I-Hydrofluoric Acid, i-Rust Remover, kunye ne-Industrial Chemical Burns¶

Amanani kaxakeka ayohluka ngokwamazwe. Eli phepha lisebenzisa u-911, inani laseMelika naseKhanada. Amanye amazwe amaninzi asebenzisa i-112, 999, okanye elinye inani. Fumana inombolo yelizwe lakho.

Ngokungafaniyo nomlilo otshisayo otshisayo oyeka ukupheka izicubu xa ilangatye licinywa, ikhemikhali itshisa i-hydrofluoric acid ($HF$)**, ialkalis ezomeleleyo (i-sodium hydroxide lye, ii-drain openers, izicoci ze-oven, i-samente ye-Portland emanzi, i-ammonia anhydrous), i-acidic mineral acids (i-sulfuric, i-chloric ne-nitric emhlophe) ulusu lomntu, amanqatha, imisipha, kunye nethambo kangangeeyure de wonke umkhondo wekhemikhali ukhukuliswe okanye uthatyathwe. Eyona nto iyingozi kuzo zonke yi-Hydrofluoric Acid ($HF$): ayifumaneki kuphela kwiifektri ze-semiconductor kunye ne-glass-etching, kodwa nakwi- i-rust removers yasekhaya, izicoci ze-aluminiyam/i-chrome wheel cleaner, nezikhazimli zemasonry: ezidlula ngokungenantlungu eluswini ukuze zihlube icalcium kunye nemagnesium, iphume ngokukhawuleza igazi ukubanjwa kwentliziyo ekutshiseni okungaphezu kwentende yesandla sakho.

Esi sikhokelo sinika inyathelo-nge-nyathelo kwintsimi yokuchithwa kunye neeprothokholi ze-antidotal zeklinikhi ezihambelana nezikhokelo ezivela kwi-World Health Organization (WHO), i-United States Centres for Disease Control and Prevention (CDC / NIOSH), i-Arhente ye-Toxic Substances and Disease Registry (ATSDR), i-American Burn Association (ABA), kunye ne-UK National Poisons Information Service (NPIS). Ukuhluba iimpahla ezingcolisekileyo, ukuxubha umgubo owomileyo phambi kokongeza amanzi, ukugungxulwa ngamanzi abalekayo kwi-15 ukuya kwimizuzu engama-60, kunye nokuphulula 2.5 ekhulwini ngalinye i-calcium gluconate gel kwi-hydrofluoric acid ukutshisa igcina amalungu kunye nobomi.

Yenza oku ngoku¶

Ukuba wena okanye umntu okufutshane uye watshiza, wachitha, okanye waguqa nge-hydrofluoric acid, isicoci serust, isicoci samavili, isivula-manzi, isamente emanzi, ikalika, okanye nayiphi na iasidi yeshishini okanye ialkali:

Nxiba iiglavu ezixhathisa iikhemikhali kwaye ukhulule zonke iimpahla ezingcolisekileyo kunye nobucwebe kwangoko: Ungaze ubambe iimpahla ezifakwe imichiza okanye ulusu ngezandla ezingenanto (sebenzisa nitrile, butyl, okanye iiglavu zeneoprene). Sebenzisa izikere ukusika zonke iimpahla ezimanzi, iikawusi, izihlangu, imisesane, kunye neebhanti zokubukela kwimizuzwana engama-60, njengoko imichiza evaleleke ngaphakathi kwelaphu okanye phantsi kwezangqa ibangela ukutshisa okugcweleyo okujikelezayo.
Jonga i-"Dry Powder First Rule" NGAPHAMBI kokuvula amanzi: Ukuba ulusu lugqunywe nge- DRY chemical powder: ezifana** ne-quicklime eyomileyo (calcium oxide / $CaO$)**, i-Portland eyomileyo yothuli lwesamente, i-sodium hydroxide lye flakes, isinyithi se-elemental (sodium, i-lithium, i-phosphorus, i-lithium*, i-SH, i-SH) umgubo owomileyo wususe ngobunono ngelaphu elomileyo okanye ibrashi PHAMBI kokugalela amanzi**. Ukongeza intwana yamanzi ngokuthe ngqo kwi-quicklime eyomileyo okanye kwikristale eyomileyo yelye kubangela ukusabela kobushushu obunobundlobongela obutshisayo obupheka ulusu phezu kokutsha kwemichiza.
Guqula ngamanzi abalekayo anomthamo ophezulu ngoko nangoko: Xa umgubo owomileyo ukhutshiwe (okanye ngoko nangoko ukuba i-splash ibilulwelo):
Nge-Hydrofluoric Acid ($HF$), i-Rust Remover, okanye i-Wheel Cleaner: Gubha phantsi komlambo onamandla wamanzi apholileyo aphuma empompo (okanye isisombululo se-Hexafluorine ukuba sikhona kwindawo yoshishino) imizuzu eyi-15 ukuya kwengama-30* (okanye nge-*5 imizuzu ukuba i-2.5% i-Calcium Gluconate Gel idibanisa i-calcium ngoko nangoko unokuqalisa ngesandla).
NgeeAlkalis Ezomeleleyo (I-Lye, iSivuleli sokuKhula, Isamente eManzi, i-Ammonia): Gubha ngokuqhubekayo phantsi kwamanzi aphuma empompo abalekayo kangange-30 ukuya kwimizuzu engama-60 epheleleyo* (iialkali zinyibilikisa amafutha ezithishu kwisepha kwaye zingene nzulu kakhulu kuneeasidi).
Ngezitshizi zamehlo: Gubha iliso elivulekileyo phantsi komlambo othambileyo wamanzi abalekayo okanye ityuwa ecocekileyo kangangemizuzu* engama-30 ukuya kuma-60** ngokuqhubekayo (bona ukwenzakala kwamehlo).
Faka i-2.5% ye-Calcium Gluconate Gel ngoko nangoko kuyo nayiphi na i-Hydrofluoric Acid ($HF$) okanye iRust Remover yokutshisa: Ukunxiba iiglavu ze-nitrile (ukuze ungafunxi i-fluoride eminweni yakho), uthambise 2.5 pesenti ye-Calcium Gluconate Gel ngesisa kwisikhumba esitshisiweyo, rhoqo nge-45 de kube yimizuzu eyi-30* enzulu ukuqaqanjelwa kwamathambo kuyayeka. Ukuba awunayo iGalcium Gluconate Gel yorhwebo ekhaya: tyumza ipilisi ezili-10 zeCalcium Carbonate antacid (ezifana neTums) zibe ngumgubo ocolekileyo kwaye uxube ne 30 milliliters (1 ounce / 2 tablespoons) yejeli enyibilikayo ye-K-Y okanye i-aloe vera gel ukuyitshisa ngexesha likaxakeka.
UNGAZE uzame "ukuphazamisa" ukutshiswa kweasidi ngesoda yokubhaka okanye ukutshiswa kwealkali ngeviniga: Ukugalela iviniga kwindawo yokutshisa ilye okanye isoda yokubhaka kwisulfuric/hydrochloric acid ukutsha kubangela i-exothermic acid-base yokusabela kobushushu kanye enyameni ekrwada, oko kubangele ukwenzakala okukhulu kwekhemikhali phezu kokutsha okushushu. (I-Calcium gluconate kwi-Hydrofluoric Acid AYISIYO i-asidi-base neutralization: yi-non-thermal ionic calcium-fluoride reaction reaction kwaye KUPHELA ngaphandle).
Fowunela u-911/112/999 ngoko nangoko malunga ne-Hydrofluoric Acid, i-Eye Burns, okanye i-Deep Alkali Burns: Tsalela umnxeba kwinombolo yakho kaxakeka yasekuhlaleni ngokusebenzisa yethu. amanani kaxakeka ulawulo. **Yonke enye i-Hydrofluoric Acid (i-$HF $) yokuvezwa ifuna ukuvavanywa kwesebe likaxakeka esibhedlele kunye nokuhlolwa kwe-ECG yenhliziyo eqhubekayo **, nokuba ulusu lubukeka luqhelekileyo kwaye alubuhlungu okwangoku, kuba nciphisa i-$HF $ (< 20%) kuthatha ** i-6 kwiiyure ze-24 ** ukuqala ukulimaza ngelixa kuthula ukulahla i-calcium yegazi kumanqanaba abulalayo.

Kutheni ukutshiswa kwe-Hydrofluoric Acid ubukhulu besundu kunokubangela ukubanjwa kwentliziyo ngokukhawuleza

Ngokungafaniyo ne-sulfuric okanye i-hydrochloric acid (edibanisa iiproteni zomphezulu kwaye iyeke ukungena), i-Hydrofluoric Acid ($ HF $) yi-asidi ebuthathaka enemolekyuli engatshajwanga ityibilika ngokungenamgudu ngolusu olungagungqiyo kunye ne-lipid cell membranes. Xa sele unzulu ngaphakathi kwezicubu zakho kunye negazi, i-ion nganye ye-fluoride ($ F^{-$) isebenza njenge-scavenger ye-metabolic: ibambelela kwi-charged positively **Calcium ($Ca}$)** kunye ne- **Magnesium ($Mg^{2+}$)** ion egazini lakho kunye nemithambo-luvo, izigqithise kwi-calcium fluorible_ $F i-insoluble). Ukuvinjwa kwe-calcium kunye nezikhukhula kunye ne-potassium ekhutshwe kwiiseli ezifayo (** i-hypocalcemia, i-hypomagnesemia, kunye ne-hyperkalemia **), inkqubo yombane yentliziyo iyawa kwi-refractory ** i-QT yokwandisa, i-Torsades de Pointes, kunye ne-Fatal Ventricular Fibrillation **. Ugxininise (> 50%) $ HF $ ukutshisa ukugubungela nje ** i-1 ipesenti ukuya kwi-2.5 ipesenti yendawo yomzimba (ubukhulu besundu esinye) ** inokubulala ngaphandle kokuhlangula ngokukhawuleza kwe-intravenous kunye ne-calcium yendawo.

Ukutshiswa kweekhemikhali ezingxamisekileyo kunye netshati ye-neutralization¶

flowchart TD
    Start["I-Chemical Splash okanye iTswe kuLusu okanye kwamehlo"] --> PPE["Nxiba iiglavu zeNitrile/Neoprene<br/>Sika zonke iimpahla, izihlangu, kunye nemisesane engcolileyo kwimizuzwana engama-60"]

    PPE --> FormCheck{"Loluphi uhlobo lwekhemikhali olubangele ukutyhileka?"}

    FormCheck -->|Dry Powder: Quicklime (CaO), Dry Lye Flakes, Dry Cement,<br/>Elemental Sodium/Potassium, or White Phosphorus| DryRule["UMGAQO WEPOWDER OYOMILEYO: Gcoba yonke ipowder eyomileyo KUQALA<br/>Ye-Sodium/Potassium: Gubungela nge-oyile yeminerali (UNGAZE manzi)<br/>Nge-Quicklime/Dry Lye: Emva kokuxubha i-brush ecocekileyo, hlamba ngamanzi aphezulu 30-60 min."]

    FormCheck -->|Hydrofluoric Acid (HF), Household Rust Stain Remover,<br/>Aluminum Brightener, Chrome Wheel Cleaner, Glass Etcher| HFRule["UMGAQO WE-HYDROFLUORIC ACID (HF): CALL 911 / 112 / 999<br/>1. Gubha ngamanzi aphuma empompo (okanye iHexafluorine) imizuzu emi-5-15<br/>2. Massage 2.5% Calcium Gluconate Gel (okanye i-Tums echotshoziweyo + ijeli yamanzi) ngesandla seglavu<br/>3. Ukujongwa kwe-ECG yesibhedlele + i-Subcutaneous/Intra-arterial Calcium Gluconate<br/>+ IV Calcium Gluconate & Magnesium Sulfate for systemic toxicity"]

    FormCheck -->|Phenol (Carbolic Acid / Creosote)| Phenol["I-PHENOL PROTOCOL (I-soluble kakubi emanzini kuphela)<br/>Sula ulusu ngokuphindaphindiweyo nge-Polyethylene Glycol (PEG 300/400)<br/>okanye i-Isopropyl Alcohol / i-Oil yemifuno, ngokutshintshana neshawari yamanzi ephezulu."]

    FormCheck -->|Strong Alkali: Drain Opener (NaOH/KOH), Wet Concrete,<br/>Oven Cleaner, Ammonia, Bleach| Alkali["I-LIQUEFACTIVE NECROSIS PROTOCOL<br/>Guqula ngokuqhubekayo phantsi kompompo wamanzi asebenzayo i-30 ukuya kwi-60 IMIZUZU EPHELELEYO<br/>UNGAZE ufake iviniga okanye i-asidi; khangela i-pH yesikhumba / iliso kude kube ngathathi hlangothi (7.0-7.5)"]

    FormCheck -->|Strong Mineral Acid: Sulfuric (Battery Acid),<br/>Hydrochloric (Muriatic), Nitric Acid| Acid["I-COAGULATIVE NECROSIS PROTOCOL<br/>Guqula ngokuqhubekayo phantsi kompompo wamanzi asebenzayo kwi-15 ukuya kwi-30 IMIZUZU EPHELELEYO<br/>UNGAZE usebenzise i-baking soda; zigqume ngokukhululekileyo ngeyasuyasu elimanzi elinyumba"]

Pathophysiology: Coagulative (Acids) vs. Liquefactive (Alkalis) vs. Fluoride Scavenging ($HF$)¶

Kutheni ukuchaphaza kwesicoci sombhobho wealkaline okanye ikhonkrithi emanzi kubangela ukutshisa okunzulu kakhulu, okutshabalalisayo kunokuchaphaza kweasidi yebhetri yamandla afanayo, kwaye kutheni i-hydrofluoric acid iziphatha ngokwahlukileyo kuzo zombini?

1. Ii-Acids ezinamandla ($\text{pH} <2$): I-Coagulative Necrosis (I-Self-Limiting Crust)¶

Xa igxininiswe i-asidi yesulfuric (i-asidi yebhetri yemoto / isicoci se-industrial), i-hydrochloric acid (i-muriatic pool/i-masonry acid), i-nitric acid, okanye i-** trichloroacetic acid** ibetha ulusu lomntu, ii-ion ze-hydrogen ($H^+$) ngoko nangoko i-denature kunye nokuwisa iiproteni zeethishu kumphezulu zibe yi-impergulative, i-impergulable necrosis)**:

Ngenxa yokuba le protein crust coagulated isebenza njengesithintelo somzimba, ** uninzi lwee-acids zeminerali ezomeleleyo zinciphisa ukungena kwazo okunzulu ** nje ukuba umaleko womphezulu utshiswe (ukuba iasidi igungxulwe ngamanzi kwimizuzu embalwa yokuqala).
Imikhondo yombala eluswini: Iasidi ye-nitric ijika ulusu olutshileyo lubeyinto eyahlukileyo ibetyheli ekhazimlayo ukuya kuorenji, i-sulfuric acid chars tissue dark brown to black, kunye nehydrochloric acid ijika ulusu mhlophe ukuya kugreyish-brown.

2. IiAlkalis Ezomeleleyo / Iziseko ($\text{pH} > 11.5\text{ ukuya kwi-}12$): I-Liquefactive Necrosis (I-Relentless Deep Burrowing)¶

Xa i-sodium hydroxide ($\text{NaOH}$ / lye), i-potassium hydroxide ($\text{KOH}$), i-calcium hydroxide (i-Portland emanzi isamente okanye udaka), i-ammonia anhydrous, okanye i-oven ye-industrial/drain cleaners ichukumisa ulusu lomntu okanye i-cornea hydroxide (i-cornea hydroxide) ifom ye-$ uqweqwe olukhuselayo. Endaweni yoko, zibangela liquefactive necrosis:

I-Saponification yamafutha omntu: I-alkali ngokwekhemikhali idibana ne-fatty acids kwi-membrane yeseli yomntu kunye namafutha angaphantsi kwe-subcutaneous, ngokoqobo ** ukuguqula izicubu zakho eziphilayo zibe isepha elulwelo (saponification)** ngelixa unyibilikisa iiproteni ze-collagen ezithambileyo, iiprotheyini ezithambileyo.
**Ukungena okunzulu okungenakuthintelwa **: Ngenxa yokuba i-liquefied, izicubu zesepha zinika umqobo we-zero ngokomzimba, i-alkali iyaqhubeka ingena nzulu ngokunzulu ngedermis, amanqatha, imisipha, kunye ne-cornea yeliso ukuya kwigumbi elingaphambili kangangeeyure kude kube ngu-30 ukuya kwimizuzu engama-60 yokunkcenkceshela okuqhubekayo kwamanzi ** ihlamba yonke i-lique ye-hydroxide kwi-matrix yokugqibela.

3. Hydrofluoric Acid ($HF$): I-Double-Action Ion Trap kunye ne-Deep Bone Pain¶

IHydrofluoric acid ($HF$) yityhefu ekhohlisayo enezigaba ezibini:

Kutheni udilute i-$HF$ (< 20%) akenzi buhlungu ekuqaleni: Kwindlu izisusi ze-rust stain (eziqulethe i-6% ukuya kwi-12% ye-HF$ okanye i-ammonium bifluoride), i-aluminiyam/izicoci zamavili e-chrome, kunye izicoci zezitena/zamatye, i-ion ye-hydrogen ($H^+$) yoxinaniso ibuthathaka kakhulu ukuba ingatshisa imithambo-luvo yomphezulu ngoko nangoko. Umntu ufumana into yokususa umhlwa eminweni okanye phantsi kweenzipho, uvaakukho ntlungu kwaye abone ukuba bomvu kweqanda, kwaye aqhubeke esebenza iiyure.
**I-nerve enzulu ye-fluoride kunye nokutshatyalaliswa kwamathambo **: Okwangoku, iimolekyuli ezingahlawulwanga ze-HF $ ezisasazwa ngokuthe ngqo kwi-epidermis engaguqukiyo kwi-dermis enzulu, i-digital nerve sheaths, kunye nethambo lomnwe (**phalangeal periosteum **), apho bahlukana kwaye bakhulule i-ions ye-fluoride yamahhala ($ F^{-$) **. I-Fluoride ihluba yonke i-calcium kwi-membrane zeseli, inyanzela amajelo e-potassium agayiweyo avuleke kwaye alahle izixa ezikhulu ze-intracellular potassium ($K}+$) ngokuthe ngqo kwisiphelo semithambo-luvo.
Intlungu ebuhlungu "ebuhlungu bethambo" ngaphandle komlinganiso woviwo : Ngequbuliso, ** 6 kwiiyure ze-24 emva kokuhlanjululwa kwe-$< 20\%$ exposure (or within 1 to 8 hours for a 20% to 50% exposure, and immediately for $> 50\% $ industrial $HF $), ixhoba liphuhlisa ** ezibuhlungu, ezingapheliyo, iintlungu ezibuhlungu ezibuhlungu ezivakalelwa ngathi amathambo abo omnwe atyunyuzwawi-vise **, nangaphambi kokuba amadyunguza amhlophe / angwevu okanye ama-blue-black necrotic patches avele phezu komhlaba. **I-morphine eqhelekileyo okanye i-fentanyl opioids aziyichukumisi le ntlungu: Ukuhintsha kuphela ikhalsiyam ebiweyo ngeCalcium Gluconate kunqanda ukuqhawuka kwemithambo-luvo kwaye kuthomalalise iintlungu.

Ukuthelekisa okuPhambili kokuTshiswa kweMichiza okuMngcipheko oPhezulu kunye nokuNcitshiswa okuKhethekileyo¶

I-Arhente yeMichiza kunye neMithombo yeKhaya/yeMveliso	Uqwalaselo kunye nokuQala ukuLatency	Izihlunu eziphambili kunye neNkqubo yeNkqubo	Ukungcoliswa okuthe ngqo kunye noMthetho woNcedo lokuQala	Unyango lweSibhedlele oluchanekileyo / Ukhathalelo
I-Hydrofluoric Acid ($HF$) & ne-Ammonium Bifluoride (I-Semiconductor/i-glass etching, i-alkylation yokucoca, izisusi ze-rust zasendlini, izikhanyisi ze-chrome/aluminiyam, izicoci zamatye/zamatye)	`> 50%` $HF $: Intlungu engoko nangoko kunye necrosis emhlophe / engwevu. `20%, 50%` $HF$: Iintlungu zilibazisekile 1 ukuya 8 iiyure . `< 20%` $HF$ (Irust remover): Iintlungu zilibazisekile 6 ukuya kwiiyure ezingama-24.	Ukungena Transdermal $\rightarrow$ free Fluoride ($F^-$) chelates izicubu & igazi $Ca^{2+}$ kunye $Mg^{2+}$ $\rightarrow$ deep bone necrosis, i-hypocalcemia ebulalayo, i-hypomagnesemia, i-hyperkalemia, kunye ne-Ventricular Fibrillation.	Gubha ngamanzi 5 ukuya kwi-15 min (okanye Hexafluorine), emva koko uthambise 2.5% iGalcium Gluconate Gel (okanye I-Tums etyumkileyo eyi-10 + 30 mL K-Y jelly) eluswini ngokuqhubekayo ngeeglavu ze-nitrile.	1. I-Topical/Subcutaneous 5%, 10% yeCalcium Gluconate yokungena. 2. I-Intra-arterial Calcium Gluconate infusion (i-radial/brachial artery ngenxa yokutshisa okukhulu kwesandla/kweminwe). 3. IV Calcium Gluconate + IV Magnesium Sulfate + ECG eqhubekayo.
Isamente yasePortland emanzi & neConcrete (Amacwecwe okwakha, udaka, istucco, udaka: iqulethe iCalcium Oxide $\rightarrow$ Calcium Hydroxide, pH 12 to 14)	I-2-to-6-iyure ethuleyo iqala : I-alkaline yesamente emanzi ibangela iziphelo zemithambo-luvo ngelixa inyibilika i-shins kunye namadolo.	Liquefactive alkali necrosis ($\text{pH } 12.9$) + isanti ebrasive + hygroscopic ukufuma umzobo $\rightarrow$ cwaka ukutyeba okupheleleyo 3^rd-degree-skin necrosis efuna ukufakelwa kwesikhumba.	Khupha ibhulukhwe efakwe ikhonkrithi kunye neebhutsi ngokukhawuleza; xubha i-samente eyomileyo; hlamba ngamanzi abalekayo30 ukuya kwimizuzu engama-60 (dilute iviniga egoqweni kuphela emva kokuhlamba ngokucokisekileyo ngamanzi ngokweyunithi yokutshisa).	Uqhaqho lweyunithi yokutshisa iyunithi kunye nokuqhekeka kolusu lokutyeba ngokutshisa okunzulu kwamadolo.
I-Quicklime eyomileyo (iCalcium Oxide / $CaO$) kunye neeFlakhe zeDry Lye ($\text{NaOH}$) (Ikalika yezoLimo, umxube we-masonry mortar, i-crystal drain opener eyomileyo)	I-exothermic thermal ngoko nangoko + ukutsha kweekhemikhali ukuba idibene nokubila okanye ukuchaphaza okuncinci kwamanzi.	Iphendula ngobundlobongela emanzini ($CaO + H_2O \rightarrow Ca(OH)_2 + \text{Intense Heat}$ up to $150^\circ\text{C} / 300^\circ\text{F}$) + kakhulu liquefactive alkali burn.	GULA wonke umgubo owomileyo ngokupheleleyo ngelaphu elomileyo/ibrashi KUQALA; emva koko ukhukulise ngamanzi ahambayo aphezulu ahambayo kangangemizuzu 30 ukuya kuma-60.	Tshisa ukhathalelo lweziko; ukunkcenkceshela nge-ophthalmology ukuba kwiliso (zikhuphe ngokucacileyo iinkophe ukuze zisuse amasuntswana ekalika avaleleke kwi-conjunctival fornices).
IPhenol (iCarbolic Acid) & neCreosote (Amaxolo eKhemikhali, izithinteli zomthi, iiplastiki zamashishini/izibulali ntsholongwane)	Ukujija okumhlophe okukhawulezileyo okungenantlungu (iphenol sisithomalalisi esinamandla sendawo esiphelisa ukutsha ngoko nangoko).	Iiprotheyini ze-Denatures + zifunxa ngokukhawuleza ngesikhumba esingaguqukiyo ukuze kubangele ukuxhuzula kwe-CNS, i-coma, i-methemoglobinemia, i-hepatic / renal failure, kunye ne-cardiac arrhythmias ebulalayo .	Ukunyibilika kwamanzi aphantsi (umlinganiselo omncinci wamanzi ngokwenene ukwandisa ukufunxa kwesikhumba): Sula ngokuphindaphindiweyo ngezipontshi ezifakwe kwi-Polyethylene Glycol (PEG 300 okanye 400) okanye 70% Isopropyl Alcohol / I-Oli yeVegetable, utshintshise nge-deluge shower ephezulu.	Ukujongwa kwe-ECG eqhubekayo, i-IV fluids, i-methylene eluhlaza okwesibhakabhaka ukuba i-methemoglobinemia ikhula, kunye nokutshisa ukunakekelwa kwenxeba.
Iintsimbi ze-Alkali ze-Elemental (i-Metallic Sodium [$Na$], i-Potassium [$K$], i-Lithium [$Li$]: iilabhoratri, ukwenziwa kwebhetri ye-EV)	Ugqabhuko-dubulo olukhawulezileyo nomlilo ekudibaneni namanzi okanye ulusu olumanzi.	Iphendula ngobundlobongela ngokufuma kwesikhumba ukukhupha isiqhushumbisi serhasi yeHydrojeni ($H_2$) + etyhidiweyo Isodium/iPotassium Hydroxide ($\text{NaOH}/\text{KOH}$) thermal/alkali burns.	UNGAZE usebenzise amanzi. Gcoba amaqhekeza esinyithi kwaye untywilise okanye ugqume indawo ngokukhawuleza kwi-Mineral Oli, i-Oyile yeVegetable, okanye i-Kerosene ukuvala umoya nokufuma; susa amaqhekeza nge forceps phantsi kweoli.	Ukususwa ngotyando lwazo zonke iziqwenga zetsimbi phantsi kweoyile yeminerali ngaphambi kokuba kuzanywe ukhathalelo lwenxeba elimanzi.
I-Phosphorus emhlophe ($P_4$) (Izixhobo zomkhosi, iziqhushumbisi, iziqhushumbisi, amadangatye oshishino)	Ibasa ngokuzenzekelayo ekudibaneni nomoya ngaphezulu kwe-$30^\circ\text{C}$ ($86^\circ\text{F}$), ivutha nge-$800^\circ\text{C}$ ($1,470^\circ\text{F}$) nomsi oshinyeneyo omhlophe wekonofile onevumba elimnandi.	Ukushisa okunzulu kwe-thermal + corrosive i-asidi ye-phosphoric ukulimala + i-hypocalcemia yenkqubo kunye ne-hepatorenal toxicity (efana ne-$ HF $).	Gcina inxeba lintywiliselwe ngokupheleleyo emanzini apholileyo okanye ligqunywe ngeelokhwe ezinetyuwa ethontsizayo emanzi ukuze ulambe iphosphorous yomoya/ioksijini ngelixa ususa amasuntswana okutshaya ngeeforceps zentsimbi.	Ukuhlolwa kwesibane se-UV Wood kwigumbi elimnyama (i-phosphorus ikhanya eluhlaza-mhlophe) okanye imfutshane 1% ye-Copper Sulfate ihlambulule ukuba ibe mnyama amasuntswana okususwa kwe-forceps + IV Calcium Gluconate .
Chromic Acid ($CrO_3$) (Iibhafu zokugquma ngeChrome, ukusukwa kwesikhumba, ukugqitywa kwentsimbi yeshishini)	Ibala elikhawulezayo elityheli-orenji liqhubela phambili ukuya kutsho kubunzulu "izilonda ze-chrome."	I-chromium e-Corrosive hexavalent ($ Cr ^ {6+} $) ibangela ukufunxwa kwenkqubo enkulu , i-hemolysis ye-intravascular, i-acute tubular necrosis (ukungaphumeleli kwezintso) , kunye nokungaphumeleli kwesibindi (esibulalayo ukuba sitshise $> 2\%, 10\%$ TBSA).	Ngokukhawuleza i-15 ukuya kwi-30 imizuzu yokugungxula kwamanzi + i-topical i-10% ye-Ascorbic Acid (i-Vitamin C) isisombululo okanye i-5% ye-Sodium Thiosulfate (inciphisa i-toxic $ Cr ^ {6+} $ ukuba ifakwe kakubi i-$ Cr ^ {3+} $).	Ukutyolwa kwangoko kotyando okutyebileyo kokutsha kwechrome ukuthintela ukufunxwa kwechromium ebulalayo + nehemodialysis.

Ukuntywila nzulu 1: Gqibezela i-Hydrofluoric Acid ($HF$) iProtokholi yokuHlangula (Ekhaya ukuya e-ICU)¶

Ngenxa yokuba indlu izinto ezisusa umhlwa (zithengiswa ngeebhotile zeplastiki ezincinci ezicudiswayo kwiipaseji zempahla esuphamakethi e-6% ukuya kwi-12% ye-Hydrofluoric Acid*) kunye nemoto i-aluminium/isicoci samavili se-magnesium ayifane iprinte "HYDROFLUORIC ACID" ngoonobumba abakhulu kunye newaka leeleyibheli zesandla sasekhaya kunye neeleyibhile ezitshisayo zendlu yonke iminyaka. beqonda ukuba baye babamba eyona michiza iyingozi emhlabeni.

Inyathelo loku-1: Iresiphi yeGel yeGluconate yasekhaya kwangoko¶

Yonke indawo yokusebenza esebenzisa i-$HF$ ifuneka ukuba igcine iibhubhu ezingaphelelwanga 2.5 yeepesenti zeCalcium Gluconate Gel ecaleni kwesinki. Ukuba into ekhupha umhlwa okanye isicoci sevili kwenzeka ekhaya apho ijeli ye-calcium gluconate yorhwebo ingafumanekiyo:

**Guqula phantsi kompompo wamanzi apholileyo asebenzayo kwi-5 ukuya kwi-15 imizuzu ** ngelixa ilungu lentsapho lifowunela ** 911 / 112 / 999 ** kunye ** Ukulawulwa kwePoison (1-800-222-1222 e-US) **.
Dibanisa iCalcium Carbonate Slurry/Gel yexesha likaxakeka kwimizuzwana engama-60:
Thatha 10 rhoqo-amandla (500 mg ukuya 1,000 mg) iipilisi zeCalcium Carbonate antacid (ezifana neTums okanye iRolaids).
Ziqhekeze phakathi kwamacephe amabini okanye ngaphakathi kwingxowa yeplastiki ecocekileyo enepini yokuqengqeleka ibe ngumgubo ocolekileyo.
Xuba umgubo ngokucokisekileyo nge 30 milliliters (2 amacephe / 1 ounce) yejeli enyibilikayo emanzini (efana ne K-Y Jelly, **ijeli ye-aloe vera esekelwe kumanzi angenanto **, okanye ** 1 ukuya kwi-2 iipunipopu zamanzi ompompo **) ukwenza intlama engqindilili. (Ungaze usebenzise i-petroleum jelly / iVaseline, kuba amafutha asekwe kwi-oyile abamba ii-ion ze-fluoride kwaye avale ii-ion ze-calcium ezinyibilikayo ukuba zingangeni eluswini).
Sebenzisa ubuchule be-"Nitrile Glove Poultice" ukutshisa iminwe nezandla:
Beka iglavu ye-nitrile esandleni sakho kwaye uphulule ijeli ye-calcium kwindawo etshisiweyo ngokuqhubekayo.
Ukuba iminwe yexhoba okanye isandla sitshisiwe, gcwalisa iglavu ye-nitrile enkulu kakhulu nge-generous scoop yeCalcium Gluconate Gel (okanye ijeli yakho yeTums etyunyuziweyo) kwaye uslayide isandla esitshileyo sexhoba ngaphakathi kweglavu egcwele ijeli. Oku kugcina yonke i-square millimeter yeminwe ihlanjwe kwi-calcium ions ngexesha lokukhwela i-ambulensi esibhedlele.

Inyathelo lesi-2: Kutheni ukususwa kweminwe kunye neCalcium ye-Intra-Arterial isetyenziswa eSibhedlele¶

Xa isigulana esine-hydrofluoric acid esitshisa isandla sifika kwisebe likaxakeka:

Iingqaqambo imitha yokulinganisa iklinikhi: Ngokungafaniyo nalo naluphi na olunye uhlobo lokutsha, iintlungu zokutsha kwe-$HF$ zixelela ugqirha ngokuthe ngqo ukuba iiyoni zefluoride zasimahla zisatshabalalisa inyama. Ke ngoko, oogqirha bayakuphepha ukunika i-lidocaine nerve blocks ekuqaleni ngenxa yokuba ubambe iimaski zeminwe nokuba unyango lwe-calcium luye lwayiphelisa ngempumelelo yonke i-fluoride.
I-Subungual (Ngaphantsi Kozipho Lomnwe) Umgibe: Iiion ze-fluoride zityibilika ngokulula ngaphantsi komphetho okhululekileyo weenzipho ukuya kwibhedi yeenzipho etyebileyo, apho ijeli yekhalsiyam engaphakathi ingenako ukungena ngepleyiti yeenzipho yekeratin eqinileyo. Ukuba isigulane sineentlungu ezibuhlungu ezibuhlungu phantsi kweminwe emva kokusebenzisa i-rust remover ngaphandle kweeglavu, oogqirha bexakeka benza ibhloko yedijithali (emva kokuqinisekisa indawo) kunye ** i-trephine, ukuhlukana, okanye ukususa i-plate ye-fingernail ** ngoko i-calcium gluconate inokufikelela kwibhedi yesikhonkwane ngokuthe ngqo, igcina i-distal phalanx bone ekuchithekeni.
**I-Subcutaneous Infiltration kunye ne-Intra-Arterial Calcium Infusion **: Ukuba i-gel ye-calcium ye-topical ayiyeki intlungu ebuhlungu ngaphakathi kwe-30 ukuya kwi-60 imizuzu, oogqirha bangena ngaphakathi ** i-5% ukuya kwi-10% eyinyumba ye-Calcium Gluconate yesisombululo ** ngaphantsi kwe-subcutaneous ngokuthe ngqo phantsi kokutshisa (ukunciphisa umthamo ukuya 0.5 mL per square centimeter kwiminwe ukuphepha i-compartment syndrome; **ungaze usebenzise iCalcium Chloride ngaphantsi kwesikhumba, njengoko iCalcium Chloride ibangela i-tissue necrosis eyingozi **), okanye ubeke i-catheter ye-arterial kwi radial okanye i-brachial artery yesandla/yengalo kwaye ugalele idilute **I-Calcium Gluconate (i-10 mL ye-10% ye-calcium gluconate ihla ngeeyure ze-D5W0 ngokuthe ngqo kwi-calcium gluconate) iminwe.
Ukuphefumla okanye ukuTyelwa kwe-$HF$: Ukuba umntu uthe waphefumlela umsi we-$HF$, oogqirha bexesha likaxakeka balawula i-nebulize i-2.5% ukuya kwi-3% ye-Calcium Gluconate (1.5 mL ye-10% ye-Calcium Gluconate ehlanjululwe kwi-4.5 mL ye-saline eyinyumba) ngokukhawuleza nge-mask ye-nebuliza nge-nebulizer IGluconate ** kunye ne-Magnesium Sulfate* ukukhusela intliziyo.

Ukuntywila nzulu 2: "Ukuguqa okuthe cwaka ukutshisa" kweConcrete emanzi kunye nodaka¶

Rhoqo ngeempelaveki, zenzeleni abaninimzi kunye nabasebenzi abatsha bokwakha bagalela ipatio yekhonkrithi, i-driveway, okanye umgangatho ongaphantsi kwaye bachithe iiyure ezi-2 ukuya kwezi-4 begudisa ikhonkrithi emanzi ngelixa ** beguqe ngeejini zedenim eziqhelekileyo ** okanye benxibe izihlangu zokusebenza zesikhumba apho ikhonkrithi emanzi ithe yafafaza ngaphezulu.

Kutheni ungeva ikhonkrithi emanzi inyibilikisa amadolo akho kude kube lixesha lesidlo sangokuhlwa¶

Isamente eyomileyo yasePortland iqulethe ** i-60 ekhulwini ukuya kwi-65 ipesenti yeCalcium Oxide (i-quicklime) **. Lo mzuzu amanzi exutywa ukwenza ikhonkrithi emanzi okanye udaka, i-calcium oxide iguqulwa ibe yi-saturated Calcium Hydroxide ($\text{Ca(OH)}_2$) nge-alkaline eyingozi ye-caustic pH ye-12.5 ukuya kwi-14.0: phantse njenge-alkaline njengesicoci solwelo.

Kutheni kungekho ntlungu kwiiyure ezi-2 ukuya kwezi-4: Ngokungafaniyo nokutsha kwe-thermal okanye i-asidi yebhetri, i-calcium hydroxide ingena kancinane ngelaphu ledenim elimanzi kwaye iqale yonakalise imicu yeentlungu ezingaphaya kwesikhumba ngelixa i-saponifying lipids eluswini, idala ubundisholo obumnyama endaweni yokuluma okubukhali.
Ukwenzakala kweNdlela Ezintathu: Ikhonkrithi emanzi evaleleke ngaphakathi kweejini okanye iibhutsi ibangela ukonzakala okuthathu ngaxeshanye: (a) Liquefactive alkali necrosis kwi-pH 13, (b) I-Mechanical sand abrasion njengoko umsebenzi etshintsha amadolo okanye ehamba ngeebhutsi zabo, ekhuhla i-protectne corroum straw ngokupheleleyo deiccation** njengoko isamente eyomisayo ikhupha amanzi kwiiseli zomntu.
UThintelo kunye noNcedo lokuQala:
Ungaze uguqe ngekonkile emanzi ngaphandle kweepadi zerabha ezingangeni manzi kunye neebhutsi zerabha ezingangenwa manzi ezincanyatheliswe phezulu.
Ukuba isamente emanzi ichukumisa ulusu lwakho okanye ivuza ibhulukhwe yakho, yima ngoko nangoko, khulula ibhulukhwe/ikawusi ezimanzi, kwaye uhlambe ulusu ngesepha namanzi abalekayo imizuzu engama-30 epheleleyo. Ezinye iiprothokholi zokutshiswa komsebenzi nazo zisebenzisa i-rinse emfutshane kunye nendlu dilute iviniga (5% i-acetic acid) okanye i-pH-buffered diphoterine kuphela emva kokuba yonke intlama yesamente ihlanjwe kakuhle ngamanzi, ukuthoba i-alkalinity eyintsalela emiliselwe kwimingxuma yolusu.
Ukuba i-shins okanye amadolo akho ajonge ** amnyama amfusa, aluhlaza-omnyama, amhlophe / esikhumba, okanye ama-blistered ** ngaloo ngokuhlwa emva kokusebenza ngekhonkrithi, yiya kwiyunithi yokutshisa esibhedlele ngokukhawuleza: ukutshiswa kwekhonkrithi phantse kuhlale kunzulu ** ukutshisa okugcweleyo (i-third-degree) iikhemikhali ezitshisa ** ezifuna ukuchithwa kotyando kunye nokufakwa kwesikhumba.

Ukuntywila nzulu 3: Ukutshiza kwamehlo eChemical: Umthetho wokunkcenkceshela wemizuzu engama-30 ukuya kuma-60¶

Ukuchaphaza kwesicoci se-drain, isicoci se-oveni, i-ammonia, ikalika, isamente emanzi, iblitshi, okanye iasidi yebhetri emehlweni yimeko kaxakeka yokwenyani apho okwenzayo kwimizuzwana eli-10 yokuqala kumisela ukuba umntu uya kuba yimfama ubomi bakhe bonke (jonga ukuzinikela kwethu. Isikhokelo sokulimala kwamehlo iinkcukacha ezipheleleyo).

Qalisa ukugungxulwa ngamanzi kwisithuba semizuzwana eyi-10: Sukulinda ukuya esibhedlele kuqala: I-alkali splash (i-lye, i-ammonia, i-lime, i-drain opener) ingena ngokupheleleyo kwi-cornea yomntu ukuya kwigumbi elingaphambili leliso **ngaphantsi kwe-15 ukuya kwi-60 imizuzwana **, ukutshabalalisa i-corneal limbal stem cell, ukunyibilika kunye nokufika.
**Indlela yokunkcenkceshela iliso ekhaya okanye emsebenzini **:
Susa iilensi zoqhagamshelwano ngoko nangoko njengokuba uqala ukugungxula (iilensi zoqhagamshelwano zibamba iasidi ejiyileyo okanye ialkali ngqo kwicornea).
Bamba iinkophe zivuleke ngeminwe yakho (kuba iintlungu eziqatha zixhokonxa ngokuzenzekela i-blepharospasm ebamba iinkophe zivaleke) kwaye uqondise umjelo othambileyo, oqhubekayo wamanzi etephu adikidiki, amanzi asebhotileni, okanye ityuwa eqhelekileyo engenazintsholongwane ukusuka *kwikona engaphakathi yeliso (ekufuphi nebhulorho yempumlo ayidibanisi nempumlo ikhuphe i-eye ngaphandle).
Guqula ubuncinci bemizuzu engama-30 ukuya kuma-60 eqhubekayo ngayo nayiphi na ialkali, isamente, ikalika, okanye i-hydrofluoric acid splash (kunye ubuncinane nemizuzu eli-15 ukuya kwengama-30 yeeasidi/iblitshi).
Jonga ngaphantsi kweenkophe ezingaphezulu nezisezantsi (iinkophe) zekalika evalelekileyo okanye igrit yesamente: Kudaka, udaka, okanye ukuchaphaza kwekalika eyomileyo, amasuntswana amhlophe ekhalsiyam hydroxide ahlala nzulu phantsi kwenkophe engaphezulu kwaye aqhubeke nokunyibilikisa iliso nasemva kwemizuzu engama-30 yokugungxulwa ade ugqirha ajikelezise (ehlala) ecoca inkophe engaphezulu. ngelixa ujonga ifilimu yokukrazula i-pH ngephepha le-litmus de lihlale lingathathi hlangothi kwi-**pH 7.0 ukuya ku-7.4 **.

Imibuzo edla ngokubuzwa¶

Ndisebenzise isixhobo sokucoca umhlwa kwimpahla yasekhaya ngaphandle kwegloves kwiiyure ezimbini ezidlulileyo. Iminwe yam yayikhangeleka iqhelekile ukugqiba kwam, kodwa ngoku iqalisa ukubetheka ngokuqaqanjelwa nzulu ngaphakathi kwethambo. Kutheni kusenzeka oku, kwaye ngaba kungxamisekile?

Ewe: yiya kwisebe likaxakeka esibhedlele ngokukhawuleza uze nebhotile yokususa umhlwa. Phantse zonke izinto ezisusa amabala erust kwilaphu lentengiso zine-6% ukuya kwi-12% ye-Hydrofluoric Acid (HF) okanye i-ammonium bifluoride. Kwiindawo ezixineneyo ezingaphantsi kwe-20%, i-hydrofluoric acid ibangela iintlungu zero kunye nokungabikho bubomvu xa udibana, ivumela iimolekyuli ze-fluoride ukuba zingene ngaphakathi kwesikhumba sakho naphantsi kweminwe yakho ngaphezulu kweeyure ezi-2 ukuya kwezili-12. Ubunzulu, obubuhlungu "intlungu yamathambo" ovakalelwa ngayo ngoku ibangelwa yi-fluoride ion ekhupha i-calcium kwimithambo-luvo yomnwe kunye nethambo. Ngoxa umntu ekuqhubela kwi-ER (okanye ngelixa ulinde i-ambulensi), utyumle iipilisi ezili-10 eziqhelekileyo ze-Tums (calcium carbonate) kwiipuniponi ezi-2 ze-K-Y jelly okanye amanzi, ugcobe i-paste ngokukhululekile phezu kweminwe yakho ngaphakathi kweglavu ye-nitrile, kwaye uxelele umongikazi we-ER umzuzu xa uhamba: "I-Hydrofluoric acid idinga ukutshiswa kwe-Calcistum kunye ne-ECGlu yokususa i-rucistum."

Kutheni kuyimpazamo eyingozi ukugalela iviniga kwi-lye/drain-cleaner burn, okanye i-baking soda kwi-battery-acid burn, "ukunciphisa" i-pH?

Kwibeaker yeglasi kwiklasi yekhemistri, ukuxuba iasidi eyomeleleyo kunye nesiseko esomeleleyo kunciphisa ipH: kodwa ikwakhupha ubushushu obukhulu bobushushu (i-exothermic neutralization reaction). Xa ugalela iviniga kwi-sodium hydroxide yelye (okanye i-baking soda paste kwi-concentrate sulfuric acid) ehleli eluswini lomntu okrwada, ukusabela kwemichiza kuvelisa ubushushu obugqithisileyo kanye kumphezulu wenxeba, ukupheka idermis esele yonakele kwaye iguqula ukutshisa kwemichiza engaphezulu kwiqondo lesithathu lokutshisa kwekhemikhali. Amanzi abalekayo anomthamo ophezulu opholileyo (imizuzu engama-30 ukuya kuma-60) ngokukhuselekileyo angcungcuthekisa kwaye akhukulise zombini imichiza kunye nobushushu bomxube ngaphandle kokupheka inyama.

Yintoni umahluko phakathi kweCalcium Gluconate kunye neCalcium Chloride, kwaye kutheni iCalcium Chloride UNGAZE utofwe phantsi kwesikhumba ukuze utshiswe yiHydrofluoric Acid?

Zomibini iyeza zibonelela nge-calcium ion ($ Ca ^ {2 +} $) nge-intravenously ngokusebenzisa umgca ophakathi ngexesha lokuvuselelwa kwentliziyo, kodwa i-Calcium Chloride (i-$ CaCl_2 $) iqulethe i-calcium ephindwe kathathu ye-ionized nge-milliliter kwaye i-hyperosmolar enamandla kunye ne-caustic kwizicubu ezithambileyo. Ukuba iCalcium Chloride ingene ngaphantsi kolusu okanye ivuze kwi-peripheral IV vein (extravasation), ibangela ukuthotywa kwezicubu eziqinileyo, ezityebileyo kunye ne-necrosis. Ngoko ke, KUPHELA **i-Calcium Gluconate** ehlala isetyenziselwa ijeli ye-topical, i-subcutaneous infiltration, okanye i-intra-arterial infusion kwi-hydrofluoric acid burns.

Kutheni le nto kufuneka uhlambe i-lime eyomileyo okanye umgubo wesamente owomileyo esikhumbeni PHAMBI kokuba uvule ishawa yokhuseleko, endaweni yokutsiba nje ngqo emanzini?

I-quicklime eyomileyo (i-calcium oxide) kunye neekristale zesodium hydroxide yelye eyomileyo zisabela ngamanzi kwi-exothermic exothermic reaction reaction ($CaO + H_2O \rightarrow Ca(OH)_2 + \text{Heat}$). Ukuba iingalo zakho kunye nehempe zinekeyiki yomgubo wekalika eshinyeneyo kwaye utshize amanzi amancinci kuzo, umgubo omanzi uguquka ube yintlama ebilayo, i-pH-13 yecaustic ethi incamathele eluswini lwakho kwaye ikutshise ngokushushu kunye nangekhemikhali ngaxeshanye. Ukuthatha imizuzwana eli-15 ukukhulula ihempe enothuli kwaye uxukuxe umgubo owomileyo ngetawuli eyomileyo okanye ibrashi kuqala, emva koko ukhukulise ulusu ngeshawari enkulu, enomthamo omkhulu okhukulayo kangangemizuzu engama-30, kuthintela eso sikhewu sobushushu esishushu.

*Esi sikhokelo senzelwe iinjongo zolwazi kwaye asithathi indawo yovavanyo lobungcali lwezonyango okanye uqeqesho oluqhutywayo. Ngenxa yokuba ukutshiswa kweekhemikhali ezinzulu kunye nokuvezwa kwe-hydrofluoric acid kunokubangela i-arrhythmias ye-cardiac ngokukhawuleza, sincoma kakhulu ukuba uthathe uncedo lokuqala oluqinisekisiweyo kunye nekhosi ye-CPR 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 woqeqesho lwendawo oqinisekisiweyo.

Imithombo ijongiwe¶

I-Arhente ye-Toxic Substances kunye neRegistry yeZifo (ATSDR, eUnited States) kunye namaZiko oLawulo lweSifo kunye noThintelo (CDC): * Izikhokelo zoLawulo lwezoNyango lwe-Hydrogen Fluoride / Hydrofluoric Acid ($ HF $) * kunye ne-Calcium Gluconate Gel / Infiltration Protocols *.
Iziko leSizwe loKhuseleko lwezeMisebenzi kunye neMpilo (NIOSH, eUnited States): Isikhokelo sePokotho yeNIOSH kwiiNgozi zeMichiza (iHydrogen Fluoride, iSodium Hydroxide, iCalcium Oxide, iPortland Cement, iPhenol, kunye nePhosphorus emhlophe).
I-American Burn Association (i-ABA, eUnited States): * I-Advanced Burn Life Support (ABLS) Incwadi yoMboneleli yoMboneleli: Ukutshiswa kweMichiza kunye noLawulo oluKhethekileyo lwe-Agent *.
Umbutho wezeMpilo weHlabathi (i-WHO): INkqubo yeHlabathi yoKhuseleko lweMichiza: Ulawulo lokuTsha iikhemikhali kunye neNxilo ye-Acidi yeHydrofluoric.
INkonzo yeSizwe yoLwazi lwePoisons (NPIS, eUnited Kingdom) kunye ne-UK ye-Arhente yoKhuseleko lwezeMpilo (i-UKHSA): * I-TOXBASE yoLawulo lweKlinikhi ye-Hydrofluoric Acid, i-Alkalis, kunye ne-Corrosive Dermal / Ocular Exposures *.

I-Hydrofluoric Acid, i-Rust Remover, kunye ne-Industrial Chemical Burns¶

Yenza oku ngoku¶

Ukutshiswa kweekhemikhali ezingxamisekileyo kunye netshati ye-neutralization¶

Pathophysiology: Coagulative (Acids) vs. Liquefactive (Alkalis) vs. Fluoride Scavenging (\(HF\))¶

1. Ii-Acids ezinamandla (\(\text{pH} <2\)): I-Coagulative Necrosis (I-Self-Limiting Crust)¶

2. IiAlkalis Ezomeleleyo / Iziseko (\(\text{pH} > 11.5\text{ ukuya kwi-}12\)): I-Liquefactive Necrosis (I-Relentless Deep Burrowing)¶

3. Hydrofluoric Acid (\(HF\)): I-Double-Action Ion Trap kunye ne-Deep Bone Pain¶

Ukuthelekisa okuPhambili kokuTshiswa kweMichiza okuMngcipheko oPhezulu kunye nokuNcitshiswa okuKhethekileyo¶

Ukuntywila nzulu 1: Gqibezela i-Hydrofluoric Acid (\(HF\)) iProtokholi yokuHlangula (Ekhaya ukuya e-ICU)¶

Inyathelo loku-1: Iresiphi yeGel yeGluconate yasekhaya kwangoko¶

Inyathelo lesi-2: Kutheni ukususwa kweminwe kunye neCalcium ye-Intra-Arterial isetyenziswa eSibhedlele¶

Ukuntywila nzulu 2: "Ukuguqa okuthe cwaka ukutshisa" kweConcrete emanzi kunye nodaka¶

Kutheni ungeva ikhonkrithi emanzi inyibilikisa amadolo akho kude kube lixesha lesidlo sangokuhlwa¶

Ukuntywila nzulu 3: Ukutshiza kwamehlo eChemical: Umthetho wokunkcenkceshela wemizuzu engama-30 ukuya kuma-60¶

Imibuzo edla ngokubuzwa¶

Imithombo ijongiwe¶

Izikhokelo ezinxulumeneyo¶

I-Arhente yeMichiza kunye neMithombo yeKhaya/yeMveliso	Uqwalaselo kunye nokuQala ukuLatency	Izihlunu eziphambili kunye neNkqubo yeNkqubo	Ukungcoliswa okuthe ngqo kunye noMthetho woNcedo lokuQala	Unyango lweSibhedlele oluchanekileyo / Ukhathalelo
I-Hydrofluoric Acid (\(HF\)) & ne-Ammonium Bifluoride (I-Semiconductor/i-glass etching, i-alkylation yokucoca, izisusi ze-rust zasendlini, izikhanyisi ze-chrome/aluminiyam, izicoci zamatye/zamatye)	`> 50%` $HF $: Intlungu engoko nangoko kunye necrosis emhlophe / engwevu. `20%, 50%` \(HF\): Iintlungu zilibazisekile 1 ukuya 8 iiyure . `< 20%` \(HF\) (Irust remover): Iintlungu zilibazisekile 6 ukuya kwiiyure ezingama-24.	Ukungena Transdermal \(\rightarrow\) free Fluoride (\(F^-\)) chelates izicubu & igazi \(Ca^{2+}\) kunye \(Mg^{2+}\) \(\rightarrow\) deep bone necrosis, i-hypocalcemia ebulalayo, i-hypomagnesemia, i-hyperkalemia, kunye ne-Ventricular Fibrillation.	Gubha ngamanzi 5 ukuya kwi-15 min (okanye Hexafluorine), emva koko uthambise 2.5% iGalcium Gluconate Gel (okanye I-Tums etyumkileyo eyi-10 + 30 mL K-Y jelly) eluswini ngokuqhubekayo ngeeglavu ze-nitrile.	1. I-Topical/Subcutaneous 5%, 10% yeCalcium Gluconate yokungena. 2. I-Intra-arterial Calcium Gluconate infusion (i-radial/brachial artery ngenxa yokutshisa okukhulu kwesandla/kweminwe). 3. IV Calcium Gluconate + IV Magnesium Sulfate + ECG eqhubekayo.
Isamente yasePortland emanzi & neConcrete (Amacwecwe okwakha, udaka, istucco, udaka: iqulethe iCalcium Oxide \(\rightarrow\) Calcium Hydroxide, pH 12 to 14)	I-2-to-6-iyure ethuleyo iqala : I-alkaline yesamente emanzi ibangela iziphelo zemithambo-luvo ngelixa inyibilika i-shins kunye namadolo.	Liquefactive alkali necrosis (\(\text{pH } 12.9\)) + isanti ebrasive + hygroscopic ukufuma umzobo \(\rightarrow\) cwaka ukutyeba okupheleleyo 3^rd-degree-skin necrosis efuna ukufakelwa kwesikhumba.	Khupha ibhulukhwe efakwe ikhonkrithi kunye neebhutsi ngokukhawuleza; xubha i-samente eyomileyo; hlamba ngamanzi abalekayo30 ukuya kwimizuzu engama-60 (dilute iviniga egoqweni kuphela emva kokuhlamba ngokucokisekileyo ngamanzi ngokweyunithi yokutshisa).	Uqhaqho lweyunithi yokutshisa iyunithi kunye nokuqhekeka kolusu lokutyeba ngokutshisa okunzulu kwamadolo.
I-Quicklime eyomileyo (iCalcium Oxide / \(CaO\)) kunye neeFlakhe zeDry Lye (\(\text{NaOH}\)) (Ikalika yezoLimo, umxube we-masonry mortar, i-crystal drain opener eyomileyo)	I-exothermic thermal ngoko nangoko + ukutsha kweekhemikhali ukuba idibene nokubila okanye ukuchaphaza okuncinci kwamanzi.	Iphendula ngobundlobongela emanzini (\(CaO + H_2O \rightarrow Ca(OH)_2 + \text{Intense Heat}\) up to \(150^\circ\text{C} / 300^\circ\text{F}\)) + kakhulu liquefactive alkali burn.	GULA wonke umgubo owomileyo ngokupheleleyo ngelaphu elomileyo/ibrashi KUQALA; emva koko ukhukulise ngamanzi ahambayo aphezulu ahambayo kangangemizuzu 30 ukuya kuma-60.	Tshisa ukhathalelo lweziko; ukunkcenkceshela nge-ophthalmology ukuba kwiliso (zikhuphe ngokucacileyo iinkophe ukuze zisuse amasuntswana ekalika avaleleke kwi-conjunctival fornices).
IPhenol (iCarbolic Acid) & neCreosote (Amaxolo eKhemikhali, izithinteli zomthi, iiplastiki zamashishini/izibulali ntsholongwane)	Ukujija okumhlophe okukhawulezileyo okungenantlungu (iphenol sisithomalalisi esinamandla sendawo esiphelisa ukutsha ngoko nangoko).	Iiprotheyini ze-Denatures + zifunxa ngokukhawuleza ngesikhumba esingaguqukiyo ukuze kubangele ukuxhuzula kwe-CNS, i-coma, i-methemoglobinemia, i-hepatic / renal failure, kunye ne-cardiac arrhythmias ebulalayo .	Ukunyibilika kwamanzi aphantsi (umlinganiselo omncinci wamanzi ngokwenene ukwandisa ukufunxa kwesikhumba): Sula ngokuphindaphindiweyo ngezipontshi ezifakwe kwi-Polyethylene Glycol (PEG 300 okanye 400) okanye 70% Isopropyl Alcohol / I-Oli yeVegetable, utshintshise nge-deluge shower ephezulu.	Ukujongwa kwe-ECG eqhubekayo, i-IV fluids, i-methylene eluhlaza okwesibhakabhaka ukuba i-methemoglobinemia ikhula, kunye nokutshisa ukunakekelwa kwenxeba.
Iintsimbi ze-Alkali ze-Elemental (i-Metallic Sodium [\(Na\)], i-Potassium [\(K\)], i-Lithium [\(Li\)]: iilabhoratri, ukwenziwa kwebhetri ye-EV)	Ugqabhuko-dubulo olukhawulezileyo nomlilo ekudibaneni namanzi okanye ulusu olumanzi.	Iphendula ngobundlobongela ngokufuma kwesikhumba ukukhupha isiqhushumbisi serhasi yeHydrojeni (\(H_2\)) + etyhidiweyo Isodium/iPotassium Hydroxide (\(\text{NaOH}/\text{KOH}\)) thermal/alkali burns.	UNGAZE usebenzise amanzi. Gcoba amaqhekeza esinyithi kwaye untywilise okanye ugqume indawo ngokukhawuleza kwi-Mineral Oli, i-Oyile yeVegetable, okanye i-Kerosene ukuvala umoya nokufuma; susa amaqhekeza nge forceps phantsi kweoli.	Ukususwa ngotyando lwazo zonke iziqwenga zetsimbi phantsi kweoyile yeminerali ngaphambi kokuba kuzanywe ukhathalelo lwenxeba elimanzi.
I-Phosphorus emhlophe (\(P_4\)) (Izixhobo zomkhosi, iziqhushumbisi, iziqhushumbisi, amadangatye oshishino)	Ibasa ngokuzenzekelayo ekudibaneni nomoya ngaphezulu kwe-\(30^\circ\text{C}\) (\(86^\circ\text{F}\)), ivutha nge-\(800^\circ\text{C}\) (\(1,470^\circ\text{F}\)) nomsi oshinyeneyo omhlophe wekonofile onevumba elimnandi.	Ukushisa okunzulu kwe-thermal + corrosive i-asidi ye-phosphoric ukulimala + i-hypocalcemia yenkqubo kunye ne-hepatorenal toxicity (efana ne-$ HF $).	Gcina inxeba lintywiliselwe ngokupheleleyo emanzini apholileyo okanye ligqunywe ngeelokhwe ezinetyuwa ethontsizayo emanzi ukuze ulambe iphosphorous yomoya/ioksijini ngelixa ususa amasuntswana okutshaya ngeeforceps zentsimbi.	Ukuhlolwa kwesibane se-UV Wood kwigumbi elimnyama (i-phosphorus ikhanya eluhlaza-mhlophe) okanye imfutshane 1% ye-Copper Sulfate ihlambulule ukuba ibe mnyama amasuntswana okususwa kwe-forceps + IV Calcium Gluconate .
Chromic Acid (\(CrO_3\)) (Iibhafu zokugquma ngeChrome, ukusukwa kwesikhumba, ukugqitywa kwentsimbi yeshishini)	Ibala elikhawulezayo elityheli-orenji liqhubela phambili ukuya kutsho kubunzulu "izilonda ze-chrome."	I-chromium e-Corrosive hexavalent ($ Cr ^ {6+} $) ibangela ukufunxwa kwenkqubo enkulu , i-hemolysis ye-intravascular, i-acute tubular necrosis (ukungaphumeleli kwezintso) , kunye nokungaphumeleli kwesibindi (esibulalayo ukuba sitshise \(> 2\%, 10\%\) TBSA).	Ngokukhawuleza i-15 ukuya kwi-30 imizuzu yokugungxula kwamanzi + i-topical i-10% ye-Ascorbic Acid (i-Vitamin C) isisombululo okanye i-5% ye-Sodium Thiosulfate (inciphisa i-toxic $ Cr ^ {6+} $ ukuba ifakwe kakubi i-$ Cr ^ {3+} $).	Ukutyolwa kwangoko kotyando okutyebileyo kokutsha kwechrome ukuthintela ukufunxwa kwechromium ebulalayo + nehemodialysis.