Occupational health and accidents
First aid for chemical-related accidents and injuries
Ensiapu kemikaalitapaturmissa ja -onnettomuuksissa englanti - Sisältö
If the first aid instructions for the chemical are not known, they must be checked in the safety data sheet. The safety data sheet must also be given to rescue personnel as soon as they arrive. This ensures that rescue personnel also have the necessary information on the hazards related to the chemical, proper protection and first aid instructions. Therefore, safety data sheets for chemicals that are particularly hazardous must be easily accessible at the location where chemicals are used or stored.
The person providing first aid must be protected as necessary. For example, respirator masks are needed to protect against chlorine and ammonia as well as durable protective gloves when performing first aid on people exposed to strong bases and acid splashes. The exposed patient is kept at rest and warm. A semi-seated or seated position is recommended for patients who have inhaled an irritant gas.
General operating principles in the event of a chemical accident
Taking action after a chemical accident is susceptible to risk. For this reason, the medical team to arrive at the scene of the accident must follow the instructions of the fire brigade and on-site personnel on how to approach safely and where they can safely work. Personnel must also protect themselves appropriately with personal protective equipment, such as a disposable, polyethylene chemical protective suit, rubber or plastic protective gloves, rubber boots and full face protection with a filter suitable for the chemical on top of suitably warm clothing.
Cleaning of patients exposed to chemicals is important. If the patients' clothing is contaminated with toxic or corrosive substances or if the gas or steam released from the clothing seriously irritates the patients’ mucous membranes, the patients’ clothing must be removed and they must be reclothed as soon as possible. When patients are brought in for treatment, the facility must be prepared to wash their skin. Cleaning skin is difficult outdoors when it is cold, as the removal of clothing poses an immediate risk of hypothermia. It is therefore important to prepare in advance for temporary accessories such as blankets, capes, sleeping bags and sleeping beds.
Ensiavun toimintaohjeet_kemikaalitapaturmat_englanti - plussisällöt
A person exposed to dangerous substances by inhalation is transferred to a location with fresh air and, if necessary, given CPR, which is most effective when preformed with bellows. Oxygen flow from a pressure cylinder can be connected to the bellows. Oxygen provision is particularly important in the event of carbon monoxide, hydrogen sulphide and cyanide poisoning.
Acids, bases and other toxic chemicals cause damage to the eye. Bases and very strong acids in particular penetrate quickly into the tissues, causing eye damage in a few dozen seconds. Irrigation of the eye with an abundance of water must be initiated immediately.
If a base or protein-denaturising substances such as lye and formalin have entered the eye, the eye must be irrigated with water for at least 15–20 minutes, and if necessary for the entire journey to further treatment.
If acid has splashed in the eye, the eye should be irrigated for 5–15 minutes.
When eyes are exposed to splashes of other irritants, such as organic solvents, the eye must be thoroughly rinsed with plenty of water.
The exposed skin area is rinsed as quickly as possible with plenty of water. In serious accidents involving corrosive substances, rinsing (emergency shower) should be started with clothing on.
However, it should be noted that certain corrosive substances, such as chlorosulfonic acid, form toxic gases when reacting with water. Special guidance should be considered in specific cases such as this.
After the emergency shower, dirty clothing is removed and isolated if necessary. Skin is washed with soap and water, and then dried. Finally, the injuries are covered with sterile dressing. Special substances are recommended for the cleansing of skin and neutralising the effects in accidents involving some substances, such as phenol and hydrofluoric acid. Adsorbing powders, e.g. kaolin, may also be used to remove substances that are only slightly water-soluble, such as fatty soluble pesticides from the skin.
In accidents involving the swallowing of dangerous substances, the chemical and physical properties of the substance, the toxicity, the time taken to swallow the substance, and the clinical status of the patient affect the type of first aid measures to be taken.
The absorption of organic substances in the gastrointestinal tract can usually be restricted by encouraging the patient to drink activated charcoal mixed in water. Immediately inducing vomiting could be necessary if the substance is very toxic and when swallowed is likely life/threatening.
Vomiting should not be induced when corrosive substances are swallowed; instead the substance should be diluted by encouraging the patient to drink water and rinsing their mouth. If the patient has swallowed an organic solvent, vomiting should not be induced, as this may allow the substance easy access to the lungs, where it could cause serious inflammation.
If the patient's level of consciousness is not normal or the patient is convulsing, they should not be given anything to swallow.