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Author: Amshel CE, Fealk MH, Phillips BJ, Caruso DM. Department of Surgery, Maricopa Medical Center, Phoenix, AZ 85008, USA.
Journal: Burns. 2000 Aug;26(5):493-7.
Abstract: Chemical burns are associated with significant morbidity, especially anhydrous ammonia burns. Anhydrous ammonia is a colorless, pungent gas that is stored and transported under pressure in liquid form. A 28 year-old patient suffered 45% total body surface area of second and third degree burns as well as inhalational injury from an anhydrous ammonia explosion. Along with fluid resuscitation, the patient’s body was scrubbed every 6 h with sterile water for the first 48 h to decrease the skin pH from 10 to 6-8. He subsequently underwent a total of seven wound debridements; initially with allograft and then autograft. On post burn day 45, he was discharged. The injuries associated with anhydrous ammonia burns are specific to the effects of ammonium hydroxide. Severity of symptoms and tissue damage produced is directly related to the concentration of hydroxyl ions. Liquefactive necrosis results in superficial to full-thickness tissue loss. The affinity of anyhydrous ammonia and it’s byproducts for mucous membranes can result in hemoptysis, pharyngitis, pulmonary edema, and bronchiectasis. Ocular sequelae include iritis, glaucoma, cataracts, and retinal atrophy. The desirability of treating anhydrous ammonia burns immediately cannot be overemphasized. Clothing much be removed quickly, and irrigation with water initiated at the scene and continued for the first 24 h. Resuscitative measures should be started as well as early debridement of nonviable skin. Patients with significant facial or pharyngeal burns should be intubated, and eyes irrigated until conjunctivae sac pH below 8.5 is achieved. Although health care professionals need to be prepared to treat chemical burns, educating the public, especially those workers in the agricultural and industrial setting, should be the first line of prevention.
I just spent three hours in the ER. The trip to the ER was precipitated by my getting a mixture of bleach, Mr. Clean and water in my left eye while scrubbing the soffits of the siding on my house. Whilst in the ER, I had my eye irrigated twice with a 0.9% solution of NaCl using the Morgan Lens to facilitate the irrigation. THANK YOU for creating the Morgan Lens. My eye felt so much better after the second round of irrigation, and it did take two rounds before the pH level in my eye returned to normal. I know companies always hear about the things that go wrong with their equipment. I want you to know that your equipment did something wonderful, and I want you to know how very much I appreciate it.Patient - Platteville, WI
The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.