White phosphorus toxicity - Revision history

Rossdonaldson1: /* Background */

2020-09-08T20:53:56Z

Background

← Older revision		Revision as of 20:53, 8 September 2020
Line 1:		Line 1:
	==Background==		==Background==
			[[File:A-1E drops white phosphorus bomb 1966.jpg\|thumb\|Dropping of white phosphorus bomb.]]
	*White phosphorus is classically among only 2 chemical burns (other is [[Hydrofluoric Acid]]) that required an antidote		*White phosphorus is classically among only 2 chemical burns (other is [[Hydrofluoric Acid]]) that required an antidote
	**The antidote of copper sulfate is controversial and is not universally recommended		**The antidote of copper sulfate is controversial and is not universally recommended

Rossdonaldson1: /* Clinical Features */

2020-09-08T20:49:52Z

Clinical Features

← Older revision		Revision as of 20:49, 8 September 2020
Line 9:		Line 9:

	==Clinical Features==		==Clinical Features==
			[[File:Ayman2.jpg\|thumb\|White phosphorus injuries]]
	*[[Hypocalcemia]]		*[[Hypocalcemia]]
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]

ClaireLewis: /* References */

2019-10-01T20:27:14Z

References

← Older revision		Revision as of 20:27, 1 October 2019
Line 48:		Line 48:
	[[Category:Trauma]]		[[Category:Trauma]]
	[[Category:Military]]		[[Category:Military]]
			[[category:Toxicology]]

ClaireLewis at 20:26, 1 October 2019

2019-10-01T20:26:54Z

← Older revision		Revision as of 20:26, 1 October 2019
Line 4:		Line 4:
	*Incendiary agent that spontaneously burns in air and used during WWI, WWII, Vietnam, Korean wars; most recently in Iraq (OIF)		*Incendiary agent that spontaneously burns in air and used during WWI, WWII, Vietnam, Korean wars; most recently in Iraq (OIF)
	*Usually not seen unless in military or patients exposed to fireworks		*Usually not seen unless in military or patients exposed to fireworks
	*Damage due to both chemical and thermal ~~burn~~		*Damage due to both [[chemical burns\|chemical]] and thermal [[burns]]
	*The lethal dose when white phosphorus is ingested orally is 1mg per kg of body weight<ref>Konjoyan TR.[[http://www.atsdr.cdc.gov/toxprofiles/tp103.pdf White phosphorus burns: case report and literature review]]. Mil Med. Nov 1983;148(11):881-4</ref><ref>Agency for Toxic Substances and Disease Registry (ATSDR). U.S. Department of Health and Human Services, Public Health Service. Toxicological Profile for White Phosphorus. 1997</ref>		*The lethal dose when white phosphorus is ingested orally is 1mg per kg of body weight<ref>Konjoyan TR.[[http://www.atsdr.cdc.gov/toxprofiles/tp103.pdf White phosphorus burns: case report and literature review]]. Mil Med. Nov 1983;148(11):881-4</ref><ref>Agency for Toxic Substances and Disease Registry (ATSDR). U.S. Department of Health and Human Services, Public Health Service. Toxicological Profile for White Phosphorus. 1997</ref>
	*Particles that penetrate tissue continue to cause caustic damage until debrided		*Particles that penetrate tissue continue to cause caustic damage until debrided
Line 11:		Line 11:
	*[[Hypocalcemia]]		*[[Hypocalcemia]]
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]
	*Hepatic necrosis		*[[liver failure\|Hepatic necrosis]]
	*Death may occur from burns of only 10-15% total body surface area ([[TBSA]])		*Death may occur from burns of only 10-15% total body surface area ([[TBSA]])

Line 26:		Line 26:
	==Management==		==Management==
	*ABCs to secure airway especially if there is any sign of oral or facial burns.		*ABCs to secure airway especially if there is any sign of oral or facial burns.
	*Remove all O2 tanks and tubing from patient		*Remove all [[O2]] tanks and tubing from patient
	*As healthcare provider, avoid contact with ignited white phosphorus		*As healthcare provider, avoid contact with ignited white phosphorus
	*Continuous irrigation and grossly debride (use Wood's lamp if available to fluoresce the white phosphorus)<ref>Karunadasa et Al. White Phosphorus Burns Managed Without Copper Sulfate: Lessons From War. Journal of Burn Care & Research: May/June 2010 - Volume 31 - Issue 3 - p503.</ref>		*Continuous irrigation and grossly debride (use Wood's lamp if available to fluoresce the white phosphorus)<ref>Karunadasa et Al. White Phosphorus Burns Managed Without Copper Sulfate: Lessons From War. Journal of Burn Care & Research: May/June 2010 - Volume 31 - Issue 3 - p503.</ref>
	*Wet dressings that cut off O2 exposure to remaining white phosphorus<ref>Rabinowitch IM. et al. Treatment of Phosphorus Burns : With a note on Acute Phosphorus Poisoning. Can Med Assoc J. 1943 Apr;48(4):291-6</ref>		*Wet dressings that cut off O2 exposure to remaining white phosphorus<ref>Rabinowitch IM. et al. Treatment of Phosphorus Burns : With a note on Acute Phosphorus Poisoning. Can Med Assoc J. 1943 Apr;48(4):291-6</ref>
	*Monitor Calcium and Phosphorus levels		*Monitor Calcium and Phosphorus levels
	*Traditionally~~, copper sulfate~~ used to both convert white phosphorus and visualize end product (cupric phosphate), ~~but copper~~ is systemically absorbed and may lead to intravascular hemolysis, [[~~Renal~~ Failure]], and ~~Cardiovascular~~ collapse		*Copper sulfate
			**Traditionally used to both convert white phosphorus and visualize end product (cupric phosphate)
			**However, is systemically absorbed and may lead to intravascular [[hemolytic anemia\|hemolysis]], [[renal Failure]], and [[shock\|cardiovascular collapse]]
	*Update [[Tetanus_(Prophylaxis)\|Tetanus]]		*Update [[Tetanus_(Prophylaxis)\|Tetanus]]

Rossdonaldson1: Text replacement - "TBSA" to "TBSA"

2019-02-12T08:38:06Z

Text replacement - "TBSA" to "TBSA"

← Older revision		Revision as of 08:38, 12 February 2019
Line 12:		Line 12:
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]
	*Hepatic necrosis		*Hepatic necrosis
	*Death may occur from burns of only 10-15% total body surface area (TBSA)		*Death may occur from burns of only 10-15% total body surface area ([[TBSA]])

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* See Also */

2018-02-16T07:15:37Z

Rossdonaldson1: /* Management */

2018-02-16T07:15:13Z

Management

← Older revision		Revision as of 07:15, 16 February 2018
Line 21:		Line 21:

	{{Chemical weapon DDX}}		{{Chemical weapon DDX}}

			==Evaluation==

	==Management==		==Management==

Rossdonaldson1: Rossdonaldson1 moved page White phosphorus to White phosphorus toxicity

2018-02-16T07:14:41Z

Rossdonaldson1 moved page White phosphorus to White phosphorus toxicity

← Older revision	Revision as of 07:14, 16 February 2018
(No difference)

Rossdonaldson1 at 07:05, 16 February 2018

2018-02-16T07:05:27Z

← Older revision		Revision as of 07:05, 16 February 2018
Line 5:		Line 5:
	*Usually not seen unless in military or patients exposed to fireworks		*Usually not seen unless in military or patients exposed to fireworks
	*Damage due to both chemical and thermal burn		*Damage due to both chemical and thermal burn

	~~==Complications==~~
	*The lethal dose when white phosphorus is ingested orally is 1mg per kg of body weight<ref>Konjoyan TR.[[http://www.atsdr.cdc.gov/toxprofiles/tp103.pdf White phosphorus burns: case report and literature review]]. Mil Med. Nov 1983;148(11):881-4</ref><ref>Agency for Toxic Substances and Disease Registry (ATSDR). U.S. Department of Health and Human Services, Public Health Service. Toxicological Profile for White Phosphorus. 1997</ref>		*The lethal dose when white phosphorus is ingested orally is 1mg per kg of body weight<ref>Konjoyan TR.[[http://www.atsdr.cdc.gov/toxprofiles/tp103.pdf White phosphorus burns: case report and literature review]]. Mil Med. Nov 1983;148(11):881-4</ref><ref>Agency for Toxic Substances and Disease Registry (ATSDR). U.S. Department of Health and Human Services, Public Health Service. Toxicological Profile for White Phosphorus. 1997</ref>
	*Particles that penetrate tissue continue to cause caustic damage until debrided		*Particles that penetrate tissue continue to cause caustic damage until debrided

			==Clinical Features==
	*[[Hypocalcemia]]		*[[Hypocalcemia]]
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]
Line 34:		Line 34:
	==Disposition==		==Disposition==
	*Transfer the the patient to a burn care center		*Transfer the the patient to a burn care center

			==See Also==

	==References==		==References==
	<references/>		<references/>
Line 40:		Line 43:
	[[Category:Trauma]]		[[Category:Trauma]]
	[[Category:Military]]		[[Category:Military]]
	~~[[Category:Featured]]~~

RSarlay: Added category - Military

2018-01-19T17:57:05Z

Added category - Military

← Older revision		Revision as of 17:57, 19 January 2018
Line 38:		Line 38:

	[[Category:Dermatology]]		[[Category:Dermatology]]
	[[Category:Trauma]] [[Category:Featured]]		[[Category:Trauma]]
			[[Category:Military]]
			[[Category:Featured]]