Tar burn: Difference between revisions
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==Management== | ==Management== | ||
*Immediately | *Immediately | ||
**Cool tar with cold water until | **Cool tar with cold water until hardened to stop burning and limit tissue damage | ||
**Take care to avoid hypothermia | **Take care to avoid hypothermia | ||
*Removal | *Removal (unless small area, will generally occur in inpatient setting) | ||
** | **Needs to be dissolved as manual debridement of hardened tar/asphalt damages underlying tissue<ref name="Iuchi">Iuchi M, et al. The comparative study of solvents to expedite removal of bitumen. Burns. 2009 Mar;35(2):288-93.</ref> | ||
**Neosporin | **The best solvents are chemically similar to tar/asphalt ("like dissolves like")<ref name="Bosse" /> | ||
***Multiple agents have been suggested, such as baby oil, sunflower oil, butter, and mayonnaise<ref name="Iuchi" /><ref name="Bosse" /> | |||
*** | **Neosporin has a petroleum base and is successful at slowly dissolving tar/asphalt (may also help prevent infection)<ref name="Bosse" /> | ||
** | ***Has benefit of being readily available, but may not be available in enough quantity for large burns. | ||
**Mineral oil has also been identified as a safe, non-toxic, and effective means of dissolving tar/asphalt<ref name="Carta">Carta T, et al. Use of mineral oil Fleet enema for the removal of a large tar burn: a case report. Burns. 2015 Mar;41(2):e11-4.</ref> | |||
==Disposition== | ==Disposition== | ||
Revision as of 06:51, 1 March 2016
Background
- Tar is a product of the distillation of coal.[1]
- Asphalt (now more commonly used than tar) and tar are both forms of bitumen
- Currently used mainly for roofing and road paving
- When used for these purposes, tar/asphalt is heated to between 140-190°C (for paving) and 210-270°C (for roofing)[1]
- Injuries limited almost exclusively to occupational exposure in these fields
- Tar/asphalt is highly viscous and sticks to skin, making it difficult to remove and leading to more severe burns
- Tar itself is sterile, but dead tissue underneath is not
Clinical Features
- Viscous black substance on skin in setting of history of working with coal tar or asphalt
- May be hardened or still relatively fluid on presentation to ED
Differential Diagnosis
Caustic Burns
- Caustic ingestion
- Caustic eye exposure (Caustic keratoconjunctivitis)
- Caustic dermal burn
- Airbag-related burns
- Hydrofluoric acid
- Tar burn
- Cement burn
Diagnosis
- Clinical diagnosis
- Workup should be based on clinical presentation, and may include:
Management
- Immediately
- Cool tar with cold water until hardened to stop burning and limit tissue damage
- Take care to avoid hypothermia
- Removal (unless small area, will generally occur in inpatient setting)
- Needs to be dissolved as manual debridement of hardened tar/asphalt damages underlying tissue[2]
- The best solvents are chemically similar to tar/asphalt ("like dissolves like")[1]
- Neosporin has a petroleum base and is successful at slowly dissolving tar/asphalt (may also help prevent infection)[1]
- Has benefit of being readily available, but may not be available in enough quantity for large burns.
- Mineral oil has also been identified as a safe, non-toxic, and effective means of dissolving tar/asphalt[3]
Disposition
- Admit to burn center for >10% TBSA or significant full thickness injury
See Also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Bosse GM, et al. Hot asphalt burns: a review of injuries and management options. Am J Emerg Med. 2014 Jul;32(7):820.e1-3.
- ↑ 2.0 2.1 Iuchi M, et al. The comparative study of solvents to expedite removal of bitumen. Burns. 2009 Mar;35(2):288-93.
- ↑ Carta T, et al. Use of mineral oil Fleet enema for the removal of a large tar burn: a case report. Burns. 2015 Mar;41(2):e11-4.