Brûlures: Pensez au phosphore blanc !

Evidence for chemical burns by white phosphorus in Armenian soldiers during the 2020 Nagorno-Karabakh war
Son Brutyan S et Al.  Injury. 2021 Apr;52(4):1100-1101.

 

La reconnaissance précoce des brûlures au phosphore blanc est fondamentale du fait du risque d'arrêt cardiaque liée à une hypocalcémie majeure.  L'élimination rapide des particules de phosphore, le refroidissement des zones touchées par pansement humide et la réanimation hydroélectrolytique bien conduite sont essentiels. Pendant la guerre du Haut-Karabakh de 2020, les chirurgiens et les spécialistes des soins intensifs du Centre national des brûlés d'Erevan, en Arménie, ont  été confrontés à un afflux important de brûlés présentant des brûlures creusantes, fluorescente à l'observation sous lumière ultraviolette et associées à une hypocalcémie profonde. Une meilleure sensibilisation aux conséquences des blessures par phosphore blanc est spécifique et  peut sauver des vies. 

 

Brûlures au phosphore: Pansement humide simplement

Experimental Comparison of Efficiency of First Aid Dressings in Burning White Phosphorus on Bacon Model.

Witkowski W et Al Med Sci Monit. 2015 Aug 12;21:2361-6

BACKGROUND:

The aim of this study was to determine effectiveness of first aid dressings in extinguishing burning white phosphorous (WP), eliminating WP pieces from the surface, inhibiting re-ignition on the model (fresh bacon covered with military uniform), and preventing from late re-ignition caused by persistent WP pieces.

MATERIAL AND METHODS:

Burning WP was extinguished with several dressings: tactical Military Dressing (WJ10), wet gauze, 2 hydrocolloids, and 3 prototypes of hydrocolloids developed by the authors.

RESULTS:

All examined dressings were effective in extinguishing WP provided that the entire area of the burning substance was completely covered. Moist gauze was especially effective in extinguishing WP, and also removed and absorbed the majority of the WP mass, preventing deeper penetration of WP particles. The immediate re-ignition was observed when all the remaining examined dressings were removed from the bacon. A stream of water was dangerous, as it splashed and transferred pieces of WP around.

CONCLUSIONS:

Moist gauze placed on burning WP for approximately 3 min was most effective in extinguishing WP and removing most of the WP pieces. We recommend moist gauze, used once or twice, as the best primary means for WP elimination and preventing tissue penetration. As a dressing used for medical evacuation (MEDEVAC), or as a second step after complete removal of visible WP, innovative hydrocolloid or hydrogel dressings should be used.