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First responder guidance issued in wake of acid attack spike

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Nurses giving first aid to patients with acid attack burns should follow new national guidance, which has been sparked by a recent increase in assaults, according to NHS England.

The guidance, drawn up by NHS England and burns specialists, is based around the directive “Report, Remove, Rinse” and is aimed predominantly at both victims or witnesses of future attacks.

“The minutes after an acid attack are critical for helping a victim”

David Ward

Specifically, people are being advised to report the attack to emergency services, remove contaminated clothing and rinse skin immediately in running water.

As well as the three simple steps to follow, NHS England highlighted that more information was available online, including on support for victims and friends or family of people affected by burns.

NHS England noted that burns patients often required different types of care, including therapy, specialist treatment, and in sometimes reconstructive surgery.

The new guidance was designed, it said, to help people to understand how the NHS can treat such patients, as well as helping them and their relatives to cope with the trauma that can follow.

  • Report the attack: dial 999
  • Remove contaminated clothing carefully
  • Rinse skin immediately in running water

A spokesman for NHS England confirmed to Nursing Times that nurses should follow the first aid guidance and apply water to affected areas.

NHS England also said it was working with police forces, ambulance services and the Royal College of Surgeons to ensure frontline public sector workers, often first on the scene, were aware of the guidance.

Chris Moran, national clinical director for trauma at NHS England, said: “We are issuing guidance today that sets out clearly and simply how people can help themselves and others in response to attacks.

“Our guidance will outline what first steps to take in the event of an attack in those crucial minutes before professional clinical help arrives on the scene,” he said.

NHS England/British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)

First responder guidance issued after acid attack spike

Acid attack guidance: Report, Remove, Rinse

He added that such assaults remained rare, but that the NHS was increasingly caring for the victims.

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Burn Association worked with the NHS body to develop the new guidelines.

David Ward, president of BAPRAS, said: “The minutes after an acid attack are critical for helping a victim.

“This guidance gives the important, urgent steps a victim or witness can take to help reduce the immediate pain and damage, and long-term injuries,” he said.

He added: “Surgeons specialising in burns and trauma have seen first-hand the devastating impact on patients admitted to A&E after vicious corrosive substance attacks.

“They cause severe pain, scarring which can be life-long, and can damage the sight, sometimes leading to blindness,” he said. “Unfortunately, these vindictive attacks are on the increase.”

Nora Nugent, consultant plastic surgeon at Queen Victoria Hospital NHS Foundation Trust, which specialises in treating burns, said: “Knowing what to do to help yourself or someone else is vital, especially if you’re first at the scene, and can help the emergency services and also specialist centres such as QVH to treat the burns.

“We hope the new guidance from NHS England will help people understand what they should do in the event of an acid or chemical attack and how important it is to remove contaminated clothing and rise the burn before the emergency services arrive,” she said. “Acting quickly can help reduce immediate pain and long-term scarring.”

In 2016, the St Andrew’s Burns Centre in Chelmsford admitted 20 patients with serious acid or corrosive burns, a similar number who were treated there over the previous 15 years.

The centre expects to help over 30 people in 2017. Clinical director at St Andrews, Peter Dziewulski, has previously said that acid attacks in London this year had reached “epidemic” levels.

Nationally, in 2014, 16 people required specialist medical advice, rising to 25 in 2015 and increasing further to 32 last year.

The level of demand for specialist burns help so far in 2017 suggests there will be another rise in patient numbers this year, said NHS England.

The guidance in full has been published on the NHS Choices website.

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