Question
The construction worker presents to the ED with this rash. What is it and what is the treatment?
Answer
This is a common presentation for a cement burn. The wet material spills over the top of the worker's boots and causes caustic burns. Treatment involves decontamination (brush off any dry cement as when applying water you will make more caustic product), copious irrigation and wound treatment similar to other burns. Remember this is an alkali material so it will create deep liquefacious necrosis.
Burn Center Transfer Criteria
- Partial thickness >20% BSA (10-50 years old)
- Partial thickness >10% BSA (<10 or > 50 yrs old)
- Full thickness >5% BSA (any age)
- Burns involving face, eyes, ears, genitalia, joints, hands, feet
- Burns with inhalation injury
- High voltage electrical burn
- Chemical burns
- Burns complicated by fracture or other trauma (in which burn is main cause of morbidity)
- Burns in high-risk patients
References
- https://1stamericansafety.com/prevent-concrete-burns/ (image)
- https://www.ehspractice.com/blog/concrete-burns/
- https://wikem.org/wiki/Cement_burn