Summary
Chemical decontamination in the emergency department: epidemiology, clinical features, treatment, and clinical course
Affiliation of the authors
DOI
Quote
Amigó Tadín M, Uría Álvarez E, Canut Fusté E, Calderón González S, Nogué Xarau S. Chemical decontamination in the emergency department: epidemiology, clinical features, treatment, and clinical course. Rev Esp Urg Emerg. 2024;3:214–20
Summary
OBJECTIVE. To analyze epidemiologic and clinical characteristics of cases of eye or skin exposure to chemicals, and to evaluate clinical course according to decontamination protocol used.
MATERIAL AND METHODS. Over a period of 7 years we prospectively collected information on cases of exposure to chemical agents in patients treated in the chemical decontamination area of our emergency department. Patients were distributed according to type of exposure. In the first group, individuals had been exposed to caustic products or personal defense sprays, for which washing with a polyvalent solution was indicated for decontamination. In the second, individuals were exposed to detergents, alcohols, solvents, or noncaustic products, for which water or soap and water were indicated.
RESULTS. A total of 156 patients were studied. The median age was 35 years (interquartile range, 21 years), and 50% were men. Caustic agents accounted for the largest proportion of exposures (36.5%), and the eyes were the organ most often affected (64.8%). Workplace accidents caused 45.8% of the events. The group exposed to caustic agents comprised 85 patients. Seventy-one rinsed with a polyvalent solution. Symptom improvement was significantly better after such treatment than after decontamination with water (P = .016), but we saw no significant differences in pain measured on a pain scale (P = .442), the need for 2 or more follow-up visits (P > .05), or the persistence of signs or symptoms after 30 days (P = .072). Of the 71 patients exposed to noncaustic agents, 58 were decontaminated with water. When rinsing with water was compared to rinsing with a polyvalent solution in this group, there were no significant differences in subjective evaluation of improvement (P = .696), pain relief (P = .918), need for 2 or more follow-up visits (P > .05), or persistence of signs or symptoms (P = .352).
CONCLUSIONS. Decontamination is effective for improving symptoms of exposure. A polyvalent solution gives better results than water after exposure to a caustic agent or a personal defense spray. Other chemical exposures can be treated as well with water.