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Magnesium and Thermite Poisoning Follow-up

  • Author: Jayson Tappan, MD; Chief Editor: Zygmunt F Dembek, PhD, MPH, MS, LHD  more...
 
Updated: Sep 08, 2015
 

Further Outpatient Care

Outpatient care is identical to care for other thermal burns. A physician experienced in burn management usually should provide follow-up care for patients. Treatment may include dressings, topical antibiotics, analgesia, and grafting.

Outpatient care for UV keratitis is cycloplegic drops to reduce ciliary muscle spasm and to reduce pain. Topical antibiotics, drops or ointments should be prescribed, to decrease the chance of secondary infection. Patients should also have close follow-up with an ophthalmologist within 24 hours.

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Further Inpatient Care

Inpatient care is identical to care for other thermal burns, and it usually involves topical antibiotics (eg, silver sulfadiazine) and surgical debridement. Skin grafting may be needed; institute life-support measures as necessary.

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Transfer

Transfer patients with thermal burns to a burn center if they meet any of the following burn center criteria[10] :

  • Partial-thickness burns over 20% or more of body surface area
  • Full-thickness burns over 10%or more of body surface area
  • Burns involving hands, feet, eyes, ears, and/or perineum
  • Airway involvement
  • Significant underlying illness
  • Age younger than 1 year or older than 65 years
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Deterrence/Prevention

Workplace and military instruction in the dangers and correct handling of incendiary metals are the mainstay of prevention for accidental exposure and injury. Similarly, public awareness campaigns targeting firework safety in particular can reduce accidental injury and exposure.

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Complications

Complications are similar to those encountered in other thermal injuries.

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Prognosis

Prognosis depends on the extent of the burn injury, the underlying medical history of the victim, and the extent of care available.

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Patient Education

For patient education information, see Chemical Warfare and Personal Protective Equipment.

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Contributor Information and Disclosures
Author

Jayson Tappan, MD Staff Physician, Department of Emergency Medicine, National Naval Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Robin A C Marshall, MD Core Staff Physician, Assistant Residency Director, Civil Service Advocate, Department of Emergency Medicine, Naval Medical Center Portsmouth; Consulting Staff, Department of Emergency Medicine, Riverside Emergency Physicians, Riverside Regional Medical Center

Robin A C Marshall, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Zygmunt F Dembek, PhD, MPH, MS, LHD Associate Professor, Department of Military and Emergency Medicine, Adjunct Assistant Professor, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine

Zygmunt F Dembek, PhD, MPH, MS, LHD is a member of the following medical societies: American Chemical Society, New York Academy of Sciences

Disclosure: Nothing to disclose.

Additional Contributors

Mark Keim, MD Founder, DisasterDoc, LLC; Adjunct Professor, Emory University Rollins School of Public Health; Adjunct Professor, Harvard Affiliated Disaster Medicine Fellowship

Mark Keim, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Jonathan L Burstein, MD, to the development and writing of this article.

References
  1. Chemical casualties. Smokes, fuels, and incendiary materials. J R Army Med Corps. 2002 Dec. 148(4):395-7. [Medline].

  2. Stewart CE, Sullivan JB, eds. Military munitions and antipersonnel agents. Hazardous Materials Toxicology. 1992. 1007-1008.

  3. Mendelson JA. Some principles of protection against burns from flame and incendiary munitions. J Trauma. 1971 Apr. 11(4):286-94. [Medline].

  4. Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia: Mosby Elsevier; 2006.

  5. Tintinalli, et al, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw-Hill; 2004.

  6. Kaye P, Young H, O'Sullivan I. Metal fume fever: a case report and review of the literature. Emerg Med J. 2002 May. 19(3):268-9. [Medline].

  7. Spector J, Fernandez WG. Chemical, thermal, and biological ocular exposures. Emerg Med Clin North Am. 2008 Feb. 26(1):125-36, vii. [Medline].

  8. Warden CR. Respiratory agents: irritant gases, riot control agents, incapacitants, and caustics. Crit Care Clin. 2005 Oct. 21(4):719-37, vi. [Medline].

  9. Curreri PW, Asch MJ, Pruitt BA. The treatment of chemical burns: specialized diagnostic, therapeutic, and prognostic considerations. J Trauma. 1970 Aug. 10(8):634-42. [Medline].

  10. US Department of Transportation. Emergency Response Guidebook. 2004.

  11. Schwartz SI, ed. Principles of Surgery. 8th ed. New York: McGraw Hill; 2004.

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