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Thread: Caustic Cocktails - First Aid / Treament

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    Always Learning. Fort Collins Bob will become famous soon enough Fort Collins Bob will become famous soon enough Fort Collins Bob will become famous soon enough Fort Collins Bob's Avatar
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    Caustic Cocktails - First Aid / Treament

    Hello Everyone,

    What first Aid and Treatments can be giving a CCR Diver having been
    burned by a Caustic Cocktail ?

    I would be asking this question in reference to diving in very remote
    locations where medical Treatment could be delayed.

    Are there medications that can be used to help with the swelling that
    are said to be a complication from this ?

    Thanks to all.

  2. #2
    RBW Member Loneshark is on a distinguished road Loneshark is on a distinguished road Loneshark's Avatar
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    Drager FGT

    Drager Ray, AKA60, RGUFM

    Re: Caustic Cocktails - First Aid / Treament

    Quote Originally Posted by Fort Collins Bob  View Original Post
    Hello Everyone,

    What first Aid and Treatments can be giving a CCR Diver having been
    burned by a Caustic Cocktail ?

    I would be asking this question in reference to diving in very remote
    locations where medical Treatment could be delayed.

    Are there medications that can be used to help with the swelling that
    are said to be a complication from this ?

    Thanks to all.
    I would suggest milk, if it was ingested, however if you are "very" remote, this may be an issue? Not sure there is any specific 1st aid treatment other than drinking/rinsing with copious ammounts of fresh water. If you have inhaled a caustic cocktail, I would think the only treatment would be at a hospital..... I would give O2 in the mean time.
    If there is swelling associated with it, you could try a steroid, such as hydrocortisone, or as a last ditch an adrenaline injection, which you may have available if kitting up for a remote site....?
    Just a thought and I can't recommend them though. Any Doc's out there?

  3. #3
    Decodiver
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    Re: Caustic Cocktails - First Aid / Treament

    Drink Coke.

  4. #4
    RBW Member diveladydive is on a distinguished road diveladydive is on a distinguished road diveladydive's Avatar
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    Re: Caustic Cocktails - First Aid / Treament

    Allow me to quote Mark Drekker, owner of Fill Express on this topic. Mark has a background in chemistry, & his sister, Lisa, worked as a chemist.

    Mark, I’m thanking you in advance for permission to quote.

    “Peri, you asked how the chemistry of Coke works to neutralize the rebreather absorbent... So here is a bit of high school chemistry (a bit oversimplified but adequate for this explanation)....

    The absorbent mixed with water will produce mild alkaline solution which can be neutralized by mild acid solution.

    Acid or alkaline is measured using the pH scale which can have a value between 0 (very corrosive acid, say sulfuric acid) and 14 (very corrosive alkaline, say sodium hydroxide aka lye). The value 7.0 is said to be neutral (pure water has a pH of 7.0).

    The pH of regular carbonated soft drinks is about 2.5 and diet soft drinks for whatever reason are not quite as acidic with pH's around 3. The soft drinks that have a 'smoother' taste with less 'bite' like Mountain Dew are slightly less acidic... Pepsi is slightly less acidic than Coke... but we are talking very small differences... for the purpose of washing absorbent out of your mouth they will all work equally well.

    Mix a equal amount of acid and alkaline together and they will 'neutralize' each other.... i.e. a liquid with a pH of 3 (7-4) and a liquid with a pH of 11 (7+4) that mixed together in equal amounts would produce a liquid with a pH of 7. Note that just because it's neutral pH does not mean it's safe to drink... there are plenty of very nasty things you could drink that have near neutral pH.

    Here are some pH values of common substances...

    Soda lye 14.0
    Ammonia water 11.6
    Milk of magnesia 10.5
    Baking soda 8.0

    Sea water 7.36 – 8.21
    Human blood 7.35 – 7.45
    Distilled water 7.0
    Human saliva 6.3 – 6.6
    Milk 6.5

    Tomato & tomato juice 4.2
    Grapefruit juice 3 – 3.3
    Orange juice 3 – 4
    Apple juice 2.9 – 3.3
    Vinegar 2.4 – 3.4
    Lemon juice 2.3

    Stomach fluids 1 – 3
    Sulfuric acid 0.3
    Hydrochloric acid 0.1

    Most carbonated beverages like Coke contain three different mild acids... carbonic acid from the CO2 bubbles, citric acid for flavor and phosphoric acid to give it that ‘bite’... there is nothing particularly magic about Coke itself (and pays no attention to all those Coke myths... Coke will NOT dissolve nails or teeth). Instead of Coke you could use ANY mild acid with about the same Ph from the list above, but of course some acids taste much better than others... besides Coke you could use any other carbonated beverage, apple juice, or even vinegar in a pinch... I mention vinegar because nearly all commercial dive boats have vinegar on board to treat stings.

    One last note... don't drink whatever you use, just swish it around in your mouth and spit it out.”

    As far as the ER/EMT situation is concerned, prior to learning this, I took a very bad laryngeal hit on a prototype Titan during pool drills. Suffice to say that the lye was not neutralized until my instructor, Tom Mount, left the hospital & came back with a homeopathic remedy & baking soda. Tom also saved my life that day, as to my ENT's knowledge, unlike the trachea, the larynx does not re-open from that type of injury quickly enough to live through. Tom used acupressure at the scene.

    I was signaling to be trached when Tom open my airway, which was entirely shut down, with his technique. We found out later that traching a caustic is probably on the worst-to-do list, outside of dying because you didn’t try everything: By traching me, the lye would have entered the bronchioles & I wouldn’t be here to write this.

    I carry coke or another soda in a squeeze bottle, & needed it recently for a very mild hit- which may not have been so mild if not immediately neutralized. That was a no-stop training dive; now imagine the effect with a nice-sized deco obligation to fulfill.

    Hope this helps...
    Last edited by diveladydive; 3rd May 2007 at 20:05.

  5. #5
    RBW Member Loneshark is on a distinguished road Loneshark is on a distinguished road Loneshark's Avatar
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    Drager FGT

    Drager Ray, AKA60, RGUFM

    Re: Caustic Cocktails - First Aid / Treament

    [quote=diveladydive;113122]Allow me to quote Mark Drekker, owner of Fill Express on this topic. Mark has a background in chemistry, & his sister, Lisa, worked as a chemist.

    Thanks for that! Very informative!

    You live and learn.....:o

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    RBW Member diveladydive is on a distinguished road diveladydive is on a distinguished road diveladydive's Avatar
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    Re: Caustic Cocktails - First Aid / Treament

    [quote=Loneshark;113145]
    Quote Originally Posted by diveladydive  View Original Post
    Allow me to quote Mark Drekker, owner of Fill Express on this topic. Mark has a background in chemistry, & his sister, Lisa, worked as a chemist.

    Thanks for that! Very informative!

    You live and learn.....:o
    More than welcome, & thank Mark, actually :-) He was kind enough to answer my email about Coke. Tom Mount told me about that- he found out after I'd had the bad hit. Mark is n2diving.

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    Re: Caustic Cocktails - First Aid / Treament

    Quote Originally Posted by Decodiver  View Original Post
    Drink Coke.
    I washed my mouth with soda water, then i drank milk, lemon juice and coke (one after the other).

    I fully recovered from the burning in 24 hours.

    But the mix i had in my stomach had crazy effects... sarcy:

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    Re: Caustic Cocktails - First Aid / Treament

    Quote Originally Posted by Fort Collins Bob  View Original Post
    Hello Everyone,

    What first Aid and Treatments can be giving a CCR Diver having been
    burned by a Caustic Cocktail ?

    I would be asking this question in reference to diving in very remote
    locations where medical Treatment could be delayed.

    Are there medications that can be used to help with the swelling that
    are said to be a complication from this ?

    Thanks to all.
    While RB diving in the Navy we have a bottle of lime juice in the boat to neutralize the caustic cocktail. After that not much you can do without medical attention.

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    Megalodon

    NATO Multinational Guide to Diving Medical Disorders.

    NATO Multinational Guide to Diving Medical Disorders. ADivP-02(A)/ MDivP-02(A)
    0818. Caustic Cocktail
    c. Treatment
    (1) Remove Diver from the water. Remove the set as quickly as possible.
    (2) If the diver is suspected of having swallowed a cocktail give copious drinks of fresh water. Salt water may be used to rinse out the mouth but should not be swallowed, since it may induce vomiting and cause further burning.
    (3) Wash all contaminated external surfaces liberally with fresh or salt water.
    (4) Caustic burns to the eye should be treated by washing the eye with large volumes of water for at least 20 minutes. If necessary, the eyelids should be held open while this is done. Refer to an eye unit, casualty department or Medical Officer immediately.
    (5) A caustic cocktail readily provokes panic, especially in inexperienced divers. This may result in a rapid ascent and breath-holding (to avoid inhaling further alkali). Consequently, divers who as the result of a caustic cocktail, make a rapid ascent to the surface should be observed carefully for 12 hours following the dive for evidence of pulmonary barotrauma or neurological decompression illness and should be seen by a Medical Officer before diving is resumed.

  10. #10
    New Member Diver Dude is an unknown quantity at this point Diver Dude's Avatar
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    Re: Caustic Cocktails - First Aid / Treament

    I drank Pepto Bismo...a lot of it. It took some of the burning sensation away. I was good after 24 hours

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