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Fri Jan 16 04:09:20 GMT 2009

Perhaps best practices for recognizing white phosphorus injuries, and, if that's what they are, best treatment. I'm certainly not a trauma surgeon, but I have seen white phosphorus burns as a result of a lab explosion, and assisted in handling the fragments as they were removed during debridement. They smoked until under water, and then were inert. Since it's normally stored under water in lab quantities, I'm puzzled by the description of water making it sizzle.

You do want to keep the white smoke, which is mostly phosphorus pentoxide, from getting into water on the patient. 

My understanding was that the cupric sulfate neutralization was deprecated because copper phosphide was much more chemically toxic. One practical technique may be to have the surgeon lay out a basin of water, turn out the lights (perhaps dark-adjusting first), and, identifying the positions by their phosphorescence. If they can be lifted off with forceps or gloved hands, do so, or, if necessary, circle the area with a marker so you can debride it when the lights go on.

Subject: RE: Crisis in Gaza...
Date: Thu, 15 Jan 2009 20:01:59 -0600
From: nmcswai at tulane.edu
To: trauma-list at trauma.org

Re: Crisis in Gaza...

I agree. One can not change the opinions of others on either politics or religion. However we can help the injured patients by exchanges of medical ideas and information. Lets keep this site for the medical discussions.

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu

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Crisis in Gaza...