complicated by the fact that white phosphorus particlesignite upon contact with air.Superficial burns caused by simple skin contact orburning clothes should be flushed with water and treatedlike thermal burns. Partially embedded whitephosphorus particles must be continuously flushed withwater while the first aid provider removes them withwhatever tools are available (i.e., tweezers, pliers,forceps). Do this quickly, but gently. Firmly or deeplyembedded particles that cannot be removed by the firstaid provider must be covered with a saline-soakeddressing, and this dressing must be kept wet until thevictim reaches a medical treatment facility. The woundscontaining embedded phosphorus particles may then berinsed with a dilute, freshly mixed 1% solution of coppersulfate. This solution combines with phosphorus on thesurface of the particles to form a blue-black cupricphosphite covering, which both impedes furtheroxidation and facilitates identification of retainedparticles. Under no circumstances should the coppersulfate solution be applied as a wet dressing. Woundsmust be flushed thoroughly with a saline solutionfollowing the copper sulfate rinse to prevent absorptionof excessive amounts of copper. (Copper has beenassociated with extensive intravascular hemolysis.) Anadjunct to the management of phosphorus burn injuries isthe identification of the retained phosphorescent particlesin a darkened room during debridement.NOTE: Combustion of white phosphorusresults in the formation of a severe pulmonaryirritant. The ignition of phosphorus in a closedspace (such as the BAS tent or sickbay) mayresult in the development of irritantconcentrations sufficient to cause acuteinflammatory changes in the tracheobronchialtree. The effects of this gas, especially duringdebridement, can be minimized by placing amoist cloth over the nose and mouth toinactivate the gas and by ventilating the tent.HEAT EXPOSURE INJURIESLEARNING OBJECTIVE: Identify thesigns, symptoms, and emergency treatmentof heat cramps, heat exhaustion, and heatstroke.Excessive heat affects the body in a variety ofways. When a person exercises or works in a hotenvironment, heat builds up inside the body. The bodyautomatically reacts to get rid of this heat through thesweating mechanism. This depletes water andelectrolytes from the circulating volume. If they arenot adequately replaced, body functions are affected,and, initially, heat cramps and heat exhaustiondevelop. If the body becomes too overheated or wateror electrolytes too depleted, the sweat-controlmechanism of the body malfunctions and shuts down.The result is heat stroke (sunstroke). Heat exposureinjuries are a threat in any hot environment, butespecially in desert or tropical areas and in the boilerrooms of ships. Under normal conditions, it is apreventable injury. Individual and commandawareness of the causes of heat stress problems shouldhelp eliminate heat exposure injuries.Heat CrampsExcessive sweating may result in painful crampsin the muscles of the abdomen, legs, and arms. Heatcramps may also result from drinking ice water or othercold drinks either too quickly or in too large a quantityafter exercise. Muscle cramps are often an early signof approaching heat exhaustion.To provide first aid treatment for heat cramps,move the victim to a cool place. Since heat cramps arecaused by loss of salt and water, give the victim plentyof cool (not cold) water to drink, adding about oneteaspoon of salt to a liter or quart of water. Applymanual pressure to the cramped muscle, or gentlymassage it to relieve the spasm. If there are indicationsof anything more serious, transport the victimimmediately to a medical treatment facility.Heat ExhaustionHeat exhaustion (heat prostration or heat collapse)is the most common condition caused by working orexercising in hot environments. In heat exhaustion,there is a serious disturbance of blood flow to the brain,heart, and lungs. This causes the victim to experienceweakness, dizziness, headache, nausea, and loss ofappetite. The victim may faint but will probably regainconsciousness as the head is lowered, which improvesthe blood supply to the brain. Signs and symptoms ofheat exhaustion are similar to those of shock; thevictim will appear ashen gray, the skin cool, moist, andclammy and the pupils may be dilated (fig. 4-50). Thevital signs usually are normal; however, the victimmay have a weak pulse, together with rapid andshallow breathing. Body temperature may be belownormal.4-60
Integrated Publishing, Inc. - A (SDVOSB) Service Disabled Veteran Owned Small Business