1. First Aid in Laboratories
PHA297 – Laboratory Safety

2. First Aid in Laboratories
«A half doctor near is better than a whole one far away» (A German Proverb) “do no harm” Types of Lab-Related Medical Problems Many kinds of medical emergencies can occur. We will focus on lab-related emergencies and avoid the discussion of situations (such as a diabetic emergency) that require medical response but are likely unrelated to the circumstances of working in a chemistry lab.

3. First Aid in Laboratories
Lab-related emergencies:
Inhalation of gases and vapors
Skin and eye exposure to chemicals
Burns
Electric shock
Exposure to extreme cold
Cuts or open wounds
Traumatic injuries, such a bruises and broken bones
Exposure to biological agents
Radiation exposure
If any of these incidents cause serious injuries or loss of consciousness, you should call for help and ask that 112 be called. It is always better to err in calling for emergency response personnel rather than waiting when minutes might make a difference in the outcome.

4. Inhalation of Gases and Vapors
Inhaled gases and vapors can cause asphyxiation (due to lack of oxygen) and/or react with the lungs to cause other breathing difficulties. In either case, it is necessary to remove the patient to prevent further inhalation of damaging substances and to get the person to an area of fresh air. This action must be taken judiciously, however, so that you, as a rescuer, do not become the next victim. Before you attempt rescue, you must assess the safety of the atmosphere in the area of the patient. Before attempting any rescue, call for additional help. For a nonbreathing patient, administer CPR (cardiopulmonary resuscitation) (but be sure to avoid inhaling the exhalation of the patient). In some circumstances high-flow oxygen may need to be delivered, which requires an ambulance crew.

5. Skin and Eye Exposure to Chemicals
In almost all cases, rinsing the skin and eyes with copious amounts of water for at least 15 minutes is advised. The only exceptions to this are skin exposure to chemicals that react with water, which are usually solids (A common example of this is lime, CaO.) In these cases, using a credit card or similar tool to first scrape most of the chemical off the skin is required. For eye exposures and significant skin exposure, immediate transport to an emergency room or a physician is advised.

6. Burns
Chemical burns, radiation burns, electrical burns and thermal burns
All but the most modest first degree burns must be treated with care, and quickly. First, of course, the source of heat must be removed. Second, remove clothing and jewelry in the affected area if it easy to do so. If clothes are burned or melted against skin, do not pull if attached to skin. For burns with no blisters or closed blisters, tap water can be used to continue to cool the affected area briefly—do not cool torso or head for an extended period as this could cause hypothermia. Do not use nonsterile water on open blisters since this can cause infections. Never apply any ointment, cream, or salve to a burn. Never apply ice to a burn. Many burn patients should be transported to an emergency room or burn center.

7. Burns
Burn Severity

8. Electric Shock
First, make absolutely sure that the source of the electricity is off or that there is no chance that the patient is still in contact with energized electricity. Touching a patient still in contact with the electricity will make you the next victim. Assess the patient for breathing and heartbeat. Administer CPR if necessary, after calling for additional help and having someone call 112.

9. Exposure to Extreme Cold
The use of liquid nitrogen and dry ice in labs can lead to “burns” from exposure to the very cold agents. Most likely, the exposure time will have been relatively brief and not have caused severe damage. Removing the cooling agent and warming the affected area with warm (not hot) water (assuming no open wound) or even just warming a cold hand inside one’s armpit will be an effective treatment. For more serious cases of frostbite where the skin is white and hard (but perhaps not frozen solid), transport to an emergency room is advised. Do not rub affected areas as a means to warm the area.

10. Cuts or Open Wounds
The size of the cut dictates the response. Obviously, a small cut can be cleaned and a dressing can be applied. A large wound, with significant bleeding, presents a considerable risk. To stop copious bleeding, apply direct pressure to the wound, preferably with a sterile dressing but immediate action overrides a delayed search for a sterile dressing. Have someone call 112. Do not remove an impaled object since removing the object will likely increase the rate of bleeding. Apply a dressing around the object to stabilize in place and minimize bleeding. Excessive blood loss can lead to shock (which is the lack of oxygen perfusion at the cellular level). Keep the patient warm and elevate the feet until emergency personnel arrive.

11. Traumatic Injuries
An explosion or fall can lead to trauma to the body and/or broken bones. Call 112 immediately. Do not move the patient unless the local environment is life- threatening. For any fall, even from as little as a few feet, assume that there may be a spinal injury and do not move the patient unless absolutely necessary. Stabilize the head and neck area. Cut away clothing as needed to make certain that any hidden wounds are identified. Unless you are specifically trained to do so, do not try to “reset” a broken bone. Broken bones in limbs can sometimes puncture the skin (called an “open” wound). These can be disturbing to view but are rarely life-threatening. The ambulance crew will decide how to treat the patient in this regard.

12. Exposure to Biological Agents
Any exposure to a pathogen (virus or bacteria) requires transport to an emergency room for assessment. As in other circumstances, make sure that you, as a rescuer, do not become the “next victim” by becoming exposed to the same pathogen. Beyond separating the patient and the pathogen, there is no “first aid” procedure. Have as much information about the exposure (agent and duration and nature of exposure) available for ambulance personnel. In some instances, the receiving hospital may elect to treat the patient as “contaminated,” which requires special actions on their part.

13. Radiation Exposure
As with biological pathogens, there is little “first aid” possible after exposure to alpha, beta, X-ray, or gamma radiation. With due regard for your own safety, shut down or remove the source of the radiation or otherwise separate the patient from the radiation source. Call 112. Obtain as much information as possible about the exposure to give to the ambulance personnel.

14. Other General Issues Regarding Emergency Response
The first task of any rescuer is to protect themselves and not become the “next victim.” Always take a moment to stop and think about the situation before rushing to help someone. Ambulance and hospital personnel will want as much information as possible about the nature of the injury or exposure and the circumstances in which it occurred. For any patient who is not conscious or is otherwise unable to respond, you can best help by getting the patient’s name, age, and, if possible, any medical history and any medications that are being taken. For chemical exposures, try to have an MSDS available for transport to the hospital.

15. Other General Issues Regarding Emergency Response
You will notice that ambulance personnel are always wearing gloves. This universal procedure is to better protect against bloodborne pathogens. Fortunately, such gloves should be readily available in all chemistry labs and you, too, should wear gloves as a matter of routine when involved in any first aid procedure. Finally, always alert others when involved in any kind of rescue or first aid. Notifying lab assistants, professors, and campus security should be standard procedure. It is always better to err on the side of calling emergency response personnel where there are injuries. In most lab settings, there are plenty of people available to help. Assign tasks, if necessary, to make sure all relevant people are informed of the situation.

16. First Aid in Laboratories
Inhalation of gases and vapors
Skin and eye exposure to chemicals
Burns
Electric shock
Exposure to extreme cold
Cuts or open wounds
Traumatic injuries, such a bruises and broken bones
Exposure to biological agents
Radiation exposure