kwimpahla emdaka ngekhonkrithi "enye nje imizuzu engama-30 ukugqiba ukubhuqa isilabhu."
10. Khukula ulusu ngoMqulu oPhezulu waManzi aBalekayo kangangemizuzu engama-30 ukuya kuma-60 egcweleyo:
11. Emva kokuba umgubo owomileyo ukhutshiwe kwaye iimpahla ezimanzi zekhonkrithi zisusiwe, gubha ulusu phantsi komlambo onamandla, oqhubekayo wamanzi epompo apholileyo okanye umbhobho 30 ukuya kwimizuzu engama-60 de yonke imvakalelo ebhityileyo, enesepha iphele eluswini.
12. Sebenzisa i-pH ephakathi okanye isepha engamanzi eneasidi encinci (ungaze ube rhabaxa izikhuhla zepumice ezirhabaxa, ezikhuhla i-epidermis ebuthathaka).
13. Ukhetho lweVinega yasekhaya yaseSekondari yoKhenketho Kulusu Olungaguqukiyo/olungaphezulu (KUPHELA Emva kokuvaswa kwamanzi ngokucokisekileyo):
14. Ngokungafaniyo nolwelo oluxutyiweyo lwe-sulfuric acid okanye i-lye (apho ukugalela i-neutraizer eyomeleleyo kwikhemikhali eluhlaza kubangela i-spike yokushisa exothermic), i-dermatology yomsebenzi kunye nezikhokelo zokhuseleko lolwakhiwo (kubandakanywa ne-OSHA i-bulletin yokhuseleko lwekhonkrithi kunye neeprothokholi ze-samente ezitshisayo) qaphela ukuba ** emva kokugungxula yonke isamente ebonakalayo esikhumbeni ngamanzi asebenzayo ngemizuzu eyi-15 okanye i-dabbrin0. ikhonkrithi-evezwe isikhumba nge ** dilute iviniga yasekhaya emhlophe (5 ekhulwini acetic acid) diluted 50:50 ngamanzi ** (okanye buffered phosphate/amphoteric rinse) inceda neutralize anenkani alkaline calcium hydroxide ions (\(\text{pH} 13\)) ebotshelelwe ngaphakathi kwi-stratum yangaphandle ye-corneum i-rinse epholileyo yamanzi. (UNGAZE ubeke iviniga emehlweni okanye kumanxeba anzulu avulekileyo akrwada).
15. Yiya kwiSebe leSibhedlele likaNgxamiseko okanye iziko elitshileyo ngalo naluphi na uBusu obumfusa, obuMnyama, obuMhlophe, okanye obunamadyungudyungu:
16. Ngenxa yokuba ikhonkrithi emanzi ibangela i-full-full-thickness liquefactive necrosis ekhangeleka ngokukhohlisayo ithe tyaba okanye igruzukile ngomhla woku-1, nakuphi na ukutsha kwekhonkrithi emadolweni, ezinqeni, emaqatheni, okanye kwizandla ezibonisa umbala oluhlaza-mfusa, ubundisholo obumthukuthezi, amadyungudyungu, okanye izilonda zifuna ukuzivavandlaka kwangoko esibhedlele.

Ikhonkrithi engxamisekileyo, isamente, kunye netshati yetriage yekalika¶

flowchart TD
    Start["Ukubonakaliswa kwi-Concrete emanzi, i-Portland Cement, i-Mortar, i-Plaster, okanye i-Quicklime"] --> SiteCheck{"Kwenzeke phi ukutyhileka?"}

    SiteCheck -->|Eye Splash: Lime Dust, Wet Mortar, Concrete,<br/>Plaster, or Whitewash in the Eye| EyeUrgent["INGXAKEKILEYO YOKWENENE YASEMVA (I-Cornea ingene kwi-<30 Seconds)<br/>1. Qalisa ukugungxulwa ngamanzi adikidiki/alinetyuwa NGAPHAKATHI KWEMIZUZWANA eli-10<br/>2. Susa iilensi zoqhagamshelwano; bamba iinkophe zivuleke ngokubanzi ngokuchasene ne-blepharospasm<br/>3. Ukunkcenkceshela ngokuqhubekayo kangange-30 ukuya kwi-60 IMIZUZU EGCWELE<br/>4. YENZA NGAMANDLA OKUPHAMBILI KWEEYELID EVERSION: Jikuzisa iziciko eziphezulu nezisezantsi ukuze utshabhise ngaphandle<br/>zonke iindawo eziqinileyo ezimhlophe zekalika ezibanjiweyo/igrit yesamente evela kwi-fornices<br/>5. UThutho oluya kwiSebe eliNgxamisekileyo lokunkcenkceshela kweMorgan Lens kude kube ukukrazula pH = 7.0-7.4"]

    SiteCheck -->|Skin / Clothing Exposure:<br/>Hands, Knees, Shins, Ankles, or Arms| DryVsWet{"Ngaba ikhemikhali esikhumbeni Umgubo o-DRY okanye i-WET slurry?"}

    DryVsWet -->|Dry Powder: Dry Quicklime (CaO),<br/>Dry Portland Cement, or Dry Mortar Mix| BrushFirst["INYATHELO LOKU-1 (UMGAQO WEPOWDER OYOMILEYO): Khulula impahla enothuli & YISHUSHULE<br/>yonke umgubo owomileyo ngetawuli eyomileyo/ibrashi PHAMBI kokufaka amanzi<br/>(Ithintela i-150°C exothermic hydration ubushushu kwisikhumba esibilayo)"]

    DryVsWet -->|Wet Slurry: Wet Concrete, Mortar, Grout,<br/>Stucco, or Concrete-Soaked Pants/Boots| StripWet["INYATHELO 1: Yeka ukusebenza ngoko nangoko. Hlulisa ibhulukhwe efakwe ikhonkrithi, iikawusi, iibhutsi, iiglavu, iiwotshi, neringi zeminwe."]

    BrushFirst --> WaterFlush["INYATHELO LESI-2: Ulusu lwesikhukula olunomthamo ophezulu wamanzi abalekayo apholileyo kangange-30 ukuya kwi-60 IMIZUZU<br/>de yonke i-slimy, imvakalelo enesepha (amafutha ane-saponified) iphelile"]
    StripWet --> WaterFlush

    WaterFlush --> VinegarStep["INYATHELO LESI-3 (Ulusu Kuphela - UNGASOZE Amehlo): Emva kwemizuzu eyi-15-20 yokugungxulwa kwamanzi,<br/>hlambulula ulusu oluvezwe ngesamente ngokufutshane ngeviniga emhlophe yasekhaya exutyiweyo<br/>(5% yeacetic acid exutywe 1:1 namanzi) ukunqanda intsalela pH 13 alkali,<br/>uze ugungxule enye imizuzu eyi-12 ngamanzi abalekayo."]

    VinegarStep --> DepthEval{"Vavanya inkangeleko yesikhumba (Ngoku kwaye kwiiyure ze-4-12): <br/>Ngaba kukho ibala elimfusa / eliluhlaza okwesibhakabhaka / elimnyama, ukuba ndindisholo okumhlophe,<br/>amadyungudyungu, okanye iintlungu ezibuhlungu ezinzulu?"}

    DepthEval -->|Yes: Discoloration, Blisters, or Kneeling/Boot Burn| BurnUnit["YIYA KWIZIKO LOKUTSHISWA ESIBHEDLELE NGOKUNGOKO<br/>Ikhonkrithi emanzi ibangela ukuba cwaka kwe-3-degree full-thickness liquefactive necrosis<br/>efuna uqhaqho kwangoko olucinyiweyo kunye nokufakwa kwesikhumba"]
    DepthEval -->|No: Only mild dry redness ("I-Cement Dermatitis")| DermCare["Faka i-cream emollient engenavumba elimnandi; beka iliso elibukhali ngaphezu kweeyure ezingama-24<br/>(Fumana ukhathalelo lwezonyango ukuba izilonda ezilibazisekileyo, ukwaliwa kwe-chrome, okanye iintlungu ziyavela)"]

I-Pathophysiology: I-4-Fold Mechanism ye-Cement kunye nokutshatyalaliswa kweLime¶

Kutheni le nto ikhonkrithi emanzi okanye ikalika iyonakalisa kakhulu ulusu lomntu kunye namehlo kuneasidi yoxinaniso olulinganayo? Iindlela ezine ezihlukeneyo zeekhemikhali kunye nezomzimba zihlasela umzimba ngaxeshanye:

1. IAlkalinity egqithisileyo (\(\text{pH } 12.5\text{ ukuya ku}14.0\)) kunye neLiquefactive Necrosis¶

Isamente eyomileyo yasePortland iveliswa ngokufudumeza ilimestone kunye nodongwe kwiziko ukwenza i-anhydrous calcium silicates kunye ne calcium oxide (ikhawulezayo, \(\text{CaO}\)), ecaleni komkhondo i-sodium oxide (\(\text{Na}_2\text{O}\)) kunye ne **potassium oxide (\(\text*{K}\)) Amanzi angoko nangoko ayongezwa:

• I-Liquefactive Necrosis kunye ne-Saponification: Ngokungafaniyo ne-acids ezomeleleyo (ezidibanisa iiproteni ezingaphezulu kwi-eschar crust ethintela ukungena nzulu kwe-asidi), ii-ion ze-hydroxide zasimahla (\(\text{OH}^-\)) kwikhonkrithi emanzi i-saponify i-fatty acids kwi-membrane yeseli yomntu (ukuguqula eyakho i-protein ye-liquid yolusu ibe yi-collagen ye-protein yolwelo) iiprotheyini zealkaline ezinyibilikayo.
• Kutheni iConcrete ivakala "iMtyibilizi okanye isepha" ngeminwe yakho: Xa abasebenzi bokwakha beva ifilim egudileyo, imtyibilizi, enesepha kwiminwe yabo engenanto ngelixa bebamba udaka olumanzi, **loo filimu imtyibilizi AYIYOsepha kwisamente: ngumaleko wangaphandle wolusu walowo usebenzayo.

2. Ubushushu obugqithiselekayo bokuGcinwa kwamanzi (I-Quicklime Thermal Burn)¶

Xa i-quicklime eyomileyo (i-calcium oxide, i-\(\text{CaO}\)) okanye uthuli lwesamente oluphezulu lwekalika ludibana nombilo ngaphakathi kwekhola yehempe, ikawusi, okanye ibhuthi, okanye igalelwe ngamanzi amancinane, i-exothermic slaking reaction ikhupha 65.2 kilojoules ngemole (\(1,140\text{kilojoules)* ngekhilogram* nganye yobushushu. Umaleko oshinyene womileyo owomileyo omanziswe kukubila esikhumbeni somsebenzi unokufikelela kumaqondo obushushu e **\)80^\circ\text{C}\text{ ukuya ku-}150^\circ\text{C}$ (\(176^\circ\text{F}\text{ ukuya }302^\circ\text{F}\)) phezu kokutshisa i-pH ekunene, phezu kokutshisa i-pH ukutshisa.

3. I-Hygroscopic Desiccation (i-Cellular Dehydration)¶

Isamente eyomileyo neyinyangayo inoburhalarhume ihygroscopic: icrystalline calcium silicate hydrate matrix ifunxa amanzi kuyo yonke into eyichukumisayo ukuze inyange kwaye yenze lukhuni. Xa i-samente emanzi okanye eyomileyo ihlala eluswini lomntu, itsala amanzi e-intracellular kanye ngaphandle kwe-epidermal kunye neeseli ze-dermal, i-desiccating kunye nokunciphisa izicubu ngelixa igxininisa i-alkaline pore fluid.

4. iMechanical Aggregate Abrasion + Hexavalent Chromium (\(\text{Cr}^{6+}\)) Uvakalelo¶

• UkuSila kweSanti kunye neAggregate: Ikhonkrithi emanzi kunye nodaka zipakishwe ngesanti ebukhali yequartz kunye neaggregate yamatye atyunyuziweyo. Xa ikhonkrithi emanzi ingena ngaphakathi ebhuthini okanye ingena ngamadolo ejini yedenim, inyathelo ngalinye okanye ukutshintshwa kwamadolo kufana nephepha lesanti elirhabaxa, ukusila ngomatshini umqobo okhuselayo we-corneum stratum kunye nokuvula imijelo emincinci ethe ngqo ye-pH 13 calcium hydroxide ukuze ikhukulise ngqo kwi-dermis enzulu.
• I-Chromium eneHexavalent (\(\text{Cr}^{6+}\)) I-Allergic Qhagamshelana neDermatitis: Izinto zendalo ezikrwada kunye nentsimbi yokusila ishiya umkhondo wokunyibilika kwamanzi i-chromium enehexavalent (\(\text{Cr}^{6+}\)) kwi-Portland cement efunekayo (ngaphandle kokuba i-fertilizer ye-samente ifunwa yi-EU). Ngaphezulu kokutyhileka okuphindaphindiweyo, \(\text{Cr}^{6+}\) igqobhoza ulusu olonakeleyo lwealkali ukuze ibangele ubukhali, obungapheliyo, ukudumba aleji yesamente dermatitis ("i-bricklayer's itch") kunye ne-punched-out "izilonda ze-chrome."

Ukuthelekiswa kweSement, Concrete, Mortar, kunye neengozi zeLime¶

Ukuntywila nzulu 1: Kutheni ukutshiswa kweConcrete eManzi kujongeka ngathi "Imivumbo engenabungozi" ngoSuku loku-1 (Inqanaba leKlinikhi)¶

Omnye wemigibe eyingozi kakhulu kwiyeza likaxakeka kukuba ** ukutyeba okupheleleyo (i-third-degree) ukutshiswa kwe-alkali kwikhonkrithi emanzi AKUBONI njengedangatye okanye ukutshisa okutshisa xa isigulane siqala ukukhulula ibhulukhwe okanye iibhutsi zabo **:

1. Iiyure 0 ukuya ku-4 (Isigaba sesepha eNani):
2. Ngelixa ikhonkrithi emanzi intywila emadolweni ejini yabasebenzi okanye ijuxuzekile ngaphakathi kweebhutsi zabo, ulusu luziva lushushu kancinci okanye lurhawuzelelwa kancinci, luze luhambe numb njengoko i-pH 13 ye-hydroxide ion itshabalalisa imithambo-luvo ye-epidermal engaphezulu. Ukuba umsebenzi uyihlamba kwimizuzu eli-15, kuphela bubomvu obuphakathi okwenzekayo. Ukuba bayishiya ivuliwe iiyure ezi-2 ukuya kwezi-6, ukunyibilika okugcweleyo kuyaqhubeka.
3. Iiyure 4 ukuya 12 (I "Purple Bruise" Misdiagnosis Trap):
4. Xa umqeshwa ekhupha i-jean eqinile, ekhonkrithi okanye iikawusi kwi-6: 00 PM, ulusu phezu kwee-kneecaps okanye amaqatha ahlala ekhangeleka ** emnyama emfusa, i-violaceous, i-dusky blue, okanye i-brownish-black **, ngamanye amaxesha ijikelezwe ngendandatho ebomvu okanye i-blisters enzulu, okanye i-patch ye--dead-white numb, leathe.
5. Izigulana ezininzi zicinga ukuba: * "Ndivele ndagruzuka amadolo ngenxa yokuguqa kwikhonkrithi eqinileyo imini yonke," * ndize ndilale emva kokuthambisa okanye i-oint-the-counter antibiotic.
6. Enyanisweni, eso siqwenga simnyama simfusa okanye esimhlophe sityhutyha imithambo yegazi engaphantsi komhlaba ngaphantsi kwedermis efileyo ngokupheleleyo, i-saponified full-thickness dermis. Ngenxa yokuba i-calcium hydroxide eqinileyo ihlala ivaleleke ngaphakathi kwiifollicles zeenwele kunye ne-liquefied dermis, ukutsha kweekhemikhali kuyaqhubeka ukutya nzulu kumafutha angaphantsi kwesikhumba ubusuku bonke ngelixa isigulana silele.
7. Iiyure ze-12 ukuya kwi-48 (Ukuvuswa ngeentlungu eziNzululwazi eziNzulu kunye ne-Eschar Ulceration):
8. Ngobusuku okanye ngentsasa elandelayo, njengoko ukutshiswa kwe-alkali kufikelela kwimicu yentlungu enzulu kwi-subcutaneous tissue kunye ne-periosteum, isigulane sivuka nge-**intlungu enzulu, evuthayo, ehlabayo **, ukudumba, kunye nokulila izilonda ze-necrotic ezigqunywe yi-gray-black okanye i-yellow-white-soapy eschar.
9. Kutheni iZiko kwaEarly Burn iMiba yoNxibelelwano: Ngenxa yokuba utshintsho olululo lwendlela yokunxiba ekutshisweni kwekhonkrithi enzulu luthatha iiveki ** ezi-6 ukuya kwezili-12** ukuthoba izicubu ze-alkaline ezifileyo kwaye kushiye izibazi ezikhubazayo zamadolo kunye noqhagamshelo oludityanisiweyo, amaziko okutshisa akhethekileyo enza **ukucatshulwa kwangoko okuthe kratya kunye nokwahlulwa kolusu, ukuhluma kolusu olu-3.

I-Deep Dive 2: Ikalika kunye ne-Cement Izitshizi zamehlo (I-Eversion ye-Eyelid ephindwe kabini kunye ne-Limbal Stem Cell Rescue)¶

Kwi-ophthalmology, ** i-ocular splash ye-lime (i-calcium oxide okanye i-calcium hydroxide), udaka olumanzi, i-plaster, okanye ikhonkrithi ithathwa njengenye yezona zinto zingxamisekileyo kuwo wonke amayeza **, imbi kakhulu kunokuchaphaza kwe-asidi yebhetri.

1. Kutheni iLime inyibilikisa iCornea kwaye ibangela ubumfama obusisigxina ("Iliso elimhlophe lePorcelain")¶

• 15-Ukungena kweSecond: Ngelixa iasidi itshiza iproteni engaphezulu komhlaba kwi-corneal epithelium kwaye icothise ukungena kwayo, i-alkaline hydroxide ion (\(\text{OH}^-\)) ikhupha i-cell membranes ye-corneal epithelium kwi mizuzwana, inyibilikisa i-glycocorneal substance ye-straightmane ye-glycorneti ye-glycornet kunye ne-straightmant peminoosa kwi ** igumbi langaphambili leso ngaphakathi kwe-15 ukuya kwi-60 imizuzwana **, ukutshabalalisa i-lens (ebangela i-cataracts ngokukhawuleza) kunye ne-trabecular meshwork (ebangela ubukhali ** i-alkali glaucoma yesibili **).
• I-Limbal Stem Cell Ischaemia (I-"White Eye" Trap): Okumangalisayo kukuba, iliso elitshiswe ngekalika apho indawo emhlophe yeliso (i-sclera kunye ne-conjunctiva ejikeleze i-cornea) ibonakala ** i-marble-white kwaye ingenagazi ** isengozini enkulu kakhulu yokungaboni ngokusisigxina** kuneliso elikhangeleka libomvu eliqaqambileyo kunye negazi:
• Iliso elibomvu eliqaqambileyo lisenayo imithambo yegazi ephilayo eqhola i-corneal limbus (i-1-to-2-millimeter ring ejikeleze umda we-cornea apho zonke i-*limbal epithelial stem cells ** zihlala khona).
• A i-blanched, porcelain-white sclera/limbus ithetha ukuba i-pH 13 yealkali iye yajiya ngokupheleleyo kwaye yatshabalalisa imithambo yegazi etyisa i-limbal stem cells (limbal ischemia). Ngaphandle kweeseli ze-limbal stem kunye nokunikezelwa kwegazi, i-cornea inyibilika nge-collagenase enzymes (**i-sterile corneal ulceration kunye ne-perforation ), okanye iba yi-opaque ngokusisigxina kunye ne-scarred ( Roper-Hall / Dua Grade IV ocular burn **).

2. INqanaba-ngeNqanaba loMmandla kunye neProtocol yokuHlangula kwamehlo esibhedlele¶

1. Unkcenkceshelo oluQhubelekayo olukhawulezileyo (Qala kwiNdawo yeNdawo kwiSekhondi ezili-10):
2. Musa ukuphulukana nemizuzu engama-20 xa uqhuba ukuya kwikliniki yokhathalelo olungxamisekileyo nekalika isahleli emehlweni. Sebenzisa owona mthombo ukufuphi wamanzi acocekileyo ngoko nangoko: isikhululo sokuhlambela amehlo, inkonkxa yeDiphoterine, amanzi asebhotileni, umbhobho wegadi kuxinzelelo oluphantsi, isitshizi sesinki ekhitshini, okanye ishawa.
3. Bamba iinkophe ngokwahlukeneyo ngobhontsi wakho kunye nomnwe wesalathisi (ucinezela ungqameko lwe-orbital emathanjeni, ungaze ucinezele inkophe yeliso ngokwalo ukuba kukho ukwenzakala okurhanelwayo) kwaye ugungxule ukusuka kwikona yeempumlo ukuya ngaphandle ngokuqhubekayo malunga** nemizuzu engama-30 ukuya kuma-60**.
4. Uyenza njani iEversion ye-Eyelid ePhezulu ukukhupha amasuntswana eLime aBanjiweyo:
5. Kutheni ugungxulo lwamanzi alula lungasileli ukuba utsiba eli nyathelo: Udaka lwekalika, udaka, kunye nesamente* zinyibilika kancinane emanzini**. Iimvuthuluka ezimhlophe eziqinileyo zecalcium hydroxide zicudiswa phezulu kwi superior conjunctival fornix (ipokotho enzulu ye-cul-de-sac ephezulu phantsi kwenkophe ephezulu) xa ixhoba licudisa iinkophe zalo zivaleleka ngenxa yeentlungu. Nokuba usebenzisa iilitha ezi-5 zesaline ngaphambili kwibhola yeliso, ezo ngqalutye zimhlophe ezibambileyo zekalika ngaphantsi kwesivalo esingaphezulu zisebenza njenge ikhuphoni ecothayo pH 13 yedepho yealkali, igqobhoza ngokuqhubekayo iiyoni zehydroxide kwicornea iiyure.
6. Inyathelo ngeNyathelo lokuTshayela iNkophe:
   1. Tsala i-eyelid engezantsi phantsi ngelixa ucela ixhoba ukuba lijonge phezulu, kwaye usebenzise i-i-cotton-tip applicator efumileyo (Q-tip) okanye ikona yepedi ye-gauze eyinyumba emanzi ukuze itshayele ngobunono nayiphi na igrit emhlophe okanye intlama yesamente engwevu ephuma kwipokotho yesivalo esisezantsi.
   2. Cela ixhoba ukuba lijonge ngqo ezantsi ngasezinyaweni zalo (ekhulula isihlunu se-levator sesiciko esingaphezulu).
   3. Bamba i-inkophe eziphezulu* ngobunono phakathi kobhontsi wakho kunye nomnwe wesalathisi, tsala inkophe yangaphezulu kancinci phambili nasezantsi, beka ishafti yeswab yomqhaphu ngokuthe tye ngaphaya kombindi wenkophe yangaphezulu (**malunga ne-1 centimeter / 0.4 intshi ngaphezulu komgca we-Lash , kumda ongaphezulu wepleyiti eqinileyo phezu kwentloko ishafti njengokuphekuza ikofu ngaphakathi ngaphandle.
   4. Bamba isiciko sangaphezulu esijingiwe ebunzi ngomnwe omnye ngelixa usebenzisa okwesibini umqhaphu weswab omanzi ukosula ngobunono wonke umsonto omhlophe obonakalayo wekalika okanye isamente encanyathiselwe kunwebu olupinki olungaphakathi lwetarsal.
   5. Kwisebe elingxamisekileyo, oogqirha bafaka i-anesthetic eye drops (**proparacaine okanye i-tetracaine **), faka i- Desmarres lid retractor ** ukwenza ** i-double eversion ** inzulu kwi-fornix ephezulu, ukunkcenkceshela nge-Morgan Lens ** eqhotyoshelwe kwi- ** 2 ukuya kwi-3 Litha ye-Lactated Ringer to diso ED Isisombululo se-Lactated Ringer * ED okanye i-Normal ye-Ringer to diso i-Normal ye-Saline ye-ED * okanye i-Noral chelate calcified lime plaques), kwaye khangela ifilimu yokukrazula ngephepha le-litmus imizuzu engama-30 emva kokuyeka ukunkcenkceshela de i-pH ihlale ingathathi hlangothi kwi-\(\text{pH} 7.0\text{ ukuya ku-}7.4\).

Uluhlu loThintelo loThintelo: Ukusebenza ngokuKhuselekileyo ngeConcrete, iMortar, kunye neLime¶

• Nxiba iiBhutsi zerabha ezingangenwa ngamanzi ezinemilenze yebhulukhwe Etsalwe PHEZU KWEMANDLA EZIBHUTILEYO (Ayizange ifakwe Ngaphakathi): Ukuqhobosha ibhulukhwe yokusebenza ngaphakathi kweebhutsi zakho kwenza ifanitshala ekhokela ukuchaphaza kwekonkile emanzi ngokuthe ngqo ezantsi emaqatheni nakwiikawusi zakho. Tsala ibhulukhwe engangenwa manzi ngaphaya ngaphandle kweebhutsi zerabha eziphezulu kwaye uteyiphe icuff ukuba ingena emanzini anzulu.
• Ungaze Uguqe KwiConcrete eManzi Ngaphandle kweeRubber ezivaliweyo zeSeli zeRubber zamadolo okanye ibhodi yokuguqa: Ugwebu oluqhelekileyo okanye izigubu zelaphu zifunxwa nge-pH 13 yamanzi esamente ngemizuzu; soloko usebenzisa iipads zerabha ezingangeni manzi phezu kweeblukhwe ezingangeni manzi.
• Nxiba iiglavu zeNitrile eziFanayo eziTight-Fitting Alkali okanye iigloves zeNeoprene Gauntlet (Ungaze umqhaphu okanye iigloves zesikhumba zisebenze): Iiglavu zomqhaphu kunye nesikhumba zifunxa amanzi e-alkaline yesamente kwaye uwabambe emaqupheni akho imini yonke. Gcina ngaphakathi kwiiglavu zakho zome ngokupheleleyo, kwaye ungaze ukhulule iglavu ngeminwe egqunywe ngesamente.
• **Gcina iBhakethi laManzi acocekileyo okucoca, iBhotile yeVinegar emhlophe yasekhaya, kunye neGoggles etywiniweyo yoKhuseleko ecaleni kweMixer nganye **: Ukuhlamba i-splash yekhonkrithi emanzi ezandleni zakho okanye kwi-shins ngaphakathi ** imizuzwana engama-60 ** ilandelwa yi-dilute i-vinegar emfutshane kunye nokuhlamba kwamanzi acocekileyo kuthintela i-100 ipesenti yokutsha kwekhonkrithi.
• Ban Dry Quicklime (\(\text{CaO}\)) okanye Hydrated Lime (\(\text{Ca(OH)}_2\)) esuka kwiSports Field Line Marking: Ungaze usebenzise i-quicklime yezolimo okanye i-hydrated masonry lime kwimigca yetshokhwe kwibhola ekhatywayo, ekhatywayo, okanye kwibala le-baseball; xa abadlali betyibilika emgceni ngemini enethayo okanye ebilayo, banengxaki yokutsha kwekalika emfamekisayo kunye nokutshisa okugcwele kwethanga/ukutshisa kwethanga. Sebenzisa kuphela non-caustic ground calcium carbonate (\(\text{CaCO}_3\) / pulverized limestone chalk, \(\text{pH } 8\text{ ukuya }9\)) okanye ipeyinti yebala leembaleki.

Imibuzo edla ngokubuzwa¶

Ndigalele ipatio yekhonkrithi namhlanje ndiguqe kwi slab kwi jean yam. Xa ndikhulula ibhulukhwe yam ngobu busuku, ulusu oluphezu kwamadolo am omabini lumnyama-mfusa-mnyama kwaye lundisholo, lunamadyungudyungu ambalwa emacaleni. Ndivele ndagruzuka amadolo, okanye yikhemikhali yokutsha le?¶

Oko AKUSIYO inxeba: ufumene ubunzima obunzulu, obugcweleyo (inqanaba lesithathu) ukutsha kwekhemikhali yealkaline kwisamente emanzi yasePortland (enepH ye-12.5 ukuya kwi-14.0, eyomeleleyo njengesicoci se-liquid drainer), kwaye kufuneka uye kwisebe likaxakeka esibhedlele okanye kwiziko lokutshisa ngokuhlwanje. Ngenxa yokuba i-calcium hydroxide inyibilikisa amanqatha elusu nge-liquefactive necrosis kwaye ithoba imithambo-luvo yangaphezulu kwangoko, ukutshisa kwekhonkrithi okuguqayo kudume ngokungabi nantlungu ngexesha lasemini kwaye kujike kube mfusa-mnyama, mnyama-mnyama, okanye ube mhlophe ngokuhlwa njengoko imithambo yegazi engaphantsi ijika. Gubha amadolo omabini phantsi kwamanzi apholileyo ahambayo imizuzu engama-30 ngoku, vala ngokukhululekileyo ngesambatho esomileyo esicocekileyo (ungafaki amafutha anamafutha), kwaye uye esibhedlele ukuze utshise ukhathalelo lweengcali.

Kutheni kukhuselekile ukusebenzisa iviniga yasekhaya ehlanjululweyo ehlanjululwe esikhumbeni esifakwe kwisamente emanzi (emva kokuhlanjwa ngamanzi), xa izikhokelo zoncedo lokuqala zisithi UNGAZE ugalele iviniga kwi-liquid drain-cleaner (lye) ukutshisa?¶

Xa umntu ephalaza ulwelo olujiyileyo lwesodium hydroxide yelye eluswini, ukugalela iviniga ngokuthe ngqo kwikhemikhali egxininisiweyo kubangela ukusabela ngokukhawuleza kwe-asidi ephumayo (evelisa ubushushu) ethi ipheke inxeba elikrwada ngokufudumeleyo. Ngesamente emanzi yasePortland eluswini olungaguqukiyo okanye olurhabaxa kakhulu, UQALA uhlambe yonke intlama yesamente eninzi phantsi kwamanzi aleqayo aphezulu kangangemizuzu eli-15 ukuya kwengama-20. Nasemva kokuhlanjwa ngokucokisekileyo kwamanzi, ii-ion ze-calcium hydroxide ezincinci zihlala zibotshelelwe ngokuqinileyo kwiiproteni zekeratin ngaphakathi kwimibhobho yolusu yangaphandle (ukugcina ulusu pH ngaphezulu kwe-11 ukuya kwe-12 kwaye kubangele ukuziva okubhityileyo). Ukuhlanjululwa ngokufutshane ulusu oluhlanjiweyo ngeviniga emhlophe yasekhaya (i-5% yeacetic acid exutywe 50:50 ngamanzi) kukhusela ngokukhuselekileyo ezo ntsalela zealkaline zibuyele kwi-pH yesiqhelo eluswini (5.5 ukuya ku-7.0) ngaphandle kokuvelisa ubushushu, kwaye emva koko kulandelwe sisivambo sokugqibela samanzi. Ungaze ubeke iviniga emehlweni okanye kumanxeba anzulu avulekileyo akrwada.

Kwakutheni ukuze ugqirha wamehlo emana ehlamba iliso lomyeni wam iyure yonke esibhedlele nangona sasisele siyihlambile i-lime plaster ekhaya kangangemizuzu eyi-15?¶

Amasuntswana ekalika (icalcium oxide okanye icalcium hydroxide), udaka, nodaka alunyibiliki kakuhle emanzini kwaye luhlala nzulu phakathi kweepokotho ezigoqekileyo ngaphantsi kweenkophe ezingaphezulu nezisezantsi (i-conjunctival fornices). Nasemva kwemizuzu eli-15 yokuhlanjululwa komphezulu ekhaya, iimvuthuluka ezimhlophe zekalika ezivaleleke ngaphantsi kwenkophe yangaphezulu ziyaqhubeka nokunyibilika kancinane kwifilimu yeenyembezi, iqhubela i-pH yeliso ibuyele kwi-12.5 okanye 13.0 emfamekisayo nje ukuba uyeke ukugalela amanzi. Esibhedlele, oogqirha bexesha likaxakeka babangela ukuba ndindisholo iliso, bajike ijwabu elingaphezulu (double-evert) ijwabu elingaphezulu kwi-retractor ukuze bagxothe yonke into ebanjiweyo yegrit yekalika eqinileyo, kwaye unkcenkceshele ngokuqhubekayo ngeelitha ezi-2 ukuya kwezi-3 zesaline de kube i-litmus pH strip ebekwe kwiliso imizuzu engama-30 emva kokuyeka ukunkcenkceshela.

*Esi sikhokelo senzelwe iinjongo zolwazi kwaye asithathi indawo yovavanyo lonyango lobuchwephesha, ukhathalelo lwamehlo olungxamisekileyo, okanye uqeqesho oluqhutywa ngezandla. Sincoma kakhulu ukuthatha ikhosi yoncedo lokuqala eqinisekisiweyo kwindawo yokusebenza ngokusebenzisa i-International Federation ye-Red Cross kunye ne-Red Crescent Societies (IFRC), uluntu lwakho lwesizwe lwe-Red Cross, i-St John Ambulance, okanye umboneleli oqinisekisiweyo wokhuseleko lomsebenzi.

Imithombo ijongiwe¶

• UKhuseleko loMsebenzi kunye noLawulo lwezeMpilo (OSHA, eUnited States): *Ukuthintela iingxaki zeLusu ekusebenzeni ngePortland Cement (i-OSHA Guidance Document & Pocket Guide) *.
• Iziko leSizwe loKhuseleko lwezeMisebenzi kunye neMpilo (NIOSH, eUnited States) kunye namaZiko oLawulo lweSifo kunye noThintelo (CDC): * I-NIOSH Isikhokelo sePokethi kwiiMchiza yeeNgozi: i-Portland Cement, i-Calcium Oxide (i-Quicklime), kunye ne-Calcium Hydroxide (i-Hydrated Lime) *.
• I-American Burn Association (ABA): * I-Advanced Burn Life Support Manual (ABLS) Incwadi yoMboneleli: Ulawulo lwe-Alkali, i-Cement, kunye ne-Ocular Chemical Burns *.
• UMlawuli wezeMpilo kunye noKhuseleko (HSE, eUnited Kingdom): *IPhepha leNgcaciso yoKwakha CIS26: I-Cement (i-Alkali Burns kunye ne-Hexavalent Chromium Dermatitis Prevention) *.
• IKholeji yaseRoyal ye-Ophthalmologists kunye ne-American Academy ye-Ophthalmology (AAO): * Ulawulo olungxamisekileyo lwe-Acute Ocular Chemical (Alkali kunye neLime) yokulimala *.

Izikhokelo ezinxulumeneyo¶

• I-Hydrofluoric acid, i-rust remover, kunye nokutsha kweekhemikhali zamashishini
• Ukutshisa kakhulu kunye nokugungxulwa kwekhemikhali kolusu
• Ukulimala kwamehlo kunye nokunkcenkceshela kwamehlo ekhemikhali
• Itela eshushu, iasphalt, kunye nokutsha kweplastiki enyibilikayo (iprotocol yokususa ibhitumene)
• Amanani kaxakeka ngokwelizwe