Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Magnesium and Thermite Poisoning Treatment & Management

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

Prehospital Care

See the list below:

  • 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.[9]
  • 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.
Next

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[7]
  • Institute analgesia
  • Consider all incendiary burns tetanus prone and administer appropriate tetanus prophylaxis
Previous
Next

Consultations

See the list below:

  • 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
Previous
 
 
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.

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.