Bir Okul Laboratuvar Patlamasına Bağlı Yanıkların Analizi

ÖZET Giriş: Laboraturlarda gerçekleşen patlamalar genellikle birden fazla insanı etkiler ve bu hastalarda inhalasyon yanıkları gerçekleşir. Bu çalışma İstanbul’da gerçekleşen laboratuar patlaması sonucu oluşan yanık başvurularının retrospektif bir gözden geçirilmesidir. Metodlar: Değerlendirilen klinik bilgiler hastaların yaş, cinsiyet, yanık derinliği, total yanık yüzey alanı, yanık alanlarının dağılımı ve tedavi seçenekleridir. İstanbul’ da bir orta okulun laboratuarında meydana gelen patlamaya bağlı alev yanığı oluşan 6 hasta hastaneye başvurmuştur. Bu hastaların 2’si erkek ve 4’ü kadındır.Sonuçlar: Hastaların ortalama yaşı 14.3 (11-28)’ dir. Ortalama total yanık yüzey alanı %18.3(%5-45)’ tür. 2 hasta inhalasyon hasarlarına bağlı yanık yoğun bakımda tedavi edilmiştir. Yanık merkezinde ortalama yatış süresi 12 gündür (2-36 gün). 4 hasta taburcu edilmiş, 2 hasta diğer servislere transfer edilmiştir ve hiç ölüm gerçekleşmemiştir ancak 2 çocuk keloidler ve kontraktürlerin rekonstrüksiyonu için 3 kez opere edilmişlerdir. Çocuklara ve ailelerine stres bozukluğu ve oluşan skarlar nedeniyle psikolojik destek verilmiştir. Son söz: Bu önlenebilir komplikasyonlardan korunmak için gerekli tedbirler alınmalıdır. Bu konu ile ve koruyucu gözlükler, elbiseler ve eldivenlerin kullanımı ve ilk yardım eğitimi ile ilgili öğretmenlerin eğitimlerinde bazı değişikliler yapılmalıdır.

Anahtar Kelimeler:

pediatrik yanık, patlama, laboratuar kazaları, okul kazaları

The Analysis of Burns Due to an Explosion in a School Laboratory

ABSTRACT Introduction: Explosions in laboratories usually affect more than one person and chemical, flame and inhalation burns occur in these people. The study involved a retrospective review of burn admission of patients to Dr. Lutfi Kırdar Kartal Educating and Educating Hospital Burn C enter due to laboratory explosion in Istanbul. Methods: The clinical data evaluated included the patient's age and sex, the depth of the burn injury, the total burned surface area, the distribution of the burn areas and treatment. Six patients were admitted to hospital with flame burns caused by lab explosion on the elementary school in Istanbul. Patients consisting of 2 males and 4 females. Results: Mean age of patients were 14,3 (11-28 years). Mean total burned surface area was 18.3 %(5%-45%). Two patients were treated in burn intensive care unit due to inhalation injuries. Mean length of stay in burn unit was 12 days (2-36 days). Outcome included; 4 discharges, 2 transferred out to other wards and no patient died but 2 children were operated for 3 times for reconstruction of keloids and contractures and they were followed up for 5 years. Psychologic support to these children and their parents were given because of the stress disorder and the scars occurred in them. Conclusion: Take the necessary precautions so as to prevent these avoidable complications. We must promote some changes in education of teachers in this issue and in first aid and preventive measures such as using eyeglasses, protective clothes and gloves.

Keywords:

pediatric burn, explosion, laboratory accidents, school accidents,

PDF

___

1) Reed JL, Pomerantz WJ. Emergency management of pediatric burns. Pediatr Emerg Care.2005;21:118–29.
2) Zeitlin R, Somppi E, Jarnberg J. Pediatric burns in Central Finland between 1960s and the 1980s. Burns. 1993;19(5):418–22.
3) Anne H Outwater, Hawa Ismail, Lwidiko Mgalilwa, Mary Justin Temu, Naboth A Mbembati Burns in Tanzania: morbidity and mortality, causes and risk factors: a review Int J Burns Trauma. 2013; 3(1): 18–29. PMCID: 3560491
4) Kumar, P., Chirayil, P.T., and Chittoria, R. Ten years epidemiological study of paediatric burns in Manipal, India. Burns 2000 26(3), 261-264
5) Foglia RP, Moushey R, Meadows L, Seigel J, Smith M. Evolving treatment in a decade of pediatric burn care. J Pediatr Surg 2004;39(6):957-60.
6) S.M. Al-Zacko, H.G. Zubeer, A.S. Mohammad Pediatric burns in Mosul: an epidemiological study Ann Burns Fire Disasters. 2014 30; 27(2): 70–75. PMCID: PMC4396798
7) Ramesh Kumar Sharma, Atul Parashar Special considerations in paediatric burn patients Indian J Plast Surg. 2010; 43(Suppl): S43–S50. PMCID: PMC3038395
8) Arnon D. Cohen, R. Gurfinkel R. Glezinger, Y. Kriger, N. Yancolevich, L. Rosenberg Pediatric Burns in the Bedouin Population in Southern Israel The Scientific World Journal. 2007; 7, 1842–1847
9) Holland, A.J. Pediatric burns: the forgotten trauma of childhood. Can J Surg 2006; 49(4), 272-277
10) LB Rameshwar, KE Mohammed, Sharma PN Scalds among children in Kuwait European Journal of Epidemology 1997; 13(1),33-39.
11) Sheridan RL, Remensnyder JP, Schnitzer JJ, Schulz JT, Ryan CM, Tompkins RG. Current expectations for survival in pediatric burns. Arch Pediatr Adolesc Med. 2000;154(3):245–9.
12) Reed JL, Pomerantz WJ. Emergency management of pediatric burns. Pediatr Emerg Care.2005 ;21(2):118–29.
13) Zatriqi V, Arifi H, Zatriqi S, Duci S, Rrecaj Sh, Martinaj M. Facial burns - our experience. Mater Sociomed. 2013;25(1):26-7. PMID: 23687458.
14) Van Niekerk A, Rode H, Laflamme L. Incidence and patterns of childhood burn injuries in the Western Cape, South Africa. Burns 2004;30(4):341–7.
15) Hazardous chemical incidents in schools--United States, 2002-2007. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep. 2008 7;57(44):1197-1200. PMID: 18987614
16) Berkowitz Z, Haugh GS, Orr MF, Kaye WE. Releases of hazardous substances in schools: data from the Hazardous Substances Emergency Events Surveillance system, 1993-1998. J Environ Health. 2002;65(2):20-7,