What would you do if you had to deal with an acid attack?
Hardly a week has gone by recently without reports of an acid attack happening! Criminal incidents are not the only concern. As a security officer you would normally have had first aid training and hold a first aid at work qualification.
This qualification, and your security role, may well lead to your being a first responder in the event of a criminal act.
The thought of dealing with the aftermath of an acid attack is frightening to even the most experienced of first aiders. The stark reality is the number of attacks are rising year on year.
How many stories have you heard about recently?
So where to start? By equipping your place of work with appropriate personal protective equipment (PPE) and first aid equipment. This, combined with training, which takes literally minutes, can make the difference between being able to intervene with confidence during an incident, or standing by helplessly waiting for the emergency services to arrive.
Acid attacks can lead to serious life changing injury or death. The earlier and more effectively that you can intervene the better.
Although the term ‘acid attack’ has become the phrase to describe these events this is not the most accurate description. Many cases have involved other chemicals including alkalis (caustics) and ammonia. Any corrosive chemical can cause a chemical injury and this is important to understand as our first aid must be able to deal with all corrosives and irritants regardless of pH.
pH is a scale used to measure the acidity or alkalinity of a substance. It is extremely unlikely that you will know what corrosive substance is involved in the case of a criminal incident.
The important thing to remember is that your response will be the same.
If a colleague was to stumble into our office lobby having been the subject of an attack there are a number of steps we can take to safely manage the incident and reduce the consequences of the attack.
You must be mindful that the corrosive substance will still be present and presents a risk to you and anyone else helping. The casualty will be in an extreme state of panic and if the eyes are involved may not be able to see what assistance you are providing.
- Ensure there is no further risk from the attacker.
- Take charge of the situation talking firmly and calmly to the casualty explaining what you are doing for them and what to expect.
- Call for assistance and get someone to call for the emergency services.
- Protect yourself – DO NOT BECOME A CASUALTY TOO. Put on gloves, eye protection and long sleeves if possible.
- Decontamination is essential and the sooner this commences the better the outcome will be. Prioritise eyes, face and hands.
- Clothing that is contaminated with chemical must be removed. Always remove downward – cutting shoulder seams if necessary, to avoid taking chemical across the face. Cut around any clothing that has adhered to the skin
- In case of contamination to the eyes check if the casualty wears contact lenses – these should be removed as soon as practicable – either by the casualty or by trying to flush them out with the washing solution
Immediate decontamination of a corrosive splash is essential to minimise the damage caused. Strongly corrosive substances penetrate the skin and eyes almost immediately.
The chemical reacts with the bodies tissues and can cause a lot of damage in a short period of time. Victims talk about feeling their skin ‘melting’!
To reduce injury, we must try to stop penetration of the chemical or at least keep it to the outer layers where the body can often heal itself. Deeper injuries will generally require surgical intervention such as skin or corneal grafting.
Traditional decontamination uses passive washing solutions such as water.
This method relies on a continuous supply of fast flowing water to wash the chemical away from the surface of the skin and eyes.
This water will also dilute the chemical to reduce the aggressiveness. In industry this is defined under the EN15154 / ANSI standards and requires flow rates of 60+ litres per minute with sufficient water for 15 minutes washing.
Whilst water is commonly available it can give rise to issues of its own:
- Slow flow rates can increase the time taken to wash off the chemical. This allows the chemical time to penetrate further.
- Strong chemicals are slow to dilute. The chemical remains aggressive longer – favouring penetration.
- Water is hypotonic to the body – by osmosis water will be drawn into the skin and eyes therefore assisting the penetration of the chemical – known as the “wash-in effect”. In short, water on the skin makes it easier for a chemical to penetrate the skin. If all you have is water use as much as you can for as long as you can, at least 15 minutes, while waiting for help.
- Water can increase the risk of damage to other parts of the body or to responders as the still corrosive run off liquid spreads. For example, if washing chemical off someone’s shoulder have them lean to the side so that the substance is not washed off them down their back. This would increase the likelihood of secondary injury to the back.
- Hypothermia is a consideration with prolonged washing protocols.
The wash-in effect created by water can be reduced using what we call isotonic saline solutions. These solutions are a mixture of salt and water. The salt concentration is similar to that contained in tears, blood and other bodily fluids.
This eliminates the ‘wash in’ affect we discussed above.
Both the Faculty of Pre-hospital Medicine (https://fphc.rcsed.ac.uk/) and the London and South East Burns Network (http://www.lsebn.nhs.uk/) recommend the use of amphoteric solutions if immediately available.
Diphoterine® is a polyvalent amphoteric hypertonic washing solution. That is a very technical way of saying that Diphoterine® is a more effective method of washing off or decontaminating than water in the wake of an acid attack.
When used to decontaminate a chemical splash Diphoterine® can remove the chemical from the surface of the skin or eyes.
As an active washing solution, it will also bond with the aggressive element of all irritant and corrosive chemicals, therefore, preventing, or at least significantly reducing, the risk of serious injury developing.
As a hypertonic solution it also prevents the “wash-in effect” by drawing the corrosive substance away from the skin. In fact, it will create a slight reverse flow from the tissues of the skin and eyes. It draws out penetrated chemical allowing the return of a physiological skin pH more rapidly.
Diphoterine® has been used in industry and in many NHS settings for a number of years. It is now becoming more available in community as it is carried by security teams, close protection officers and specified as first aid equipment in venues and businesses who have evaluated the benefits. As an active washing solution Diphoterine® has a number of benefits:
- It is fully portable
- It is easy to deploy and provides a longer window for commencing decontamination (1 minute as opposed to immediately (10 seconds for water)
- Chelates the aggressor so run off is non-corrosive making it safer for the casualty/victim and the person administering first aid
- Provides rapid pain relief as the aggressiveness of the chemical is quickly reduced.
- Has benefits Improved outcomes in a delayed washing situation due to its hypertonic properties
DipHex Limited is managed by a team that have been active in the Health and Safety field for over 30 years. For the last 8 years we have worked closely with government agencies, medical institutions and industry to improve the understanding and treatment of chemical injuries. Give us a call to organise a demonstration or for further advice regarding your specific risks.