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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.

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


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
Contributor Information and Disclosures

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

Disclosure: Nothing to disclose.


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.


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.

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