alexa Use of an Amphoteric Solution in Eye, Skin and Oral Chemical Exposures: Retrospective Multicenter Clinical Case Series
ISSN: 2161-0495

Journal of Clinical Toxicology
Open Access

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Research Article

Use of an Amphoteric Solution in Eye, Skin and Oral Chemical Exposures: Retrospective Multicenter Clinical Case Series

Fortin JL1,2,3,4, Fontaine M4, Bodson L5, Depil-Duvala A6, Bitar MP1, Macher JM1,7, Paulin P3, Ravat F4 and Hall AH8,9*

1Emergency Department, Belfort Montbéliard Hospital, 14 Mulhouse Street, 90 000 Belfort, France

2Preventive Medicine, 82 Bergson Street, 42 000 Saint-Etienne, France

3Medical Department, Sdis 25, 10 Clairière Street, 25 042, Besançon Cedex, France

4Burn Intensive Care Unit, Saint Joseph Saint Luc Hospital, 20 Quai Claude Bernard, 69007 Lyon, France

5Emergency Department, University Hospital, Sart Tilman B, 4000 Liege, Belgium

6Emergency Department, St-Luc-St-Joseph Hospital, 20 Quai Claude Bernard, 69 007 Lyon, France

7Emergency Department, Nouvel Hôpital Street 26, 88100 Saint-Diė-des-Voges, France

8Toxicology Consulting and Medical Translating Services, P.O. Box 1255, Azle, Texas 76098, USA

9Colorado School of Public Health, University of Colorado-Denver, Denver, Colorado, USA

*Corresponding Author:
Alan H Hall
Medical Toxicologist
Toxicology Consulting and Medical Translating Services
P.O. Box 1255, Azle, TX 76098-1255, USA
Tel: 1-307-399-1564
E-mail: [email protected]

Received Date: February 22, 2017; Accepted Date: March 21, 2017; Published Date: March 27, 2017

Citation: Fortin J-L, Fontaine M, Bodson L,Depil-Duvala A, Bitar MP, et al. (2017) Use of an Amphoteric Solution in Eye, Skin and Oral Chemical Exposures: Retrospective Multicenter Clinical Case Series. J Clin Toxicol 7:343. doi: 10.4172/2161-0495.1000343

Copyright: © 2017 Fortin JL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Introduction: A polyvalent amphoteric flushing solution (Diphoterine®) has been in use for a number of years, mainly in industrial settings for decontamination of acid, base, and other corrosive or irritant substances eye and skin splashes. Methods: Retrospective collection of 34 cases from several centers reporting use of Diphoterine® decontamination of eye, skin or oral chemical exposures. The following data were retrieved: exposure circumstances (workplace, domestic, deliberate assault), chemical nature and pH, exposure type, initial clinical signs, clinical signs after flushing, initial and final visual analog scale (VAS) pain ratings, consulting specialist physicians’ conclusions. Results: 58.8% of the 34 cases were occupational exposures, 29.4% were domestic, 5.9% occurred in schools, and 5.9% were deliberate chemical assaults. Of involved chemicals, 11 were basic substances, 11 were acidic, 1 was an oxidizing substance, 2 were solvents, and 9 were miscellaneous substances. There were 21 ocular exposures, 8 cutaneous exposures, 4 mixed (ocular/cutaneous), and 1 oral exposure. Initial clinical findings in ocular exposures were: pain, blepharospasm, hyperemia, palpebral edema, excessive tearing, and blurred vision. Of cutaneous exposures, 1 was a deep necrotic injury and 7 were superficial. Median (IQR) VAS before flushing with Diphoterine® was 7; VAS after ocular or skin flushing was 1. Conclusion: Early application of the amphoteric solution to the eye or skin reduces the intensity of pain associated with chemical injury. While randomized clinical trials are lacking, early use of the amphoteric solution appears to reduce the incidence of sequelae.


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