Some standard content:
ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ51—2002
Diagnostic Criteria of Chemical Skin Burns2002-04-08 Issued
2002-06-01 Implementation
Ministry of Health of the People's Republic of China
Article 4.1 of this standard is recommended, and the rest are mandatory. This standard is formulated in accordance with the "Law of the People's Republic of China on the Prevention and Control of Occupational Diseases". From the date of implementation of this standard, if there is any inconsistency between the original standard GB16371-1996 and this standard, this standard shall prevail. In occupational activities, due to improper protection or accidents, some high-temperature or normal-temperature chemicals directly contaminate the skin of workers, causing irritation and corrosion to the skin, as well as acute skin damage caused by chemical reaction heat. In order to diagnose and treat them as soon as possible and correctly, so as to protect the health of workers, this standard is formulated. Appendix A of this standard is an informative appendix, and Appendix B, C, D, and E are normative appendices. This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard was drafted by Shanghai Chemical Occupational Disease Prevention and Treatment Institute and Ruijin Hospital Affiliated to Shanghai Second Medical University, and Shanghai Second Military Medical University, Shanghai Institute of Labor Hygiene and Occupational Disease Prevention and Treatment, Tianjin Occupational Disease Prevention and Treatment Institute, Beijing Jishuitan Hospital, Chongqing Third Military Medical University, Lanzhou Petrochemical Company Hospital, and Jilin Chemical Company Hospital. This standard is interpreted by the Ministry of Health of the People's Republic of China. Occupational Chemical Skin Burns Diagnostic Standard GBZ51-2002
Chemical skin burns are acute skin damage caused by direct skin irritation, corrosion and heat of chemical reactions of chemicals at room temperature or high temperature, which may be accompanied by eye burns and respiratory tract damage. Some chemicals can be absorbed through the skin and mucous membranes and cause poisoning. 1 Scope
This standard specifies the diagnostic standards and treatment principles for occupational chemical skin burns. This standard applies to the diagnosis and treatment of occupational chemical skin burns. 2 Diagnostic principles
2.1 According to the acute skin damage caused by skin contact with a chemical, such as erythema, blisters, and burns, it can be diagnosed as burns caused by the chemical.
2.2 Certain chemicals such as yellow phosphorus, phenol, hot barium chloride, cyanide, acrylonitrile, carbon tetrachloride, aniline, etc. can also be absorbed through the skin and mucous membranes, combined with poisoning by the chemical. Diagnostic and grading standards
3.1 Mild burns with a total area of less than 10% of the second degree. 3.2 Moderate burns with a total area of 11% to 30% or I, III, and ... 3.3 Severe burns Those who have any of the following can be diagnosed as having severe burns: total area of 31% to 50% or IIII degree of 11% to 20%; a)
Total area of burns <30%, accompanied by severe eye, esophageal or upper respiratory tract damage; burns in special parts of the head, face, neck, hands, joints, etc., although the area is small, but cause functional disorders, disfigurement, c)
disabled.
3.4 Extremely severe burns with a total area exceeding 50% or II degree burns exceeding 20%, accompanied by severe solid organ damage or lower respiratory tract damage.
4 Treatment principles
4.1 Treatment principles
4.1.1 Move away from the scene quickly, take off clothes, gloves, shoes and socks contaminated by chemicals, and immediately rinse thoroughly with plenty of running water. The rinsing time is generally required to be 20 to 30 minutes. The rinsing time should be extended after burns caused by alkaline substances. Special attention should be paid to the flushing of eyes and other special parts such as the head, face, hands and perineum. After the burn wound is flushed with water, reasonable neutralization treatment can be carried out if necessary.
4.1.2 Chemical burn wounds should be thoroughly cleaned, blisters should be cut off, necrotic tissue should be removed, and deep wounds should be cut (sliced) and skin grafted or delayed skin grafted immediately or early.
4.1.3 The routine treatment of chemical burns is the same as that of thermal burns. ..com4.1.4 When there is eye or respiratory injury or chemical poisoning at the same time, please consult a specialist. 4.2 Other treatments
4.2.1 For burns on functional parts that cause serious functional disorders of the five senses, motor system or organs, work or rest should be arranged as appropriate. For burns on non-functional parts, there is no sequelae after recovery and the patient can return to the original position. 4.2.2
Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 Chemical skin burns are acute skin damage caused by direct irritation and corrosion of high-temperature or normal-temperature chemicals on the skin and heat from chemical reactions. Flame burns, water scalds and frostbite are not included. A.2 When inquiring about the contact history and conducting on-site investigations, attention should be paid to the effects of factors such as the nature of the chemical, contact dose, contact concentration, contact time, contact method, labor protection, personal hygiene, season and flushing time on the occurrence and development of this disease. A.3 For chemical skin burns, attention should be paid to the area, degree and location of the burns. The burn area is calculated according to the new nine-point method (the area of I degree burns is not counted). When estimating the degree of burns and deciding on surgical resection, it is important to pay attention to the morphological characteristics of the wound surface of III degree alkali burns and II degree acid burns.
A.4 The diagnosis of chemical skin burns is mainly based on clinical symptoms and signs, as well as the close causal relationship between occupational exposure and the occurrence and development of skin burns. This standard refers to the National Burn Conference Grading Standard for diagnosis and grading. Although the burn area caused by some chemicals is not large, those who are disabled due to severe local tissue damage should also be considered severe burns. A.5 Some chemical skin burns may be accompanied by eye burns, respiratory burns or chemical poisoning. Some poisons such as cyanide, carbon tetrachloride, aniline or hot chlorinated chlorine may be accompanied by poisoning or delayed poisoning. Special attention should be paid and diagnosis and treatment should be carried out according to the diagnostic standards and treatment principles of corresponding chemical poisoning or burns. New Nine-point Method
Appendix B
(Normative Appendix)
Calculation of Chemical Skin Burn Area
The head and neck area account for 9% (of which the front and back sides of the neck account for 1% each). The upper limbs account for 18% (of which the front and back upper arms account for 2%, the forearms account for 1.5%, and the palm and back of the hands account for 1% each). The trunk area accounts for 27% (of which the front and back sides account for 13%, and the perineum accounts for 1%). The area of the buttocks is 5%. The area of the lower limbs is 41% (including 5% for the front and rear thighs, 3.5% for the calves, and 1.75% for the dorsum and plantar surfaces of the feet).
Both upper limbsWww.bzxZ.net
Both lower limbs
Area, %
9(1×9)
18(2×9)
27(3×9) Including perineum1
46(5×9+1)
Three-degree four-division method
Depth classification
Appendix C
(Normative Appendix)
Estimation of the depth of chemical skin burns
Depth of injury
Epidermis
Superficial dermis
Deep dermis
Full-thickness skin, involving
subcutaneous tissue or deeper
Clinical manifestations
Erythema, mild redness, swelling, pain, heat, hyperesthesia, no blisters, dryness
Severe pain, hyperesthesia, blister formation, thin blister wall, base flushing, obvious edema
There may be or may not be blisters, peeling off the epidermis reveals a moist, pale base with bleeding spots, obvious edema, and dull pain sensation. After a few days, if there is no infection, reticular embolism of blood vessels may occur
Leather-like, waxy or burnt yellow carbonization, loss of sensation, dryness, edema under the dermis, and dendritic vein embolism may occur
II° acid-burned dermis has a similar appearance, color, and hardness to II° "burned dermis". Be sure to pay attention to this feature before deciding to perform dermatectomy.
II° Alkali burns appear moist and greasy, and even skin wrinkles and hair may be present. C.3
Chemical substances
Inorganic acids
Hydrofluoric acid
Hydrobromic acid
Organic acids
Trichloroacetic acid
Glacial acetic acid
Chloroacetic acid
Acrylic acid
Inorganic bases
Potassium hydroxide (sodium hydroxide)
Ammonium hydroxide (aqueous ammonia)
Organic bases
Ethylenediamine
Ethanolamine
Dimethyl sulfate
Dimethyl sulfoxide
Appendix D
（ Normative Appendix)
First aid for burns caused by common chemicals
Cleaning agent
Flowing water
Flowing water
Flowing water
Protoplasm poison
Protoplasm poison
Protoplasm poison
Protoplasm poison
Protoplasm poison
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Flowing water
Special treatments for reference
5% sodium bicarbonate solution
5% sodium bicarbonate solution
25% magnesium sulfate solution||tt ||10% calcium gluconate solution
lime water solution
dquaternary ammonium compound-benzyl chloride
soaking and wet compressing with hydrocarbon amine solution
soaking and wet compressing with hydrofluoric acid burn treatment solution
soaking and wet compressing
amino pine vinegar:
1 part of 5% ammonia water
1 part of turpentine
95% alcohol
5% sodium thiosulfate solution
10% calcium gluconate solution
5% sodium bicarbonate solution
5% sodium bicarbonate solution
% sodium bicarbonate solution
5% sodium bicarbonate solution
5% sodium bicarbonate solution
5% sodium bicarbonate solution
3% boric acid solution
0.5%~5% acetic acid solution or 10%
citric acid solution
0.5%~5% acetic acid solution or 10%
citric acid solution
3% boric acid solution
3% boric acid solution
3% boric acid solution
5% sodium bicarbonate solution
5% sodium bicarbonate solution
50% alcohol to wipe the wound
5% sodium bicarbonate solution
soaked in glycerol polyethylene glycol or
a mixture of polyethylene glycol and alcohol
liquid (7:3)Cotton or gauze to wipe the wound
50% alcohol to wipe the wound
5% sodium bicarbonate solution
soaked in glycerol polyethylene glycol or
dichlorophenol
metal potassium (sodium)
limestone
phosphorus trichloride
protoplasm poison
protoplasm Poison
Running water
Cover with oil
Always flush with a small amount of water
Cover with oil
Avoid flushing with a small amount of water
Cover with oil
Avoid flushing with a small amount of water
Running water
Avoid flushing with a small amount of water
Mixed liquid of polyethanol and alcohol (7:3) Wipe the wound with cotton or gauze
Apply to the wound
50% alcohol Wipe the wound
5% sodium bicarbonate solution
Soaked in glycerol, polyethylene glycol or||tt ||Mixed solution of polyethanol and alcohol
(7:3) Cotton or gauze to wipe the wound
3% boric acid solution
3% boric acid solution
3% boric acid solution
a.) 1%~2% copper sulfate solution 2
b) 3% silver nitrate solution
c) 5% sodium bicarbonate solution
5% sodium bicarbonate solution
Note: 1) Hydrofluoric acid burn treatment solution: 5% calcium fluoride 20ml, 2% lidocaine 20ml, dexamethasone 5mg, dimethyl sulfoxide 60ml.
2) Copper sulfate as a display agent,
antidote.
Hepatotoxic poisons
Nephrotoxic poisons
Neurotoxic poisons
Cardiac toxic poisons
Appendix E
(Normative Appendix)
Poisons causing chemical burns and their target organs
Yellow phosphorus, antimony trichloride, carbon tetrachloride, nitrobenzene, aniline, ethylenediamine, dimethylformamide, dimethyl sulfate, etc.
Phenol, cresol, dichlorophenol, yellow phosphorus, dimethyl sulfate, etc., gasoline
Soluble barium salts (barium chloride), chlorofluoric acid, oxalic acid) 1%~2% copper sulfate solution 2
b) 3% silver nitrate solution
c) 5% sodium bicarbonate solution
5% sodium bicarbonate solution
Note: 1) Hydrofluoric acid burn treatment solution: 5% calcium fluoride 20ml, 2% lidocaine 20ml, dexamethasone 5mg, dimethyl sulfoxide 60ml.
2) Copper sulfate as a display agent,
antidote.
Hepatotoxic poisons
Nephrotoxic poisons
Neurotoxic poisons
Cardiac toxic poisons
Appendix E
(Normative Appendix)
Poisons causing chemical burns and their target organs
Yellow phosphorus, antimony trichloride, carbon tetrachloride, nitrobenzene, aniline, ethylenediamine, dimethylformamide, dimethyl sulfate, etc.
Phenol, cresol, dichlorophenol, yellow phosphorus, dimethyl sulfate, etc., gasoline
Soluble barium salts (barium chloride), chlorofluoric acid, oxalic acid) 1%~2% copper sulfate solution 2
b) 3% silver nitrate solution
c) 5% sodium bicarbonate solution
5% sodium bicarbonate solution
Note: 1) Hydrofluoric acid burn treatment solution: 5% calcium fluoride 20ml, 2% lidocaine 20ml, dexamethasone 5mg, dimethyl sulfoxide 60ml.
2) Copper sulfate as a display agent,
antidote.
Hepatotoxic poisons
Nephrotoxic poisons
Neurotoxic poisons
Cardiac toxic poisons
Appendix E
(Normative Appendix)
Poisons causing chemical burns and their target organs
Yellow phosphorus, antimony trichloride, carbon tetrachloride, nitrobenzene, aniline, ethylenediamine, dimethylformamide, dimethyl sulfate, etc.
Phenol, cresol, dichlorophenol, yellow phosphorus, dimethyl sulfate, etc., gasoline
Soluble barium salts (barium chloride), chlorofluoric acid, oxalic acid
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