Magnesium and Thermite Poisoning Treatment & Management
- Author: Jayson Tappan, MD; Chief Editor: Zygmunt F Dembek, PhD, MPH, MS, LHD more...
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- Remove patients from the burning environment, with appropriate attention to personal safety.
- Flush thermite burns with copious amounts of water and brush or debride them to remove contaminating particles.
- Initial care for magnesium burn wounds should include removal of all unburned particles by mechanical means, including wound debridement, if needed. If particles are present, do not flush with water until particles have been removed. If water irrigation is needed for burn treatment or other decontamination, use copious amounts to rapidly flush away residual magnesium before the resulting chemical reaction can cause harm. To stop burning particles that cannot be easily removed, the area can be submersed or coated in mineral oil to stop the oxidizing reaction.
- Treat burns with standard thermal burn treatment techniques. Undertake standard support of the ABCs, including intubation and fluid resuscitation if needed.[4, 5, 10]
- Cover burned areas with dry, sterile dressings or burn-specific dressings. Avoid large areas of wet dressings due to the risk of hypothermia.
- Narcotic analgesia may be useful if the patient's hemodynamic status permits.
Emergency Department Care
Emergency department care comprises the following:
- Institute airway support
- Start fluid resuscitation, guided by formulas for similar thermal burns[4, 5]
- Perform wound debridement to remove residual particles of magnesium or iron if not already performed in prehospital setting
- Aggressively seek and treat associated traumatic injuries (eg, from blast)
- Assess and start initial treatment of any ocular injuries
- Institute analgesia
- Consider all incendiary burns tetanus prone and administer appropriate tetanus prophylaxis
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- A burn surgeon or other appropriate surgeon (eg, plastic, trauma) should be involved in care
- Consult an ophthalmologist if eye injury has occurred
- Continuing critical care expertise may be required if injury severity is high
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