Hot
asphalt burns to human tissue can increase the likelihood of
infection and potential conversion of partial thickness to full-thickness
injuries. Successful intervention for hot
asphalt burns requires immediate and effective cooling of the
asphalt on the tissue followed by subsequent gradual removal of the cooled
asphalt. A review of the literature reveals that multiple substances have been used to remove
asphalt, including topical
antibiotics,
petroleum jelly, a commercial product known as De-Solv-It (ORANGE-
SOL, Chandler, AZ),
sunflower oil, baby oil,
liquid paraffin, butter, mayonnaise, and
moist-exposed burn ointment (MEBO). Although many of these products may be effective in the removal of
asphalt, they may not be readily available in an emergency department setting. Topical
antibiotics are readily available, are more commonly described in the medical literature, and would be expected to be effective in the removal of
asphalt. We developed guidelines for on scene (
first-aid) management and the initial care of such patients upon presentation to a health care facility. These guidelines emphasize the principles of early cooling, gradual removal of adherent
asphalt using topical
antibiotics, and avoidance of the use of topical agents, which are likely to result in tissue toxicity.