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Scientific publications, studies and articles on DIPHOTERINE® solution

Title Article information Abstract
Is delayed decontamination with Diphoterine® solution useful in chemical injuries? Author(s): Dr Denise Jacquemin,
Date: November 2016
Source: APAMT Congress Singapour
Demonstrate the usefulness of delayed decontaminaton with Diphoterine® solution after chemical insult.
Date: November 2016
Source: APAMT Congress Singapour
Case Reports: Summary of observations when washing with Diphoterine® solution during an industrial chemical exposure (2014)
Date: November 2016
Source: APAMT Congress Singapour
Method: During 10 months period, chemical burns were registered. Water was used by patient within the first 10 minutes after exposure on site. Polyvalent solution was used 20 minutes after exposure upon arrival at clinic. When both rinsing solutions were used, water was used within 10 minutes after exposure and polyvalent solution after 30 minutes. The clinic being situated only 10 minutes away from the industrial area, some patients came to the clinic without first rinsing with water at accident site. Statistical analysis was performed following large or small samples according to the population. After 6 months’ study (70 cases), we noticed that the following elements could help improve outcome and they were introduced them from December onwards (40 cases): pain factor upon arrival versus pain factor when leaving clinic and visual acuity upon arrival versus visual acuity when leaving the clinic.
Date: November 2016
Source: APAMT Congress Singapour,
Objectives: Compare treatment results obtained from different first aid managements using water and/or polyvalent hypertonic amphoteric first-aid solution stopping corrosive reactions registered as a Medical Device.
Use of amphoteric rinsing solution for treatment of ocular tissues exposed to nitrogen mustard Author(s): Chevion M,
Source: Acta Ophthalmol. 2012 Oct 5. doi: 10.1111,
Goldich & al present their animal study (rabbits’ eyes) to assess the effectiveness of rinsing with Diphoterine® solution, following 5 minutes exposure with a nitrogen mustard analogue, (2% mechlorethamine) compared to normal saline solution. Various parameters are assessed by examiners masked to the treatment assignment following exposure. They demonstrate that immediate washing with Diphoterine® solution is superior to immediate irrigation with normal saline solution, because it reduces the corneal chemical lesions, the intra-ocular pressure and systemic oxidative stress.
Complex chemical burns following a mass casualty chemical plant incident. How optimal planning and organization can make a difference Author(s): Fiona Wood,
Date: AUGUST 2012
Source: Burns, Volume 38, Issue 5, August 2012, Pages 713-718,
This publication presents complete hospital care of 4 victims of chemical injuries, following the explosion of a pipeline containing 100 % sulphuric acid. These victims were immediately taken to safety showers on the accident site. However, given the corrosivity of the acid, severe injuries developed. Diphoterine® solution was not available at the industrial site where the accident took place. However, since the accident and its multiple cause’s analysis, Diphoterine® solution is implemented on site and cited as first-aid measure superior to standard washing with water.
Low Diphoterine® provision in UK industrial chemical manufacturing plants highlights the need for new research Author(s): Dheansa B,
Date: OCTOBER 2012
Source: Burns. Oct. 25, 2012. pii: S0305-4179(12)00311-7,
Kalson & al, state in a letter addressed to the editor of BURNS journal, to mobilize burns specialists, to work with industries. Their objective is to help approving the efficacy of new molecules, susceptible to improve first-aid in the work environment. This letter leans on a fast phone study with industries of various sizes in UK, to find out if they were aware of the existence of Diphoterine® solution. Studies should be organized to promote the implementation of Diphoterine® solution directly on the scene of potential chemical projections.
Decontamination of Tetramethylammonium Hydroxide (TMAH) splashes: Promising Results with Diphoterine® in vitro Author(s): Maibach HI,
Date: 2011-03
Source: ACMT Spring meeting, mars 2011, Clearwater Beach, Florida,
TMAH is an alkaline corrosive, with a contre-ions, TMA-, which is likely responsible for deaths in industrial accidental TMAH exposures because of its systemic toxicity. These results suggest that the longer time-frame required for better decontamination and the much larger volume of decontamination fluid involved as compared to Diphoterine® decontamination might delay required supportive care. They also suggest that Diphoterine® may be the preferred decontamination solution in cases of concentrated TMAH skin exposure. Fosse C1, Mathieu L1, Hall AH², Bocchietto H3, Burgher F1, Fischbach M3, Maibach HI4 1 Laboratoire PREVOR, Valmondois, France; ² Toxicology Consulting and Medical Translating Services, Inc., Laramie, Wyoming, USA; Colorado School of Public Health, Denver, Colorado, USA; 3 ABICH Srl, Verbiana, Italie, 4 Department of Dermatology, University of California-San Francisco, San Francisco, California, USA
Base (Sodium Hydroxide; NaOH) Skin Injury and Decontamination: In vitro, Experimental Animal, and Human Skin Explant Ex Vivo Studies Author(s): Hall AH,
Date: 2011-03
Source: 44th scientific annual meeting of the BBA (British Burn Association), March 2011, Salisbury, Royaume-Uni,
In vitro, ex vivo and animal studies on cutaneous injuries due to sodium hydroxide are presented in this poster. These studies confirm the need of a fast and effective decontamination in order to prevent or limit lesions spreading. Presented results support previous studies and the clinical use of the Diphoterine® solution as a decontamination solution in cases of cutaneous sodium hydroxide splashes. Mathieu L1, Wang H-f2, Zhang F3, Fosse C1, Coudouel H1, Lati E4, Peno-Mazzarino L4, Bouzard D4, Hall AH5,6 1Prevor Laboratory, Valmondois, France; 2Department of Fire Engineering, The Chinese People’s Armed Forces Police Academy, Langfang, Heibei Province, China; 3Tianjin No. 1 Special Firefighting and Rescue Detachment, Tianjin, China; 4BIO-EC Laboratory, Clamart, France; 5Toxicology Consulting and Medical Translating Services, Inc., Laramie, Wyoming, USA; 6Colorado School of Public Health, Denver, Colorado, USA
Chemical ocular burns : experimental data and clinical implications [Lésions chimiques oculaires : données expérimentales et implications cliniques] Author(s): NS Schrage,
Date: 2011-06
Source: Medichem congress, June 2011, Heidelberg, Deutschland,
The objective of this work was to describe the corneal penetration mechanisms of various chemicals and to define the modes of action of various decontamination solutions. OCT makes it possible to visualize in real time the intraocular penetration of sodium hydroxide, sulphuric acid or of hydrofluoric acid. The amphoteric solutions washing capacities superiority is shown by deducting the cells number put into culture remaining alive, after being exposed to chemical substances and then washed. This kind of study should in the long term makes it possible to define standardized protocols for the first responders or for the ophthalmologists confronted by ocular chemical lesions. NS Schrage Dept Ophthalmology, University hospital of Cologne Merheim, Cologne, Germany
Amphoteric Compound Chemical Eye/Skin Splash Decontamination: Clinical Experience [Décontamination chimique cutanée ou oculaire avec un compose amphotère : experience Clinique] Author(s): Blomet J,
Date: 2011-09
Source: 14th EBA (European Burn Association) congress, September 2011, Den Hague, The Netherlands,
Oral presentation whose objective was to extend the data previously published with the spontaneous feedbacks from customers on the use of an amphoteric solution, Diphoterine®. Among 44 feedback cases, sodium hydroxide and sulphuric acid were the most frequent implied chemicals in industrial accidents. In this not randomized case series, washing with Diphoterine® solution was associated with good clinical outcomes. Hall AH1, Mathieu L2, Burgher F2, Fosse C2, Blomet J2 1Toxicology Consulting and Medical Translating Services, Inc., Laramie, Wyoming, USA and Colorado School of Public Health, Denver, Colorado, USA, 2Laboratoire Prevor, Valmondois, France
Prise en charge des brûlures oculaires – Retour vers un pH intraoculaire normal avec des solutions de premiers secours – Résultats expérimentaux et cliniques [Managing of eye burns – Return to normal intraocular pH First Aid – Experimental and clinical results] Author(s): Schrage Norbert,
Date: 2011-10
Source: AAO (American Academy of Ophtalmology), October 2011, Orlando, USA,
Presentation on the physiopathology of ocular chemical lesions and comparison in terms of effectiveness of various washing solutions. Diphotérine® solution appears as a solution of choice. Schrage Norbert Dept Ophthalmology, University hospital of Cologne Merheim, Cologne, Germany
Chemical ocular injuries – Use of washing Diphoterine® solution for ocular fisrt aid washing [Verätzungen des Auges – Diphoterinhaltige Augenspüllösung in der Erste-Hilfe-Therapie] Author(s): Schrage N,
Date: 2003
Source: Ophtalmologe, 2003, 100:727-731,
This publication shows the results of the Previn® solution use (equivalent to the Diphoterine® solution) on 10 healthy eyes, compared to the use of phosphate buffer solutions, a comparative in vitro study and an in vivo study in rabbits, following a 1 mol/l caustic soda exposure. The Previn® solution does not show any adverse effect. The in vitro study, comparing the Previn® solution to a phosphate buffer and to Ringer’s lactate solution, shows a higher effectiveness of the Previn® solution on the acid and alkaline solutions tested. The in vivo study shows the superiority of the Previn® solution on a phosphate buffer and on saline solution. The Previn® solution must be used as first aid solution. Langefeld S1, Press UP2, Frentz M3, Kompa S3, Schrage N3 1ACTO, Aix la Chapelle ²Augenklinik am Krankenhaus der Barmherzigen Brüder Trier 3Hôpital universitaire d’Aix la Chapelle, Aix la Chapelle
Corrosive chemicals: chemical burns by ingestion, inhalation, cutaneous or ocular splashes [Produits corrosifs : brûlures chimiques par ingestion, inhalation, projection cutanée ou oculaire] Author(s): M. Labadie,
Date: 2009
Source: Urgences toxicologiques de l’adulte – Guide pratique à l’usage des services d’urgence et de réanimation, Editions Arnette, 2009, p161-171,
This chapter gives physiopathology as well as emergency services protocols based on thermal burns one (10/15 rules in cases of skin exposure or profuse isotonic solution washing in cases of eye exposure). Specific case of acids with specific toxicity such as hydrofluoric acid is noted. Diphoterine® and Hexafluorine® solutions are cited, with the precision that their efficacy compared to water is not demonstrated yet. V. Danel1, B. Mégarbane², P. Chanseau3, M. Labadie4, 1Hôpital Albert Michallon, Grenoble, France, ²Hôpital Lariboisière, Paris, France, 3Hôpital Robert-Boulin, Libourne, France, 4Hôpital Pellegrin, Bordeaux, France
Ophtalmology [Ophtalmologie] Author(s): Gabriel Perlemuter,
Date: 2010
Source: Guide de thérapeutique (6e édition), Elsevier Masson, Paris, 2010, Pages 1385-1463,
This book is a therapeutic guide with a specific chapter for ophtalmology. Washing with tap water, mineral water or with the Diphoterine® solution is recommended in cases of chemical ocular injury. Léon Perlemuter1, Gabriel Perlemuter² 1Hôpital Henri Mondor, Créteil, France, ²Hôpital Antoine Béclère, Clamart, France
Systematic revue – Washing solutions use following hydrofluoric acid and other strong acids and bases acute exposure [Kunskapsöversikt – Spolvätskor för behandling av akut exponering för fluorvätesyra och andra starka syror och baser] Author(s): Gunnar Johanson,
Date: 2010-12
Source: Rapport 2010:6, décembre 2010,
The Swedish Work Environment Authority has therefore commissioned this independent review of the literature and a compilation of experiences from industrial users. Their conclusions are that Hexafluorine® solution works more effectively than water when the irrigation begins immediately after the splash. Its interest regarding systemic effects if chemical burn has already developed is to be demonstrated. Regarding Diphoterine® solution, experimental studies and case reports support for the positive effects of Diphoterine® solution use for personal decontamination of strong acids and bases. Mattias Öberg, Bengt Sjögren, Anders Boman, Gunnar Johanson Occupational Medicine Institute, Karolinska Institute, Stockholm, Sweden
A systematic review of methods of eye irrigation for adults and children with ocular chemical burns Author(s): Suzanne Lo,
Date: 2011-06
Source: Worldviews on Evidence-Based Nursing, 7 juin 2011, [Epub ahead of print],
The authors have decided to present a systematic review based on English and Chinese literatures regarding the different washing solutions available when faced with an ocular chemical splash. This review includes Diphoterine® solution yielded positive ocular outcomes suggesting for its use in hospital settings. Janita PC Chau, Diana TF Lee, Suzanne Lo Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, Hong Kong
Diphoterine® card [Fiche Diphotérine®] Intoxication due to toxic chemical vesicants [intoxication aux toxiques chimiques vesicants] Author(s): Hachelaf M,
Date: 2011-09
Source: Les Intoxications – Prise en charge initiale, 3ème édition, Urgence Pratique Publications, septembre 2011, p28 et 93,
Diphoterine® solution is introduced as a possible washing solution in cases of chemical splashes. Mégarbane B1, Fortin JL², Hachelaf M² 1Réanimation médicale et toxicologique, Hôpital Lariboisière, Paris, France ²Service des Urgences, Hôpital Universitaire, Besançon, France
Chemical injury and thermal eye burns. Conservative and surgical options of a stage-dependent therapy [Verätzungen und Verbrennungen des Auges – Konservative und chirurgische Optionen einer stadiengerechten Therapie] Author(s): Schrage NF,
Date: 2011-10
Source: Ophthalmologe. October 2011;108(10):921-928,
The basic principles of first aid for chemical and thermal burns are discussed. The primary goal of all measurements is the prevention or limitation of injury spreading. In cases of chemical injuries, experimental data confirms the interest of washing with hyperosmolar and amphoteric solutions. In cases of hydrofluoric acid splashes, Hexafluorine® solution’s washing is recommended, with per orbital calcium gluconate’s use if necessary. The further therapeutic care is focused on the modulation of the inflammatory response, the prevention of bacterial infection and secondary glaucoma, and the stimulation of wound healing. Regime therapies should be standardized and scientifically valid. Struck HG 1, Schrage NF 2 1Ophtalmology department of Halle / Saale University ; 2Ophtalmology department, Aachen University, Aachen Center of Technology Transfer in Ophtalmology, Germany
Recommendations for acute treatment for chemical and thermal burn injuries of eyes and lids [Empfehlungen zur Akutbehandlung von Verätzungen und Verbrennungen der Augen und Lider] Author(s): Gérard M,
Date: 2011-10
Source: Ophthalmologe. 2011 Oct;108(10):916-20,
Recommendations for the management of chemical and thermal burn injuries, based on experimentations and clinical experience of eyes cases effectively treated. Systematic review of the literature suggested, shows that washing with an amphoteric solution, such as Diphoterine® solution, was improved clinically, unlike other solutions, such as water. Side-effects of phosphate buffers have been demonstrated in both retrospective clinical and prospective experimental studies. Schrage NF1, Struck HG2, Gérard M3. 1Département ophtalmologie, université Aix la Chapelle, Aachen Center of Technology Transfer in Ophtalmology , Allemagne ; 2Département d’ophtalmologie de l’Université de Halle / Saale; 3Service Ophtalmologie, Centre Hospitalier Universitaire de Fort de France, Cayenne
Sodium hydroxide – Management of ocular and cutaneous chemical splashes Author(s): L. MATHIEU,
Date: 2011
Source: Prevor
Study on the decontamination of sodium hydroxide. This publication contains different comparative data between Diphoterine® and tap water or saline. In vitro studies, using a new model to evaluate the irritant or corrosive potential of chemicals and effectiveness of decontamination, show a rapid return to physiological pH with Diphoterine®. Several in vivo studies: • The first shows that using Diphoterine®, the process of chemical skin lesion is stopped and tissue repair improved. • A second shows that Diphoterine® limits the increase of pH due to sodium hydroxide exposure, preventing thus a stromal edema development. These results are in accordance with results obtained in the industrial world and with a clinical study on ocular alkali injury showing a period of re-epithelialization shortest with Diphoterine® (versus saline).
Efficacy of Hexafluorine® for emergency decontamination of hydrofluoric acid eye and skin splashes [L’efficacité de l’Hexafluorine® pour la décontamination d’urgence de projections oculaires ou cutanées d’ acide fluorhydrique] Author(s): Mathieu L, Nehles J, Blomet J, Hall AH
Date: 2002
Source: Veterinary and Human Toxicology (Vet Hum Toxicol) 2001, 43 (5), 263-265,
11 cases of eye or skin splashes due to 40% HF or the mixture 5% HF/15% HNO3 were effectively decontaminated with Hexafluorine® in a German company between 1994 and 1998. There were 5 cases of splashes due to 40% HF, and one of them involved at the same time the eye and the skin, and a body surface larger than 16%. Neither secondary care, nor loss of work were necessary for any of the splashes rinsed with Hexafluorine®. No after- effects were observed.
Cutaneous chemical burns : mechanisms and caring – Burn center specialist point of view [Brûlures chimiques cutanées : mécanismes et prise en charge – Le point de vue du brûlologue] Author(s): Breden A, Laguerre J
Date: 2009
Source: Congrès de la Société de Toxicologie Clinique, Toulouse, France, mai 2009,
This is a generalist review of the protocols to apply in cases of chemical burns. Diphoterine® is named as a controversial solution, which cannot be recommended as soon as “there is no methodologically accurate human study conducted”.
Sulphuric acid burn: Evaluation and decontamination Author(s): Mathieu L, Fosse C, Coudouel H, Hall AH,
Date: 2010
Source: British Burn Association annual meeting, East Grinstead, UK, avril 2010,
This poster describes results of an ex vivo study on human skin explants exposed to 95% sulphuric acid as well as of in vitro experiments on the acid diffusion and its decontamination. From the first minute, alterations are observed on the explants, on the epidermis layer. Skin penetration is complete in only 4 hours with this ex vivo model. In vitro experiments show that the mechanical flushing effect at the tissue surface is the main washing effect. Dilution effect is the minor effect. The chemical effect, bring by a solution such as Diphoterine®, helps to improve the surface mechanical effect. Thus, a more rapid return to pH normalisation is promoted, compared to a tap water washing.
Chemical injuries [Lésions chimiques] Author(s): Lucien Bodson
Date: 2010
Source: Chemical risk conference: from civil to military, Emergency Medecine College of Franche Comté, May 19, 2010, France,
Diphoterine®’s use on chemical eye/skin injuries feedback from an intensive care unit or from ambulance. The use of Diphoterine® allays the pain fastly, helps to facilitate care and participates to a faster healing.
Comparative evaluation of decontaminant solutions in eye/skin chemical burns: effects on severity and healing of burn [Avaliação comparativa de soluções descontaminantes em queimaduras químicas de olhos/pele : efeitos sobre a gravidade da queimadura e cicatrização] Author(s): Carlos Yoshimura
Date: 2010
Source: ANAMT (Brasilian occupational Health congress), Gramado, Brazil, May 2010,
Feedback on the use of Diphoterine® and Hexafluorine® in different companies and in SAMU. The 2 washing solutions facilitate burn’s secondary care and a faster healing is observed. Presentation of one case report on delayed washing of a 70% hydrofluoric acid exposure on 10% TBSA. A first washing with tap water, added with a local application of a magnesium ointment, helped to remove the chemical at the body surface, but a severe and painful burn developed. However, delayed washing with Hexafluorine®, completed with repeated calcium gluconate application, administrated by massage or by IV, helped to calm the pain by stopping burn development. Despite a fatal risk, no systemic effect was observed.
Série de 111 cas de lésions chimiques sur un site industriel turc [Series of 111 cases of chemical burns in a Turkish industrial plant] Author(s): Dr Cüneyt
Date: 2010
Source: ISBI, Istanbul, Turkey, June 2010,
Among 111 chemical splashes cases, Diphoterine® washing protocol as primary action (63 cases) is compared with tap water washing, alone (4 cases) or followed by a Diphoterine® washing (44 cases). When Diphoterine® is used as a primary action, the injury rate average is 0.67 day whereas it is 2.62 days when tap water is used alone, or 4.5 days when tap water washing is followed by a Diphoterine® washing. In this last group, no special protocol was followed, because it happened to inexperienced workers. So Diphoterine® used in a primary action, appears like the best decontamination agent.
Opiacés endogènes et comportement : 2004 [Endogenous opiates and behavior: 2004] Author(s): Bodnar RJ, Klein GE
Date: 2005
Source: Peptides, 2005 (26) : 2629-2711,
Diphoterine® action on β-endorphins is mentioned, following Dr Cavallini’s study on the effectiveness of different washing solutions on a confirmed chemical burn with concentrated hydrochloric acid.
Chapter 64 – Irritant Incapacitant Exposure Author(s): P Buttaravoli
Date: 2007
Source: Minor Emergencies: Splinters t fractures, 2nde Edition, Mosby Elsevier, 2007 – p249-251,
Description of the procedures to apply if a person or more came to the emergency department with an irritant incapacitant agent exposure. Presentation of Diphoterine® has an interesting potential decontamination solution.
Ophtalmologic Procedures in the Emergency Department Author(s): Babineau MR, Sanchez LD
Date: 2009
Source: Emergency Medicine Clinics of North America, 2008 (26): 17-34,
This publication gives procedures to apply in the Emergency department in case of an ocular irritant exposure and names Diphoterine® as a potential rinsing solution (p.28, paragraph 4, “eye irrigation”): “The preferred buffer solutions are amphoteric (universal) buffers that may help to limit further damages to the eye caused by exothermic chemical reaction between the irrigant and the offending agent. Ethylenediaminetetracetic acid (EDTA) used to be the primary amphoteric buffer, but has now been largely replaced by Diphoterine®”. The impact of the osmolarity of the rinsing is also mentioned.
Rapid Decontamination of Chemical Warfare Agents Author(s): RK Gordon, ED Clarkson
Date: 2009
Source: Chapter 71 of Handbook of Toxicology of Chemical Warfare Agents, Gupta R, 1st Edition, Academic Press Elsevier, 2009,
A literature review is given on Diphoterine®, describing it as a potential rapid decontamination agent in case of chemical warfare agents’ exposures.
Book review – Handbook of Toxicology of Chemical Warfare Agents, Gupta R, 1st Edition, Academic Press Elsevier, 2009 Author(s): Ryan Chuang
Date: 2010
Source: Clinical Toxicology, janv. 2010, 48 : 93-95,
It is a critical analysis of a book on chemical warfare agents with the advantage to be one of the first standard text of this topic. Diphoterine® is named as a decontamination solution.
Decontamination of tetramethylammonium hydroxide (TMAH) splashes: promising results with Diphoterine in vitro Author(s): Fosse C, Mathieu L, Hall AH, Bocchietto E, Burgher F, Fischbach M, Maibach HI.
Date: 2010
Source: Cutaneous and Ocular Toxicology. 2010 June;29(2):110-115,
TMAH, used in microelectronic industries and research and development, has both corrosive and toxic properties. 2 fatal exposures have been already published. This publication presents results of in vitro comparative studies between an initial washing with Diphoterine® and a tap water rinsing: a pHmetric assay and a cytotoxicity test (MTT test). For pH normalisation, 17 times more tap water than Diphoterine® was required. In the cytotoxicity test, 2/3 of the cells remained viable after Diphoterine® washing, compared with only 1/3 after tap water washing. So Diphoterine® washing compared to tap water washing seems effective to prevent injuries from TMAH exposure.
Current Recommendations for Optimum Treatment of Chemical Eye Burns [Aktuelle Empfehlungen zur optimalen Therapie von Augenverätzungen] Author(s): Norbert Schrage
Date: 2010
Source: Zeitschrift Für Praktische Augenheilkunde & Augenärzliche Fortbidung (ZPA), June 2010; 31; 327:332,
This article gives therapeutical indications to follow in cases of ocular chemical burn injuries, pointing out the significancy of an early decontamination by washing the eye on the accident site, in the medical center, in the emergency department and/or at the ophtphtalmologist’s. The malpractices are also evocated. Previn (washing solution from PREVOR, equivalent to Diphoterine®) is presented in this article, as the best alternative to a chemical splash.
Diphoterine for alkali chemical splashes to the skin at alumina refineries Author(s): Michael Donoghue
Date: 2010
Source: International Journal of Dermatology, 2010; 49:894-900,
This publication presents the study performed by the company Alcoa in Australia on three alumina refineries, in order to validate the implementation of Diphoterine®. This study includes two parts: the first one is a comparative clinical study between a group of people who applied Diphoterine® first and a group applying tap water first, among 180 cases. The second part compares the injury rate before and after Diphoterine®’s setting up. The implementation of Diphoterine® helped not only to reduce the underlying accident frequency, and so it increases the prevention message to workforce, but more than anything, it helped to reduce significantly severity of injury, or even to eliminate it.
Management of ocular surface chemical burns Author(s): Gicquel JJ
Date: 2010
Source: British Journal of Ophtalmology, November 2010, doi: 10.1136/bjo.2010.187104,
Diphotérine® is cited as a possible washing solution that can be used in cases of alkali ocular splashes. This citation referred to H. Merle et al.’s study performed in French West Indies and published in Burns in 2005. The different therapeutical protocols to apply, depending on Dua’s classification, are also available.
Decontamination for emergent concentrated sulphuric acid skin splash research Author(s): Wang H.
Date: 2009
Source: Occupational Health and Emergency Rescue, Jun 2009, vol. 27, N° 3,
This article presents the results of an in vitro studytogether with an animal study (in rabbits), on a sulphuric acid splash decontaminated with Diphoterine®, sodium bicarbonate or with water. The pH, the temperature and the macroscopic observation of the lesions are the comparative factors of the study. With Diphoterine® the temperature increases less and healing is more rapid.
Research on Diphoterine® for emergent rinsing off cutaneous alkali burns Author(s): Wang H.
Date: 2009
Source: Journal of Chinese People’ s Armed Police Forces Academy Jun 2009, vol. 25, N°6,
Cutaneous animal study in rabbits compares the impact of various decontamination solutions (Diphoterine®, boric acid and water) after a caustic soda splash. The results of an in vitro test in a beaker are also compared. The pH is the indication of end of washing and the animal observations are macroscopic. The importance of immediate decontamination is raised. Diphoterine® appears to be the best washing solution when compared to boric acid and water.
Chemical burns: Pathophysiology and treatment Author(s): R. Palao , I. Monge, M. Ruiz, J.P. Barret
Date: 2009
Source: Burns, juillet 2009, epub. 3133, 10 pages,
A review of the physiopathology of chemical burns and their treatment. Diphoterine® appears to be a promising decontamination solution. Studies on the subject should be developed.
Safety of dermal Diphoterine application: an active decontamination solution for chemical splash injuries Author(s): Hall A.H. et al
Date: 2009
Source: Cutaneous and Ocular Toxicology. 2009;28(4):149-56,
All reports and studies currently available published or not, on the innocuousness of Diphoterine® for dermal application, are reviewed. Cutaneous toxicology studies have recently been made to supplement the existing data, and thus show that there are no cutaneous harmful effects. This supports the conclusion that Diphoterine® can be used without toxic, irritation, allergic or sensitization effects, including on skin lesion. These results are promising for the development of a protocol for the delayed cutaneous washing of chemical splashes to complement the existing protocol for immediate use.
Sulphuric acid – Management of eye and skin chemical splashes Author(s): C. FOSSE,
Date: 2009
Source: PREVOR
This publication contains different comparative data between Diphoterine® and tap water or saline. In vitro studies, using a new model to evaluate the irritant or corrosive potential of chemicals and effectiveness of decontamination, show a rapid return to physiological pH with Diphoterine®. Several in vivo studies: • The first shows that using Diphoterine®, the process of chemical skin lesion is stopped and tissue repair improved. • A second shows that Diphoterine® limits the increase of pH due to ammonia exposure, preventing thus a stromal edema development. These results are in accordance with results obtained in the industrial world and with a clinical study on ocular alkali injury showing a period of re-epithelialization shortest with Diphoterine® (versus saline).
Comparative evaluation of the active eye and skin chemical splash decontamination solutions Diphoterine® and Hexafluorine® with water and other rinsing solutions: Effects on burn severity and healing Author(s): J. BLOMET,
Date: 2007
Source: Journal Chemical Health And Safety, 2007, 14, N°4, 32-39
This publication gathers the various data comparing Diphotérine® to water or to saline solution. In vitro studies, according to a new model making it possible to evaluate the irritating and corrosive potential of chemicals and the effectiveness of decontamination, show a rapid return to the physiological pH with Diphotérine®. Various in vivo studies: • The first study presented shows that by using Diphotérine®, the process of a cutaneous chemical lesion is stopped and the reparation of the tissues is improved. • A second study shows that Diphotérine® limits the increase in pH due to an exposure to ammonia, averting the formation of a stromal oedema. These results are corroborated by the results obtained in the workplace and a clinical study undertaken concerning ocular chemical lesions due to alkaline substances, showing a shorter re-epithelialisation time for Diphotérine® (versus saline solution).
Dynamic analysis of chemical eye burns using high-resolution optical coherence tomography Author(s): N. SCHRAGE,
Date: 2007
Source: Journal of Biomedical Optics, July/August 2007,12 (4), 041203
This publication evaluates the use of high-resolution optical coherence tomography (OCT) to visualize penetration kinetics during the initial phase of chemical eye burns. It demonstrates the potential of HR-OCT for the visualization and direct non-invasive measurement of specific interaction of chemical with the eye. This capacity shows the effectiveness of an active washing solution, Previn® (the German version of Diphotérine®) when compared to not rinsing at all, on a splash due to caustic soda.
Diphotérine® Chemical Splash Decontamination Solution: Skin Sensitization Study in the Guinea Pig Author(s): A. H. HALL,
Date: 2007
Source: Cutaneous and Ocular Toxicology, 2007, N°26, 181-187
Diphotérine® was evaluated for its sensitization potential in the guinea pig with primary induction (day 1, intra dermal injection), sensitization (day 9, topical application), and challenge (day 22, topical application). No irritation was noted at 24 and 48 hours in negative controls and in animals. Diphotérine® showed no allergenicity reaction after 24 and 48 hours. Diphotérine® appears to have no sensitizing capacity in the guinea pig.
Diphoterine for emergent decontamination of skin/eye chemical splashes : 24 cases Author(s): J. BLOMET, 
Date: 2006
Source: Cutaneous and Ocular Toxicology, 2006, 25, 249-258
Feedback from a German metallurgy company concerning 24 cases of ocular and / or cutaneous projections, from either acids or bases. After the use of the Diphotérine®, there were neither burns nor after-effects, and no need for secondary care.
Emergency treatment of eye burns: which rinsing solution should we choose ? Author(s): R. RIHAWI,
Date: 2006
Source: Graefe’s Arch Clin Exp Ophtalmol, juillet 2006, 244(7), 845-854,
This comparative study tests by in vitro and ex vivo methods of pH measurements, various solutions of ocular washing on a sodium hydroxide projection (2M) : water, saline solution, Cederroth® (borate buffer solution), Previn®, Diphotérine®, Ringer lactate and a phosphate buffer solution. The authors recommend using an active solution on alkaline projections noting that an isotonic phosphate buffer solution does not have an effect on the intra-ocular pH. Previn®, Diphotérine® and Cederroth® are more effective than water in returning the pH of the anterior chamber to an acceptable zone.
Alkali ocular burns in Martinique (French West Indies). Evaluation of the use of an amphoteric solution as the rinsing product Author(s): H. Merle
Date: 2005
Source: Burns, 2005, 31, 205-211
This publication describes the clinical study, conducted in Martinique, French West Indies, of alkali ocular burns. It concerns chemical eye burns with delayed Diphoterine® rinsing, compared with saline solution, followed by a specific treatment adapted to the seriousness of the case. 28 patients (42.4%) had a unilateral burn, and 38 (57.6%) a bilateral one. Amongst the circumstances of the burns, sorted by order of decreasing frequency, one finds: assaults in 45.5% of the cases (n = 30), work related accidents (32%, n = 21) and domestic incidents (23%, n = 15). For grade 1 and grade 2 burns, reepithelialization time is shorter when rinsing has been done with Diphoterine®: 1.9 ? 1 days, compared with 11.1 ? 1.4 days (p = 10-7) and 5.6 ? 4.9 days compared with 10 ? 9.2 days (p = 0.02).
Prevention of CS “Tear Gas” Eye and Skin Effects and Active Decontamination with Diphoterine®: Preliminary Studies in 5 French Gendarmes Author(s): A. H. HALL,
Date: 2005
Source: Journal of Emergency Medecine, 2005, 29, 1, 5-8
Ortho-chlorobenzylidine malononitrile (CS) “tear gas” is a lacrimating riot control agent causing eye irritation, excessive lacrimation , and blepharospasm. Diphoterine® rinsing was used in human volunteers for : 1) post-exposure decontamination of CS and 2) pre-CS exposure prophylaxis in the eyes and on the face. Five French Gendarmes were exposed to CS in an exposure chamber. For post-exposure, volunteers developed the expected effects of excessive lacrimation, eye irritation and blepharospasm. These effects were rapidly resolved after Diphoterine® rinsing. For pre-CS exposure, Diphoterine® was applied to the eyes and face and the expected effects of CS did not occur. Based on the preliminary data presented here, Diphoterine® may be an efficacious eye and skin prophylactic and decontamination solution for CS exposure and further studies are warranted.
Diphoterine®: skin sensitization study in the guinea pig Author(s): AH. HALL,
Date: 2004
Source: ICT congress, ampere, Finlande, Juillet 2004 SOT, Mars 2004, Baltimore, MD, USA,
Since 1999, a supervision of the market was organized by Prevor Laboratory in order to collect the complaints from the users : no case of sensitization with Diphotérine® was reported by the companies. A sensitization study was realised to confirm this observation and to add a new proof of the Diphotérine®‘s innocuousness. The capacity to induce a delayed sensitization was evaluated for the pig (Guinea) according to OCDE recommendations and 67/548/EEC directive. The study was realized by CERB Laboratory, Baugy, France (Report of study n° 20030418ST). The test was realized according to Magnusson-Kligman and Guillot’s method.
A review about Diphotérine®: the solution for first aid emergency decontamination of eye/skin chemical splashes. Author(s): F. SIMON,
Date: 2003
Source: ISSA Congress – May 2003, Athens, Greece,
METHODS: we present here the different significant results obtained with Diphotérine® during the last twelve years in the industry.
Emergency treatment of chemical and thermal ocular burns. Author(s): G. KELLER,
Date: 2002
Source: Acta Ophthalmologica Scandinavia 2002, 80, 1, 4-10,
Water is hypotonic to the corneal stroma. The osmolarity gradient causes an increased water influx into the cornea and the invasion of corrosive substance into deeper corneal structures. We therefore recommend higher osmolarities for the initial rinsing to mobilize water and the dissolved corrosives out of the burnt tissue.
Comparison of emergency eye-wash products in burned porcine eyes. Author(s): N.SCHRAGE,
Date: 2002
Source: Graefe’s Arch Clin Exp Ophthalmol 2002,
The long term prognosis of patients with chemical eye burns depends on immediately rinsing the eye after the trauma. The emergency treatment after the burn should consist of rinsing with a solution of a high buffer capacity and with a high osmolar difference in comparison with the cornea.
Experimental immunological study in chemical burns in rats. Author(s): M. CAVALLINI,
Date: 2002
Source: SOT – March 2002 SFETB – September 2001,
Amphoteric solution (Diphoterine®) showed satisfactory results not only in immunological responses but also in wound healing and pain control (high level of b -endorphin, and low level of substance P), in comparison with other solutions used
Interest of Diphotérine® as an ocular rinsing solution for the emergency treatment of serious ocular burns. Author(s): N. SCHRAGE,
Date: 2002
Source: SFO Congress – May 2002,
This presentation reports a case of serious eye burn (grade IV of Ropper Hall’s classification) healed by a simple conservative therapeutic regimen, preceded by an initial rinsing with one litre of Diphoterine®, one hour after the accident.
Is there a delay for the external ocular rinsing in the treatment of an eye burn due to ammonia? Comparison between 2 rinsing solutions : physiological serum and Diphotérine®. Author(s): H. MERLE,
Date: 2000
Source: J Fr Ophtalmol 2000,
As a part of ocular burns with ammonia, the interest of a rinsing with Diphotérine® compared to physiological serum in the ten first minutes is reinforced thanks to the abscence of stromal oedema and the pH inflexion of the aqueous humour during the treatment. The importance of a rinsing with Diphotérine® is underlined by the link between the importance of the stromal oedema and the scar leucoma.
First aid measures after a chemical and thermal burn in the eye. Author(s): N. SCHRAGE,
Date: 2000
Source: Dt Ärztebl 2000,
First of all, this publication introduces a precise classification of the different stages of an ocular chemical burn and its clinical prognosis. The authors insist on the importance of an early rinsing and on its quality in order to avoid important ocular injuries. The rinsing must be isotonic or hypertonic to tears and active on the aggressive chemical products. The experience of occupational doctors shows that the length of work losses for the employees is shorter after a rinsing with Diphotérine®, that has ideal chemical and physical properties, than after a rinsing with another emergency treatment.
Diphotérine® for emergent eye-skin chemical splash decontamination : a review. Author(s): J. BLOMET,
Date: 2000
Source: Semi Conductor and Safety Association European Congress October 2000, Milan,
This text summarizes the different European experiences and studies carried out on the action of Diphotérine® on chemical burns and its efficiency. It also evokes the testimonies of companies satisfied with Diphotérine®. In conclusion, Diphotérine® appears as a major improvement in the field of the emergency rinsing of splashes due to chemical products.
A review about Previn® (Diphotérine®) : A solution for first aid emergency decontamination of eye/skin chemical splashes. Author(s): J. NEHLES,
Date: 2000
Source: International Congress on Environmental Health October 2000, Germany,
This poster presents all the results obtained with Previn® (Diphotérine®) in Germany. These results show the Previn® (Diphotérine®) efficiency for the decontamination of ocular and cutaneous splashes. A decrease of the loss of work and secondary care is noticed in all cases.
A review about Diphotérine® : the solution for emergency decontamination of chemical splashes. Author(s): H. UELLNER,
Date: 2000
Source: Eurotox 2000 London,
The testimony of Diphotérine® users allowed to assemble about ten ocular or cutaneous splashes, rinsed efficiently with Diphotérine®. We notice the absence of sequelae, and a decrease of secondary care and loss of work.
A review about Diphotérine® : the solution for emergent decontamination of eye / skin chemical splashes. Author(s): J. NEHLES,
Date: 2000
Source: Occupational Hygiene 2000 Manchester,
The use of Diphotérine® is a good system for the emergency treatment after splashes with chemical products. It permits to decrease the number of days lost from work and the secondary care and also the after-effects for the injured persons.
Comparison water / Diphotérine®: Rinsing of more than 600 chemical splashes during 7 years in the factory ATOCHEM Saint-Avold. Author(s): F. SIMON,
Date: 2000
Source: Brulologie 2000 20th National Congress SFETB Toulouse,
The preliminary analysis of the observations study obtained during 7 years on the Atochem Saint Avold plant allowed to show the tendency to the superiority of the rinsing with Diphotérine® compared to the rinsing with water no matter the chemical product involved. Its use entails a less important seriousness for the accidents and permits to significantly decrease the number of days lost from work.
Diphotérine® and Hexafluorine®. Principles and indications for use Author(s): L MATHIEU,
Date: 2008
Source: PREVOR
The principles of action of both solution Diphotérine® and Hexafluorine® and recommendations for use.
Evolution of oesophagus caustic burns. In vitro and in vivo histologic and pHmetric study. Author(s): E. VIGUIER,
Date: 1999
Source: SFETB Congress,
To perfect several experiences in vitro and in vivo that permit to study the evolution of oesophagus caustic burns in order to adjust a method of emergency decontamination. The study shows that the muscular is reached after 10 minutes permitting thus a therapeutic intervention delay.
New physiological approach of digestive burns due to ingestion of caustic products. Therapeutical experimental interest of Diphotérine®. Author(s): S. BARATTE,
Date: 1999
Source: 37th European congress of toxicology Eurotox 1999 Oslo,
In vivo study carried out on an animal model (pig) that permits to valuate the evolution of oesophagus cautic burns and to create a decontamination method with Diphogel® in a pHmetric, endoscopic and histologic way. Diphogel® reestablishes without any delay the physiological pH at mucous membranes level and muscular membranes level. This study shows an immediate tissue decontamination of the caustic by stopping the burn at its injural level.
First results of the toxicological research with the civil safety. Author(s): D. AMADON,
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
The Prevor company has initiated a study to put a methodology into service that permits to prevent the toxicological activity of a molecule starting from the study of its chemical structure. This methodology should permit to help the first aid department to take the appropriate decisions when they are fronted to unknown chemical products or chemical weapons.
Anesthesia and resuscitation of a pig in a protocol of treatable caustic injuries of the oesophagus. Author(s):
Date: 1999
Source: 1st Prevor scientific daytime Avril 14th 1999, Paris,
Ethic problems met for the anesthesia and the resuscitation of the pork, as an animal model.
Critical methods of the antidotes valuation. Author(s): F. BAUD,
Date: 1999
Source: 1st Prever scientific daytime April 14th 1999, Paris,
The clinical study is the sole valuation that is really reliable regarding the capacity of “antidotes”.
Chemical dimension of the allergy. Author(s): F. BURGHER,
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
A labour group has initiated a project to put into service information means regarding the allergens, their action mechanisms and the current balance of the knowledges about this subject.
Pulmonar chemical burns and Diphotérine®: current situation. Author(s):
Date: 1999
Source: 1st Prevor Scientific daytime April14th 1999, Paris,
Preliminary study as regards to Diphotérine® capacities to treat pulmonar burns due to ammonia. The first results are cheering but it remains to determinate the good proportion of Diphotérine® respect to the inhalated ammonia, its way of administration and its possible toxicity inside the organism.
Surgical technic for the limbic autotransplantation in case of serious and early ocular burns. Author(s): R. RICHER,
Date: 1999
Source: J Fr Ophtalmol 1999,
The authors report their surgical technic for the limbic autotransplantation used for the serious and early ocular burns. They underline the fundamental points of this operation by reminding the initial importance of an emergency ocular rinsing.
Experimental study on the intraocular penetration of ammonia. Is there a delay for the external ocular rinsing during the treatment of serious ocular burns due to bases? Author(s): JM. MENERATH,
Date: 1999
Source: J Fr Ophtalmol 1999,
Study that permits to valuate the influence in the cornea due to the penetration of ammonia. It confirms the fast penetration of ammonia (1 to 3 minutes). The results of pH and ammonia concentration prove that chemical reactions with tissue proteins exist. It opens a research way on the dangerousness of a base by correlating its pK to the proteins density consumed by the base.
Hyperosmolar Rinsing as First Aid in Eyes Burns? Author(s): S. KOMPA,
Date: 1999
Source: 37th toxicology european congress Eurotox 1999 Oslo,
The study on 10 sane humans shows that the use of PREVIN® (Diphotérine®) as an hypertonic solution dedicated to the emergency ocular rinsing is not dangerous for the health : complete recovery of physiological capacities after 3 days. As a consequence the hypertonicity is a characteristic to use for the emergency ocular decontamination.
Radioactive decontamination. Valuation of a decontaminating molecule activity. Author(s): Col. P GERASIMO,
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
In the field of radioactive decontamination studies, a valuation of differents molecules was carried on by a distribution test of radio-elements (Pu, U, Sr, Cs) between the contaminated parts of the cornea layer and the incubation place where the product to test is located. Diphotérine® was positioned in a good place with ideal properties among a wide range of complexing products.
OSWI 10th annual congress. Author(s): P. JOSSET,
Date: 1999
Source: West Indian Medical Journal July 1999,
This abstract summarizes 3 studies titled : “Ocular alkali burns : limbal autograft”, “Ocular ammoniac burns : treatment” and “Intraocular penetration of toxic substances”.
Evaluation of the decontaminating activity of Diphotérine®. Author(s): Col. P GERASIMO,
Date: 1999
Source: Radiological protection Department from the French Army.
The valuation of the efficiency of Diphotérine® for the decontamination of mustard gas gave satisfactory results compared to the results obtained with soapy water and physiological serum. After a ten minutes rinsing, the tests show that Diphotérine® decontaminates twice faster than physiological serum and 4 times faster than soapy water.
Report about the decontamination with Diphotérine® of mustard gas. Author(s):
Date: 1999
Source: Direction of the Defense and Civil Safety,
During the mines clearance of shells containing mustard gas that have not exploded, there were 6 cases noticed of serious cutaneous injuries. There were no cutaneous or systemic injuries noted after the immediate treatment with Diphotérine®. The recovery was complete and without after-effects, which was not the case for the civil victims who were not decontaminated with Diphotérine®.
Evaluation of PREVOR’s researches. Author(s):
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
Document summarizing the different speeches during the congress “First PREVOR scientific daytime”.
Preliminary results about the use of emergency rinsing solutions PREVIN® (Diphotérine®) and Hexafluorine® during chemical splashes in a company. Author(s): J. NEHLES,
Date: 1999
Source: 14th Daytime of the French Society for Medical Emergencies SFUM Marseille,
Results of a German company about the use of Prévin® (Diphotérine®) and Hexafluorine® as emergency rinsing solutions. There were no after-effects noticed and no secondary care necessary on 36 accidents.
Evolution towards the stenosis of oesophagus caustic burns. Histologic and pHmetric study, in vitro and in vivo. Author(s): P. JOSSET,
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
Histologic and pHmetric study researching the mechanisms of the oesophagus caustic burn and the reasons of the stenosis evolution.
Diffusion. Molecular attraction Author(s):
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
Theoretical evolution and molecular attraction of an acid chemical product in the eye, according to the different washing solutions (water, base). DUPONT V
Ocular burns due to an alkali. Comparison of human and experimental clinical data about the intraocular penetration of ammonia. Is there a delay for the external ocular rinsing in the treatment of serious burns due to bases ? Author(s):
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
In the field of the study about ocular burns due to bases, the efficiency of the rinsing with Diphotérine® in the 10 first minutes following the accident is proved not only thanks to biochemists arguments (inflexion of the pH curve during the rinsing) but also thanks to histologic arguments (absence of stromal oedema).
To optimise the application devices of the prevention against the chemical risk. Author(s):
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
Question about the conception of the application devices for the prevention products in favor of a more sensitive listening of the users and also in the aim of innovation and performance.
The ocular burn and the first stage of medical care. Author(s): L. MATHIEU,
Date: 1999
Source: Summary of the communication during the scientific daytime Paris April14th,
Several studies were carried out to examine the effect of the hypertonicity on the cornea. One of these experiences shows that the application of Diphotérine® on sane eyes of rabbits is compatible with the cornea epithelium. In the same way, a human study has proved that the use of Diphotérine® was compatible with the cornea structure, from a clinical and bio microscopic point of view or during the control of the visual acuity.
Choice of an animal experimental model for oesophagus burns. Author(s):
Date: 1999
Source: 1st Prevor scientific daytime April 14th 1999, Paris,
Research of an animal model to achieve oesophagus caustic burns, to valuate the importance and to correlate the results with the results obtained on humans after an accident. In vitro studies have underlined homologies and possible correlations between the pig oesophagus and the human oesophagus.
Analysis of the Diphotérine® scientific file Author(s):
Date: 1999
Source: Lariboisière Hospital Paris VII,
Critical review of the scientific documents and of the presentations included in the file: “Diphotérine® efficient washing solution: Documents and studies of references”.
Diphotérine® : multi-purpose solution for the decontamination.

Military file on request

Date: 1999
Source: PREVOR
In case of chemical or radiological disasters, the most important is to avoid the transfer of the injured persons towards the reception structures dedicated to the victims. All the studies summarized in this file show that Diphotérine® is the efficient solution that is able to decontaminate all the toxics : classical chemical products, products used as chemical weapons (blister gas, neurotoxics, radioactive products…).
New physiopathological approach of digestive burns due to an ingestion of caustics. Experimental therapeutic interest of Diphotérine®. Author(s): E. SCHMITT,
Date: 1998
Source: Faculty of Medicine Saint-Antoine Paris,
This in vitro and in vivo study opens the way to set up an emergency decontamination method with Diphotérine® in the form of a gel in case of oesophagus caustic burns. The rinsing with Diphotérine®, that is 4 times faster than a rinsing with water or physiological serum, will allow to decrease considerably the length of contact of the caustic on the oesophagus tissues. In addition, its hypertonic effect will reverse the flow of caustic ions inside the tissues. The caustic ions will then be absorbed in the surface of the oesophagus by Diphotérine® which will permit a more efficient rinsing. This hypertonic effect will be even more important as it will be prolonged due to the gel form of Diphotérine®.
Contribution to the study about the treatment of oesophagus burns due to caustic on the human. In vitro study and creation of an animal model. Author(s): D. VAUCOULOUX,
Date: 1998
Source: Thesis of Veterinary Doctorate,
First of all, the work consisted in setting up an in vitro animal model to test the efficiency of Diphotérine® in case of oesophagus caustic burns. This study underlines the important characteristics of the treatment to set up: a good absorption capacity of the caustic, an impressive osmotic pressure that is able to influence the penetration of caustic ions and an adapted viscosity to preserve as long as possible the action of the treatment on the oesophagus walls. The results of this study show that Diphotérine® has the ideal characteristics. However, Diphotérine® in the form of a solution is not adapted to the oesophagus because it does not maintain efficiently enough a continuous hypertonicity. It has entailed the creation of Diphogel® which composition is optimal to compensate oesophagus burns.
Ocular burns due to bases : Comparison of human and experimental clinical data about the intraocular penetration of ammonia. Is there a delay for the external ocular rinsing during the treatment of serious ocular burns due to bases ? Author(s): M. GERARD,
Date: 1998
Source: Faculty of Medicine from Auvergne Clermont 1,
This work compares the data of a clinical prospective study and the experimental data about the ocular burns due to ammonia. The notion of delay for an ocular rinsing is underlined. A serie of in vivo experiments is carried out to comfort this data study, which shows that a rinsing after more than 30 minutes would have little effect as the return to the physiological pH was quasi re-established by itself. Paradoxically, a rinsing in the ten first minutes would have a beneficial effect. The study proves that an early rinsing with Diphotérine® entails the absence of a stromal oedema and a significant decrease of the intraocular pH that is not noticed with a rinsing with water or physiological serum.
Chemical burns : place of Diphotérine®. Author(s): P. BROCHARD,
Date: 1998
Source: Society of Occupational and ergonomics medicine from Bordeaux and its area.,
The treatment of the chemical burn is an emergency that must be done on the places of the accident. Diphotérine® seems to be a promising alternative front to the lack of efficiency of water in case of chemical burns. Several results from experimental and industrial studies show the superiority of a rinsing with Diphotérine® compared to the classical methods of rinsing. The action mechanism of Diphotérine® that is multiple permits an action with the corrosives without exothermic reaction linked to a fast pain relief. Its light hypertonicity permits to be influent on the penetration of the corrosive inside our tissues.
Health support during an operation in a chemical environment. Author(s): C. GONZALEZ,
Date: 1998
Source: 11th National Congress of SAMU November 1998 Toulouse,
A health support is essential during emergency first aids for situations in a chemical environment. Diphotérine® is used as rinsing method for the toxics.
The importance of the first aid measures for the chemical burn. Author(s): B. Viala
Date: 1998
Source: Urgence Pratique N°29 Spécial secourisme (page 55/56),
This article dedicated to the first aid teams explains the global concept of the chemical burn and its criteria for an efficient rinsing. It underlines the importance of the emergency treatment precariousness and recommends the use of Diphotérine® as a modern and innovative product.
Meeting of the crisis cell for the 1998 football world cup Author(s): V.DUPONT,
Date: 1998
Source: PREVOR
Organisation of the PREVOR staff as experts for toxicological and chemical risks intelligence during the creation of the cell crisis for the football world cup in 1998.
Ingestion of caustic products in Paris area. Epidemiologic study in the responsability sector of the Paris Fire Brigade. Author(s): JC. DESPORTES,
Date: 1997
Source: 1st International Congress of la Baule October 1997,
Epidemiologic study about the ingestion of caustic products. As a conclusion, the majority of the injured persons are adult males with a volontary intoxication. The caustic products entail a clinical seriousness entailing a quick and fast pick up.
Prospective study about the ocular burns due to bases in Martinique. Author(s): M. GERARD,
Date: 1997
Source: 1st International Congress from La Baule October 1997,
Epidemiologic preliminary study about ocular burns due to bases in Martinique. It takes into account the seriousness of the burns and evokes the social and sometimes legal repercussions. The clinical data of this study show the presence of a delay of several minutes before a burn becomes serious and remind the importance of an appropriate emergent ocular rinsing.
How do different rinsing solutions influence the healing process of the cornea after an ocular burn? Elementary conditioning of the cornea after a prolonged application of ocular drops. Author(s): M. REIM,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
This study aims at determining the physiological influence of 3 rinsing solutions on the cornea during a prolonged treatment of serious burns. This influence is important as it will induce the healing process of the damaged eye. The 3 solutions are : phosphate buffer (Isogutt), 0,9% saline solution and Diphotérine®. The results show an important calcification of the cornea in case of the use of the phosphate buffer entailing an important opacification. An accumulation of sodium and chloride is demonstrated for the 0.9% saline solution that entails an imbalance of cornea hydration. Diphotérine® is the only one with a beneficial effect by reducing the pH of the cornea surface and respecting in the same time the physiological status of the cornea (except the incidence on the sulphur rate).
Valuation of the first aid efficiency in case of splashes with chemical products. Author(s): F. FALCY,
Date: 1997
Source: INRS DMT 70,
This report is the next of the survey (INRS DMT 53) concerning the addition of the accidents obtained by the occupational doctors after ocular and cutaneous splashes with chemical products.
Evolution of the knowledge on the chemical burns Author(s):
Date: 1997
Source: First International Congress – La Baule October 1997,
Summary of several speeches during the International Congress of La Baule on the subject of evolution of the knowledge on the chemical burn.
First aid in the professional field. Author(s): FALCY,
Date: 1997
Source: 1st International congress from la Baule October 1997,
The INRS insists on the importance of a good first aid training and on the creation of easy and sole instructions to use during the first aid. INRS is very interested in Diphotérine® that represents an improvement in the field of first aid in case of ocular and cutaneous splashes with chemical products .
Management of a chemical crisis in an underground passage. Author(s): B. VIALA
Date: 1997
Source: 1st International Congress from la Baule October 1997,
Diphotérine® gives excellent results during its use for the mass decontamination thanks to its intrinsic properties but also thanks to the non toxicity of its rinsing effluents.
How does the SAMU take charge of chemical accidents. Author(s): ROUX,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The decontamination must be proceeded before the arrival of the SAMU. As the chemical neutralisation (an acid by a base or an oxydizing agent by a reducing agent) is not conceivable, it is necessary to create polyvalent solutions, with a fast action and that respect the physiological balances which efficiency will be proved by scientific studies.
Forum : the chemical burn, an essential emergency. Author(s): A. RAFTOPOULO,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The occupational doctors mission is to know the risks in the company in order for the first aiders to be trained and to write the specific emergency instructions. It is necessary to teach the operators how to save themselves.
Forum : Contribution from the research to the care chain. Author(s): C. GERAUD,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The future use of Diphotérine® as a therapeutic internal treatment underlines several observations. Complementary toxicological and quantitative studies but also about the galenic line are necessary.
Prevention strategy front to the chemical risks. Author(s): C. GERAUD,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The prevention rule is always as important as it is proceeded by the training to the first aid actions or by checking if the emergency material is available. It is important not to forget to proceed to a medical examination after each accident.
From care to prevention of the chemical burn, a responsible chain of care. Author(s): HENRI,
Date: 1997
Source: 1St International Congress from la Baule October 1997,
From the doctor to the rescue fire man and the safety agent, it is necessary to assemble our competences. This, in order to improve our knowledges, to organise better the care chain and to harmonize our points of view in the aim to fight the problem of the chemical burn with efficiency.
Therapeutic of the ocular burn. Author(s): M. Reim
Date: 1997
Source: 1st International Congress from la Baule October 1997,
Serious chemical and thermal burns entail a long pathologic process that damages seriously the eye. Epidemiologic researches have underlined the essential importance of the quick first aid that is to say the rinsing of the eyeball.
The different types of chemical burns – chemical and therapeutic aspects. Author(s): PEETERS,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The first aid in case of chemical burns most of the time consists in an important irrigation with water. The effect of numerous dangerous products is not only local but also systemic after the cutaneous absorption that entails respiratory and cardiac problems. This is an important characteristic of chemical burns that has to be taken into account.
Endoscopic, pHmetric and anatomo pathologic experimental study of oesophagus burns due to the ingestion of caustics. Author(s): P. JOSSET,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The oesophagus burns due to the ingestion of caustic are the origin of an important or even serious pathology that can entail the death. This in vitro and in vivo study permits to notice the mechanisms of the chemical burn and to confirm the fast use of a decontamination system after the ingestion. This study proves the intimate relation between the pH and the cellular destruction lesions in the oesophagus.
Theoretical and experimental approaches of a chemical product penetration in living tissues. Author(s): B. MEYER,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The understanding of the penetration of a chemical product into the tissues justifies the interest to create an in vitro model that is able to demonstrate the important influence of the osmotic pressure and the chemical reactivity compared to the lower importance of the natural diffusion effect. The model demonstrates the lower efficiency of an aqueous rinsing even if it is a prolonged rinsing as it interacts less on both the osmotic pressure parameters and the chemical reactivity.
Intimate action mechanism of chemical products. Author(s): L.MATHIEU,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
First of all, the chemical burn is a chemical reaction between an aggressive product and a constituent of the organism. The setting up of an interaction scale between the couple aggressive entity-target and chemical reactivity is the first step toward a methodology of Reflexive Toxicology.
Return to physiological balances of the cornea electrolytes, necessary conditions of the “Restitutio Ad Integrum”. Author(s): Dr N. SCHRAGE,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
Ocular examinations on humans and rabbits underlined that burns and some of their following treatments entail a break in the physiological balance of the cornea, compromising thus its regeneration. Then, a study was initiated to evaluate the influence of an hypertonic primary rinsing followed by an isotonic secondary rinsing in order to preserve the electrolytic balance of the cornea.
Radionucleids decontamination : study with skin models. Author(s): P. Gerasimo,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The aim of the radioactive elements decontamination is similar to the one of chemical burns that is to say the elimination of the agent that is at the origin of the burn. Then, an in vitro study was set up to determine the ideal caracteristics of a rinsing solution (osmotic pressure and complexing properties) with positive results obtained by Diphotérine®.
Chemical burns in the cement and cleaning corporation. Author(s): C. Geraut
Date: 1997
Source: 1st International Congress from la Baule October 1997,
Generally, due to a lack of information of the users, we find serious skin burns in the cement and the cleaning industry. Indeed, those jobs are often fronted to corrosive products that are used without precaution.
From the passive rinsing due to the mechanical sweeping effect to the active rinsing of chemical accidents : Diphotérine®, principle and mechanisms. Author(s): J. BLOMET,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
Due to the 11 millions of potentially dangerous molecules, it seemed neccessary to perfect a polyvalent decontamination solution, non toxic and able to stop the evolution of chemical burns. It is done with Diphotérine® which in addition is able first of all to regulate the osmotic pressure and on the other hand to control the residual level of the aggressive agent.
Case report : Burn of an employee in production provoked by a varnish (cresol) in the industrial sector. Author(s): P. Dolfen
Date: 1997
Source: 1st International Congress from la Baule October 1997,
After a splash of warm varnish (40% cresol), a Prévin® (Diphotérine®) solution was used in addition with polyethylen glycol. It gave an exceptionally good result, limiting thus the seriousness of the burn to a 1st degree burn without appearance of vesiculation. The ad integrum restitution was noticed after 4 weeks.
Remarks about the functional classification of chemical products in toxicology. Author(s): F. BURGHER,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
It is necessary to use the reflexive toxicology to conclude about the potential risk of a non described molecule. This methodology permits to prevent the reactivity of a molecule by a framing method with “close” molecules.
Ocular burn after a splash with Skydrol. Creation of an emergency protocol and results. Author(s): B PASQUET
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The setting up of a new emergency protocol was decided in accordance with the Medical Department from Air France due to the fast increase of the consequences of ocular splashes with Skydrol in terms of seriousness and days lost from work. In the same work conditions and for the same number of accidents, a 5 years study about 258 cases was initiated to compare the efficiency of ocular rinsing with Diphotérine® to the one with classical rinsing. The use of Diphotérine® in the emergency protocol entails a lasting decrease of the accidents seriousness from 25 to 5% and of the days lost from work that are linked.
Integration of Diphotérine® in an automotive production center. Author(s): C. BENADJA,
Date: 1997
Source: 1st International Congress from la Baule October 1997,
The automotive plant of Poissy that is using more than 1200 chemical products, has workshops with restrictive health conditions that need to be regularly refitted. The plant was fronted to the problems of Eyewashes with running water regarding the difficulties of setting up, maintenance, cleaning and hygiene. The introduction of mural eyewashes with Diphotérine® has allowed to solve a large number of problems due to its numerous advantages : sterility, an operational system without setting up constraints, waterproof and easy spotted protective box, easy and reliable use…
Epidemiologic study. Chemical burn at Elf Atochem Saint Avold from 1992 to the end of August 1997. Author(s): SIMON F.
Date: 1997
Source: 1st International Congress from la Baule October 1997,
Observations study about 475 chemical burns for 6 years on the Atochem St Avold plant. More than the satisfaction of users about the use of Diphotérine® for ocular splashes, the analysis permits to show a decrease of the burns seriousness, taking into account the wide range of dangerous products.
Procedure for the use of Diphotérine® in case of a splash with a tested product. Author(s):
Date: 1997
Source: PREVOR
Diagram that represents the steps for the use of Diphotérine® depending on the place of the splash and the intervention delay.
Operative system : NEP. Author(s): L. Mathieu
Date: 1997
Source: PREVOR
In vitro experiment protocol that permits to test the efficiency of a rinsing solution by measuring the pH on common corrosives used in the Industry.
Rinsing therapy in severe alkali burns of rabbit eye. Author(s): A. SCREIER,
Date: 1996
Source: JERMOV Congress Monptellier,
Comparison about the efficiency of three rinsing solutions in case of serious ocular burns due to bases (1N caustic soda) : physiological serum, phosphate buffer and Diphotérine®. This study carried out on animals underlines that the physiological serum is not efficient. Even if the phosphate buffer is positively active on the pH of the aqueous humour, it is not isotonic and represents a calcification risk of the cornea. On the other hand, the results with Diphotérine® permit to recommend it as the efficient alternative for emergency rinsing.
Training period report : study about the ions spreading through a partially permeable membrane. Author(s): Q. Brouet
Date: 1996
Source: PREVOR
In vitro study about the diffusion of acid and basic ions through a partially permeable membrane. pHmetric evidence of the rinsing efficiency with Diphotérine® compared to water and the influence of the hypertonicity on the diffusion.
Analysis procedure of a product required by the customer. Author(s): L Mathieu
Date: 1995
Source: PREVOR
Diagram that schematizes the analysis steps of a product after the demand of a customer.
PDBX13 protocol of use (Basic powder for the decontamination of chemical products). Author(s): J Blomet
Date: 1995
Source: PREVOR
Internal protocol of use for PDBX13.
Rinsing conditions for the product LOCTITE 420. Author(s):
Date: 1995
Source: PREVOR
Study in the PREVOR Laboratory about the efficiency of Diphotérine® compared to physiological serum for a rinsing after a splash with a glue of type Loctite 420.
First aid in case of ocular splashes. First results of the study. Author(s): F. FALCY,
Date: 1993
Source: INRS DMT 53,
Gathering and analysis of a series of accidents obtained by Occupational Doctors after cutaneous and ocular splashes with chemical products.
Comparative study about the rinsing methods of accidents due to caustic soda. About 45 cases observed. Author(s): Mr THEISEN,
Date: 1993
In case of accidents with basic products, this study takes back these accidents for three years considering 45 studied cases followed by different emergency rinsings. As the aim is to compare the different rinsings, the statistical tests carried out show a significant difference between the different results obtained. We can conclude that the rinsing with Prévin® is superior to other protocols like the rinsing with water or the rinsing with acetic acid. The rinsings with Prévin® have entailed a significant decrease of the number of days lost from work and a decrease of the secondary care complexity.
Historic about the use of Diphotérine® on the Rhône Poulenc plant from la Rochelle. Author(s):
Date: 1993
Source: Rhône Poulenc La Rochelle,
After different chemical accidents rinsed with water that entailed serious consequences, the decision to integrate Diphotérine ® as rinsing solution was taken. Five years later, a study was carried out to compare the efficiency of the rinsings with Diphotérine® to the rinsings with water on 182 accidents with a wide range of chemical products. It shows a clear superiority of the rinsing with Diphotérine® as the number of accidents entailing days lost from work decreased from 7 to 0% and the number of secondary care decreased from 30 to 5%.
Diphotérine®. Medical dossier. Author(s):
Date: 1993
Source: PREVOR
Synthesis about the efficiency mechanism of Diphotérine®. Results about the non toxicity of Diphotérine®, reglementary accreditations and emergency protocol.
Interest of an amphoteric isotonic solution for the early treatment of basic corneo-conjunctival chemical burns : experimental and histologic study. Author(s): J. BLOMET,
Date: 1986
Source: Soc. Opht. France 1986 article,
In case of a splash in the eye with caustic soda, the delay of 5 minutes is chosen to consider that the penetration of the corrosive is finished and that the lesions are installed. That is where the necessity of a rinsing as quickly as possible comes from. An in vivo study shows the quick reestablishment of the intra and extra ocular pH and the quasi complete preservation of the endothelial cells during the use of an isotonic and amphoteric rinsing solution. These characteristics can not be found with a water rinsing.
Penetration of a toxic into the cornea. Experimental study and simulation. Author(s): MC. MEYER,
Date: 1986
Source: SMT N°85 1986,
This study, which is corroborated by an in vivo experiment, shows from a fundamental point of view the lack of efficiency of a rinsing with water and the necessity of a specialised product with simultaneous properties of absorption and regulation of the osmotic pressure. For this reason, the authors propose a mathematic model of toxics penetration taking into account factors such as the natural diffusion, the osmotic pressure, the nature and the concentration of the toxic agent… This approach brings to the fore the penetration coefficients on which a rinsing with water has little influence opposite to a rinsing with an amphoteric and isotonic solution. Then, this study permits to show that, during the penetration of a toxic, the threshold of the physiologic pH is exceeded after 90 seconds explaining thus that the efficiency of a good rinsing is linked to the rapidity of intervention.

Rapport d’Expérimentation de la Diphotérine 100 en Traitement Curatif et Préventif des Effets Cutanés et Oculaires du Gaz Lacrymogène.


Author(s): Viala B.,

Date: 1993

Source: 431/2, France : Santé,1993

An experiment in a semi-confined environment involved spraying a large quantity of CS gas with a disperser while two people were present in the room. Rinsing was carried out with Diphoterine , a molecule originally developed by PREVOR . The results are described in this report.
Etude Comparative de l’Efficacité des Premiers Soins dans les Brûlures Chimiques sur 185 Accidents. Author(s): M. Girard

Date: 1997

Source: Rhône-Poulenc Chimie, La Baule. Communication 1er congrès sur la brûlure. pp. 99-102

The following document deals with the presentation about the set up of a treatment protocol in case of chemical accidents in the Rhône Poulenc Factory from La Rochelle – France. This protocol was tested on 195 accidents since 1987. The year indicated, two major accidents occurred.
Evaluation of Cutaneous pH after Chemical Peel and its Correction with Amphoteric Solutions. Author(s): Cavallini, M. et al.

Date: 2010

Source:Journal of Plastic Dermatology, Vol. 6, n.2


Human cutaneous pH is the result of a fine regulation, in fact several mechanisms provide for the maintainment of the physiological value of 5.5. Considerable oscillations in cutaneous pH could hesitate in damages to the skin barrier. In this article we analyze the effect of products employed in chemical peels on cutaneous pH and the results on pH correction with amphoteric solutions that are tested in association with water and alone. We conclude that amphoteric solutions alone are more effective in correcting cutaneous pH after chemical peel and that those solutions are preferable to basic solutions that could damage the skin barrier overcorrecting the pH.
Actividad de un Area de Descontaminación Química de un Servicio de Urgencias. Author(s): Nogue, S. et al.,

Date: 2012

Source: Emergencias, Vol. 24, pp. 203-207.


Exposure to chemical products with cutaneous and/or ocular contamination is a motive of consultation in the emergency department. A description of the characteristics (epidemiological, toxicological, clinical, therapeutic and evolutionary) of patients treated in a hospital area of chemical decontamination, during a period of 18 months. There were 36 patients, with a mean age of 42.8 (16.7) years, of whom 24 (66.7%) were women. The products most frequently involved were caustics (52.8%), solvents or degreasers (19.4%), glues (13.9%) and self-defense sprays (8.3%). Domestic (41.7%) and occupational accidents (36.1%) were the most frequent causes, but there were also the most frequent causes, but there were also assaults (8.3%) and a suicide attempt. The involvement was ocular (75%), cutaneous (19.4%) or mixed (2 cases). One patient contaminated his face by ingesting sulfuric acid in a suicide attempt and died a few hours later. The treatment initially applied was water, soap and water or diphotérine. Ophthalmologic follow-up was performed in 100% of the cases with ocular involvement, and three of them presented sequelae. One of the cutaneous exposures also reported sequelae.
The Initial Management of Ocular Chemical Burns in an Academic Hospital. Author(s): Mbambisa, BN. Et al.

Date: 2013

Source: Occupational Health Southern Africa.

Method and result : A case report of a 31-year-old man who had a delayed presentation with an occupational injury due to cement in both eyes. He had a Grade 3 chemical burn in his right eye and Grade 1 burn in his left eye. Immediate irrigation was done but his right eye required surgical debridement.
Chlorobenzylidene Malononitrile Tear Gas Exposure: Rinsing with Amphoteric, Hypertonic, and Chelating Solution Author(s): Bvrar, M.

Date: 2, Feb 2016

Source: Human and Experimental Toxicology 2016, Vol. 35(2) 213–218

Methods : Chlorobenzylidene malononitrile (CS) is the tear gas used by the police. This study describes Diphoterine®, an hypertonic, amphoteric solution, rinsing after CS exposure. The first (CS) group of six police officers was exposed to CS only. The second (preexposure) group of eight sprayed their faces with an aqueous, hypertonic, amphoteric, and chelating solution before CS exposure. The third (postexposure) group of eight sprayed their faces with an aqueous, hypertonic, amphoteric, and chelating solution after CS exposure. The time between exiting the CS cloud and arriving at the ‘‘ready for action’’ checkpoint was measured. Their facial pain both inside the CS cloud and at the checkpoint was assessed (0–10 points).
First Aid for Chemical Burns. Author(s): Mathieu, L.,

Date: Sept.2016

Source: Chemical News, Vol. 13, pp. 34-36.

Methods: Study with 110 cases of chemical burns . The present study compares the results obtained from different first aid managements. During a 10 months period, chemical burns were registered. Water was used 20 minutes after exposure on site. The polyvalent solution was used 20 minutes after exposure upon arrival at the hospital . When both rinsing solutions were used , water was used within 10 minutes after exposure and the polyvalent solution after 30 minutes. The hospital is situated only 10 minutes away from the industrial area , some patients came to the hospital without first rinsing with water at the accident site. Statistical analysis was performed following large or small samples according to the population.
Palytoxin-Containing Aquarium Soft Corals as an Emerging Sanitary Problem, Author(s): Pelin et al.,

Date: Mar., 2016

Source: Drugs 2016, 14, 33;

Methods: Palytoxin (PLTX), one the most potent marine toxins, and/or its analogs, have been identified in different marine organisms, such as Palythoa soft corals, Ostreopsis dinoflagellates, and Trichodesmium cyanobacteria. Although the main concern for human health is PLTXs entrance in the human food chain, there is growing evidence of adverse effects associated with inhalational, cutaneous, and/or ocular exposure to aquarium soft corals contaminated by PLTXs or aquaria waters. Indeed, the number of case reports describing human poisonings after handling these cnidarians is continuously increasing. In general, the signs and symptoms involve mainly the respiratory (rhinorrhea and coughing), skeletomuscular (myalgia, weakness, spasms), cardiovascular (electrocardiogram alterations), gastrointestinal (nausea), and nervous (paresthesia, ataxia, tremors) systems or apparates. The widespread phenomenon, the entity of the signs and symptoms of poisoning and the lack of control in the trade of corals as aquaria decorative elements led to consider these poisonings an emerging sanitary problem. This review summarizes literature data on human poisonings due to, or ascribed to, PLTX-containing soft corals, focusing on the different PLTX congeners identified in these organisms and their toxic potential.
Use of an Amphoteric Solution in Eye, Skin and Oral Chemical Exposures: Retrospective . Multicenter Clinical Case Series. Author(s): Fortin, JL. Et al.,

Date: 2017

Source: J Clin Toxicol, Vol. 7, pp. 7-12.

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.
Nursing care in prehospital care for the burned patient: a review of the literature Author(s): Rosivânia Ingrid Medeiros da Silva et a. ,

Date: 2017

Source: Rev Bras Queimaduras. 2017; :28-33

This scoping Review was conducted following the Joanna Briggs Institute guidelines and the PRISMA-ScR protocol. Six data sources were searched in the
time frame from 2016 to 2020. Twelve articles met the inclusion criteria and were selected for sampling of the results.
Results: Prominent within the scope of nursing care were fluid volume replacement by infusion; local cooling with clean, running water at room temperature; monitoring / control of vital signs, use of oxygen therapy; analgesia and wound care, using occlusive dressings, identification of the causative agent, assessment of the Burned Body Surface Area, extent and depth of the injury. Nursing in pre-hospital care for burn victims mainly involves controlling the progression of the injury caused by the incident between the moment of arrival and tertiary care.
Augenverletzungen –Welche gibt es, und was kann man vor Ort tun? Author(s): Alexander F. Scheuerle et al., Scheuerle AF, Auffarth GU,

Date: 2017

Source: Augenverletzungen – Welche… retten 2017;

The eye’s anatomy, which is difficult to assess on the spot, the many possible eye diseases and the sensitivity of the eye’s surface to pain make preclinical diagnosis and treatment difficult .This article treat with what you need to know , when dealing with eye injuries .
Effect of Initial Decontamination on 1136 Clinical Exposures with Highly Corrosive Chemicals. Author(s):  Wiesner, N et al.

Date:  2021

Source: Emerg Med Inves 6:

Highly toxic and corrosive materials involved in eye burns are identified and the initial phase of decontamination/rinsing of severe eye burns is evaluated in context of first and secondary aid. Over a time of 30 years, one initial rinsing protocol
is applied. In this longitudinal observational study we are able to compare the grade of severity related to clinically used first aid rinsing solutions like Diphoterine®/Previn®, NaCl 0,9%, Ringer’s solution and Tap water.

Date: December 2017

Source: Annals of Burns and Fire Disasters – vol. XXX – n. 4

Polyamphoteric washing solutions (PWS) have been used for several years, mainly in industries, for cases of chemical ocular or cutaneous splashes by acid or alkali. We collected 37 cases reporting the use of PWS for ocular and cutaneous chemical splashes from several centres. Among the 37 cases, 55.26% resulted from occupational exposure. Among ocular exposures, initial clinical symptoms
included pain (20 cases), blepharospasm (4 cases), hyperaemia (15 cases), palpebral oedema (2 cases) and blurred vision (7 cases). Among cutaneous exposures, 2 injuries were classified as deep, and 11 as superficial. Mean (SD) pain (VAS) before PWS was 6,29 +/- 2,74; mean (SD) pain after PWS was 1,47 +/- 1,73. Early application of PWS to the eye or skin reduces the intensity of pain that is associated with chemical damage. Early application of amphoteric solution appears to reduce the incidence of sequelae, provided its pre-hospital and hospital use is early. However, further studies are needed

First aid therapy for corrosive chemical eye burns: results of a 30-year longitudinal study with two different decontamination concepts


Author(s):  N Wiesner , R M Dutescu , D Uthoff , A Kottek , M Reim , N Schrage

Date : 2019

Source : Graefes Arch Clin Exp Ophtalmol, Aug 2019; 257: 1795-1803

A prospective evaluation of patients treated in two specialized eye clinics for eye burns was begun in 1988. Recorded data included exposure circumstances, type of corrosive, different types of first therapy, and clinical treatment and outcome. Patients were treated from clinic admission and up to 24 h after the corrosive chemical burn with rinsing for 15 min using two different protocols. From 1988 to 2005, sterile 0.9% normal saline or Ringer’s lactate was used. Since 2006, sterile, hypertonic, amphoteric Previn® solution was used. Comparative statistical analysis was done with the Fisher contingency tables and Wilcoxon tests.