Management of Chemical Burns to the Hands

Initial Management

The American Heart Association recommends brushing powdered chemicals off the skin with a gloved hand or piece of cloth before irrigation, and removing all contaminated clothing from the victim, ensuring you don't contaminate yourself in the process 1
Immediate irrigation with copious amounts of clean water is recommended for chemical burns to the hands, with a Class I, LOE B rating 2, 3
The American College of Cardiology advises against applying anything by mouth for any poisoning unless advised by poison control center or emergency medical personnel, with a Class III, LOE C rating 1, 2

After thorough irrigation, loosely covering the burn with a clean cloth or nonadherent dry dressing is recommended 3
Applying petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera after cooling may be beneficial for small partial-thickness burns being managed at home 3
Leaving blisters intact can improve healing and reduce pain, with a Class IIa, LOE B rating 5

Over-the-counter pain medications such as acetaminophen or NSAIDs can be administered for pain relief 3
Cooling the burn site can help reduce pain by affecting the inflammatory cascade, although the strength of evidence is not specified 6

Emergency medical services should be activated immediately if the patient exhibits any signs of a life-threatening condition, such as sleepiness, seizures, difficulty breathing, or vomiting 1
Burns involving the face, hands, feet, and genitals may require surgical intervention to prevent permanent disability 3
Burns with large surface area can lead to significant fluid loss and multisystem organ failure 3

Applying ice directly to a burn can produce tissue ischemia, with a Class III, LOE B rating 5
Removing jewelry before the onset of swelling can prevent constriction and vascular ischemia 3
Monitoring children for signs of hypothermia during cooling of burns is recommended 3

Wounds heal better with less infection if covered with an antibiotic ointment or cream and a clean occlusive dressing 4
Continuing to monitor the burn for signs of infection, including increased pain, redness, swelling, or discharge, is recommended 3
Seeking medical attention if the burn appears to be worsening or shows signs of infection is advised 3