context: Chemical burns can occur in the home, at work, or at school. They can result from an accident or an assault. Although few people in the United States die after contact with chemicals in the home, many substances common in both living and storage areas can do serious harm. Many chemical burns occur accidentally through misuse of products such as those for hair, skin, and nail care. Although injuries do occur at home, the risk of sustaining a chemical burn is much greater in the workplace, especially in businesses and manufacturing plants that use large quantities of chemicals. Most chemicals that cause burns are either strong acids or bases. A glance at the medical information on the labels of dangerous chemicals confirms the expected toxicity. Common sense precautions and consumer education can reduce your family's risk of injury. A variety of household products fits this description: Bleach Concrete mix Drain or toilet bowl cleaners Metal cleaners Pool chlorinators All chemical burns should be considered medical emergencies. If you have a chemical burn of the mouth or throat, call 911 and seek immediate medical attention. Most chemical burns occur on the face, eyes, arms, and legs. Usually a chemical burn will be relatively small and will require only outpatient treatment. Chemical burns can be deceiving, however. Some agents can cause deep tissue damage not readily apparent when you first look at it. Tissue damage from chemical burns depends on several factors, including: The strength or concentration of the agent The site of contact (eye, skin, mucous membrane) Whether it's swallowed or inhaled Whether or not skin is intact How much of the agent you came into contact with Duration of exposure How the chemical works Signs and symptoms of chemical burns include the following: Redness, irritation, or burning at the site of contact Pain or numbness at the site of contact Formation of blisters or black dead skin at the contact site Vision changes if the chemical gets into your eyes Cough or shortness of breath In severe cases, you may develop any of the following: Low blood pressure Faintness, weakness, dizziness Shortness of breath Severe cough Headache Muscle twitching or seizures Irregular heartbeat Cardiac arrest Chemical burns can be very unpredictable. Death from a chemical injury, although rare, can occur. Any chemical burn can be a legitimate reason to summon emergency medical help. Always err on the side of safety and call 911 if you don't know how severe the injury is or whether or not the person is medically stable. Also call 911 if you have any concerns about a chemical injury. Emergency personnel are trained to assess the extent of a chemical burn, begin treatment, and transport victims to the most appropriate hospital. Emergency officials also may determine the need for more involved decontamination of both you and the accident site prior to going to the hospital. When you contact 911, tell the dispatcher as much of the following information as possible: How many people are injured and the location where they are How the injury happened Whether emergency personnel can reach the victims or whether the victims are trapped Name, strength, and volume or quantity of the chemical causing the burn ( Give a container of the chemical to emergency personnel, if possible.) Length of time of contact with the chemical Always seek emergency care for any burn that is larger than 3 inches in diameter or is very deep. Also seek emergency care for any chemical burns involving the face, eyes, groin, hands, feet, or buttocks or if it is over a joint. Even if the exposure was very small and you have completed basic first aid, call your doctor to review the injury and the chemical involved and to make sure no further emergency treatment is needed. The doctor can arrange appropriate treatment or will direct you to go to a hospital's Emergency Department. If you're the person with the burn, ask your doctor if you need a tetanus shot. In the emergency department, you can expect the following: Initial evaluation and stabilization Rapid evaluation of the chemical Determination of the extent of injury Blood tests and other studies to determine if you should be admitted to the hospital Most people with chemical burns do not need to be admitted. Most can go home after arranging follow-up care with their doctor. In severe cases, however, they may need to be admitted to a hospital. Begin basic first aid. Call Poison Control at 1-800-222-1222 if you do not know whether the chemical is toxic. Immediately call 911 if you have a severe injury, any shortness of breath, chest pain, dizziness, or other symptoms throughout your body. If you are aiding an injured person with these symptoms, lay the person down and immediately call 911. First Aid: Remove yourself or the victim from the accident area. Remove any contaminated clothing. Wash the injured area to dilute or remove the substance, using large volumes of water. Wash for at least 20 minutes, taking care not to allow runoff to contact unaffected parts of your body. Gently brush away any solid materials, again avoiding unaffected body surfaces. Especially wash away any chemical in your or the victim's eye. Sometimes the best way to get large amounts of water to your eye is to step into the shower. IV fluids may be needed to normalize blood pressure and heart rate. The IV access may also be used for any medications needed to treat pain or protect against infection. Decontamination will begin (likely water irrigation). You will be given any antidote to counteract the chemical, if appropriate. Antibiotics often are not needed for minor chemical burns. Wounds will be cleaned and bandaged with medicated creams and sterile wraps as needed. Consultation with other medical specialists may be done. Pain from a burn can often be severe. Adequate pain control will be addressed by your doctor. If there is any indication of breathing problems, a breathing tube may be placed in your airway to help. If needed, a tetanus booster will be given. After leaving the emergency department, call your doctor within 24 hours to arrange follow-up care. Call sooner if any new problems or concerns arise. Secure all chemicals in and out of the home in locked cabinets or out of the reach of children. When using chemicals, always follow directions and safety precautions on the label provided by the manufacturer. Wear safety clothing and eye protection, and remember --- safety first! Most chemical burns are minor and can be treated without causing long-term problems. Some burns, however, cause significant scarring or other medical complications. Burns in the eye can lead to blindness. Swallowing harmful chemicals can lead to problems in your gastrointestinal tract, potentially leading to permanent disability. Media file 1: Burns, chemical. Chemical burn of the skin. Media type: Photo Media file 2: Burns, chemical. Chemical burn of the eye. Media type: Photo acid burns, chemical eye burn, skin burn, black skin, dead skin, deep tissue damage, chemical burns