# asphalt tar on face



## Apple Bill (Jan 14, 2015)

Ran a call while on FD shift, 35yom, industrial accident, hot (250-300F) asphalt tar blew up in pt's face.  Approx 80% facial coverage including left eye and up nostrils.  
We're first on scene, pt is at an outdoor eye flush station running water over his face.  Tar has hardened on the exterior but still hot.  Pt states water helps relieve pain.  Unk amount of tar in left eye, full coverage over eye from forehead to jaw.
Patent airway, but we were concerned about possible swelling from trauma due to inhaled tar.  Standing manual BP 178/104, pulse 96, no pulse ox since we were outside and it was 19F.  Once warmed in ambulance, SpO2 99%, supine BP 142/102 from LifePak12.  Pt was AOx4.  No previous medical or allergies.

The situation as-is for us as fire was simple, make sure airway is patent and pt is stable until EMS arrives.  Kept warm as best as possible while pt cooled face with water.  
We were 30 min from nearest burn center, and with the concern of inhaled hot tar, EMS made the call to air evac pt.

The question that arose was what if the pt had not cooled the tar with water prior to arrival?  What would have been the best way to handle that?


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## Apple Bill (Jan 14, 2015)

Looks like some immersion in water or saline is ok, with solid tar removal in the ED done using polysorbates.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1863198/?page=1

http://www.lni.wa.gov/safety/research/files/tarburninjuryfacts.pdf


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## teedubbyaw (Jan 14, 2015)

Absolutely would have doused him in water as soon as I could. Preferably in the ambulance, since it's below freezing, but I'm not going to waste time.

That really sucks, by the way. Poor dude.


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## Apple Bill (Jan 14, 2015)

I'm glad he was already doing it, I'm not sure I'd have thought to do it since most burns are kept dry.  

Yeah, he's in for a rough time.  I'm worried about his eye most of all.


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## DesertMedic66 (Jan 14, 2015)

One of the first steps is to stop the burning process.


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## teedubbyaw (Jan 14, 2015)

When in doubt, pee on the patient.


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## Anjel (Jan 14, 2015)

teedubbyaw said:


> When in doubt, pee on the patient.



That's my philosophy.


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## DesertMedic66 (Jan 14, 2015)

teedubbyaw said:


> When in doubt, pee on the patient.


Works good for jelly fish stings. Not so well for shark bites. That sure was one interesting write up


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## Apple Bill (Jan 14, 2015)

Thanks all.  It was a new one for me and the other EMT on the rescue truck.


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## JPINFV (Jan 14, 2015)

http://cjem-online.ca/v15/n5/p307

Like absorbs like, so you want to use a primarily inorganic substance to remove tar. Simple table butter has been used in the past for tar burns as a removal agent.


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## teedubbyaw (Jan 14, 2015)

JPINFV said:


> http://cjem-online.ca/v15/n5/p307
> 
> Like absorbs like, so you want to use a primarily inorganic substance to remove tar. Simple table butter has been used in the past for tar burns as a removal agent.



Let's be realistic, please. We only stock margarin on the ambulance.


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## Apple Bill (Jan 14, 2015)

JPINFV said:


> http://cjem-online.ca/v15/n5/p307
> 
> Like absorbs like, so you want to use a primarily inorganic substance to remove tar. Simple table butter has been used in the past for tar burns as a removal agent.



Good read, thanks.


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## broken stretcher (Jan 18, 2015)

My father is a retired construction truck driver... used to do paving. When tar would get stuck in the back of the dump trucks, they would often douse the back of the truck in diesel fuel. The article says that would cause "systemic toxic effects from absorption". Diesel was my first thought but apparently this study says no...


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## broken stretcher (Jan 18, 2015)

just to clarify i would never utilize diesel without medical direction and as a last resort... and probably not on the face.


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## JPINFV (Jan 18, 2015)

teedubbyaw said:


> Let's be realistic, please. We only stock margarin on the ambulance.


Ok, what I'm going to need you to do is go down to the cafeteria and pick up 20 of those little squares of butter and bring them back up.


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## Brandon O (Jan 20, 2015)

How about... soap?


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## Handsome Robb (Jan 22, 2015)

Just throw some feathers at him.


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## Trek7553 (Feb 18, 2015)

That article seemed to imply that Neosporin is effective for removing tar. Would it be reasonable to apply Neosporin to remove the tar?


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## samiam (Feb 18, 2015)

Trek7553 said:


> That article seemed to imply that Neosporin is effective for removing tar. Would it be reasonable to apply Neosporin to remove the tar?


It specifically is talking about neosporin CREAM not the antibiotic stuff we put on cuts/scrapes. It is a little different chemically. 

If it was me personally, I would grab a bottle of tween (Basically frangrance free everything free) detergent. I use it a lot in the lab and I think there are sterile preparations available. It is miscible in water and it dont know what other stuff the neosporin has that might be getting into the open wound. That being said as the article says, It seems to be effective and clearly does less harm then peeling it off.


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## RedAirplane (Feb 27, 2015)

teedubbyaw said:


> When in doubt, pee on the patient.



Is this actually done by uniformed EMS? I've read about it in textbooks but can't imagine some paramedic peeing on me... Opposite of BSI?


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## Brandon O (Feb 27, 2015)

I pee on almost everyone I meet. Good manners is good medicine.


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## NomadicMedic (Feb 27, 2015)

Ishan said:


> Is this actually done by uniformed EMS? I've read about it in textbooks but can't imagine some paramedic peeing on me... Opposite of BSI?



Yes, but the medic *must* be in uniform. If a volley medic is not in 5.11 or Blauer pants, it's a write up.


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