Journal of Emergencies, Trauma, and Shock
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CASE REPORT
Year : 2012  |  Volume : 5  |  Issue : 2  |  Page : 178-180

Severe metabolic acidosis following assault chemical burn


1 Burn Unit, Military Hospital; Department of Intensive Care, Université Catholique De Louvain, Cliniques St-Luc, Brussels, Belgium
2 Burn Unit, Military Hospital, Université Catholique De Louvain, Cliniques St-Luc, Brussels, Belgium
3 Department of Intensive Care, Université Catholique De Louvain, Cliniques St-Luc, Brussels, Belgium

Correspondence Address:
Philippe Hantson
Department of Intensive Care, Université Catholique De Louvain, Cliniques St-Luc, Brussels
Belgium
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.96488

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Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9) obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure). Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene.


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