Author Topic: Epidermal Injections of hydraulic oil  (Read 8963 times)

Offline bungalow

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Epidermal Injections of hydraulic oil
« on: January 27, 2006, 08:42:55 PM »
I am researching epidermal injection of pressurised hydraulic oil so that I can provide advice for users of cutting equipment.  I understand that there has been a couple of incidents of injuries within the UK.  What measures should be put in place to control this hazard?  If an injection has occured what is provided to ensure the best possible treatment?

Offline andyt

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Epidermal Injections of hydraulic oil
« Reply #1 on: January 27, 2006, 09:43:04 PM »
This is the advice sent to Brigades by the ODPM in 2002 after an event in a Scottish Brigade

Significant Safety Event 2002
Hydraulic Rescue Equipment - Hydraulic Hose Failure

Further to information provided to brigades earlier this year on the above matter another incidence of hydraulic hose failure has come to our attention, fortunately on this occasion without any personnel sustaining injury.
However as a result of this incident brigades are again reminded of the vital importance of ensuring that all hydraulic hoses associated with rescue tools are inspected and tested to ensure they remain in a satisfactory condition.
Inspection and test criteria for rescue tools including hose can be found in Technical Bulletin 1/1994. Of particular importance is the After Use Visual Inspection that states that;
'Hydraulic rescue equipment shall undergo a visual inspection after each period of use. Particular attention shall be paid to the condition of the hoses for any sign of damage or deterioration and to ensure that no undue leakage of hydraulic oil has occurred. Attention shall also be given to ensure that the equipment has suffered no mechanical damage'
It is important that competent personnel conduct any inspection and testing.
The advice of manufacturers or suppliers should be sought where there is any doubt about the inspection criteria or test protocols for a particular hydraulic hose or in relation to the period after which hose should be replaced. Guidance should also be sought from manufacturers where any damage to the tool or hose is identified that left unattended may subsequently result in failure.

Given the unique nature of injection type injuries, brigades are also advised to consider preparing and utilising an 'Urgent Medical Treatment Information Note' similar to that developed by the affected Fire Brigade for use when a firefighter may have received a high pressure injection injury of hydraulic oil.
A copy of the Information Note accompanies this message such that this can be used as a 'template' for brigades to develop their own version based on their own hydraulic equipment and oil used.
Clearly Brigades will also need to liaise with their own Occupational Health provider and/or their respective Health Authorities to establish the details of such an Information Note including the appropriate location(s) for treating a firefighter suffering from an injection type injury.

Discussions with hose manufacturers are continuing in order to identify what if any improvements may be available to improve hose performance, e.g. durability, and further advice will be issued as appropriate.

Urgent Medical Treatment Information Note

Name    -
Time of Injury  -
Location of injury -

URGENT MEDICAL ATTENTION REQUIRED
ATTENTION - AMBULANCE/HOSPITAL PERSONNEL
HIGH PRESSURE INJECTION INJURY
ON THE INSTRUCTIONS OF DOCTOR
CASUALTY MUST BE TAKEN TO HOSPITAL
Treatment

A firefighter may have received a high-pressure injection injury of hydraulic oil.
URGENT invasive surgery may be necessary and possible steroid therapy to minimise tissue damage and loss of function.
High-pressure injection injuries may cause destruction of body tissue and organs, result in loss of function, loss of limbs, air bubbles/blockages, or death.
This type of injury may not appear to be serious - entry wounds may be small and may not reflect the seriousness of the underlying damage - the patient may not demonstrate immediate symptoms of pain or discomfort.
Local anaesthetics or hot soaks should be avoided because they can contribute to swelling vasospasm and ischaemia.
Prompt surgical decompression, debridement, and evacuation of foreign material should be performed under general anaesthetic and wide exploration is essential.

Equipment used
The high-pressure hydraulic tools used by the firefighter operate at a pressure of 630 bar  (9450 psi)

Hydraulic oil used
The hydraulic oil is a highly refined mineral oil

Product Safety Data
??????????????????

Composition
The hydraulic oil could be any of the above or a combination of the three.  All three oils are highly refined mineral oils derived from crude petroleum and may contain additives, none of which give rise to any additional hazard in the finished product to that posed by the mineral oil components.

Treatment

High-pressure injection injuries require surgical intervention and possibly steroid therapy to minimise tissue damage and loss of function.  

Because entry wounds are small and do not reflect the seriousness of the underlying damage, surgical exploration to determine the extent of the involvement may be necessary.  

Local anaesthetics or hot soaks should be avoided because they can contribute to swelling, vasospasm, and ischaemia.  

PROMPT surgical decompression, debridement, and evacuation of foreign material should be performed under general anaesthetic and wide exploration is essential.

Offline bungalow

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Epidermal Injections of hydraulic oil
« Reply #2 on: January 28, 2006, 10:30:07 AM »
Thanks Andyt. You have filled in the some gaps in the info that I have.  I understand that there has been an incident in West Mids and another North of the Border.  Has any member further info on the incident in Scotland?

Offline Pete

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Epidermal Injections of hydraulic oil
« Reply #3 on: January 29, 2006, 03:23:52 PM »
Grampian, I believe.
And if anyone has seen photos of the injury, I think you'll agree that the immediate medical treatment made one H of a mess of the FFs forearm. Saved him tho'.
Can't remember if the photos were on computer or very colourful Safety Flashes?
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