Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
J Emerg Med. 2020 Oct;59(4):e123-e126. doi: 10.1016/j.jemermed.2020.06.038. Epub 2020 Aug 15.
In the United States, over 1 million burns require medical treatment each year. Chemical burns represent an infrequent but devastating percentage of all burns, which account for a large proportion of all burn-related deaths. Of the various causes of chemical burns, sulfuric acid is most commonly involved in occupational and accidental burns, and even cases of assault.
We describe the case of a 27-year-old man who presented to our Emergency Department (ED) after an assault with sulfuric acid. During his presentation, particular attention and care was given to his decontamination, airway management, and correction of life-threatening metabolic derangements. After stabilization in the ED he survived an extensive hospital admission. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patient outcomes and prognosis after chemical burns are dependent on prompt recognition/suspicion and rapid initiation of treatment. Even with prompt treatment, severe physiologic and psychologic injuries often afflict the patient. While encountering these devastating injuries, the emergency physician must carry a heightened sense of care and protection for both patient and staff to ensure optimum outcomes.
在美国，每年有超过 100 万例烧伤需要接受医疗治疗。化学烧伤虽然少见，但却是所有烧伤中极具破坏性的一部分，占所有烧伤相关死亡的很大比例。在各种化学烧伤的原因中，硫酸最常与职业和意外烧伤有关，甚至与袭击有关。
我们描述了一位 27 岁男性的病例，他在被硫酸袭击后来到我们的急诊部（ED）就诊。在他就诊期间，特别注意并精心处理了他的清除污染、气道管理和纠正危及生命的代谢紊乱。在 ED 稳定后，他成功度过了漫长的住院期。
为什么急诊医生应该了解这一点？： 化学烧伤后患者的结局和预后取决于对其的快速识别/怀疑和迅速开始治疗。即使及时治疗，严重的生理和心理伤害也经常会困扰患者。在遇到这些毁灭性的伤害时，急诊医生必须对患者和医护人员给予更高的关怀和保护，以确保最佳的结局。
