From the Guidelines
Mace to the face in an emergency department setting should be treated promptly with thorough irrigation of the affected areas, prioritizing removal of the patient from the contaminated area and irrigation of the eyes with copious amounts of normal saline or room temperature water for at least 15-20 minutes, as recommended by general medical guidelines 1.
Treatment Approach
When treating mace exposure to the face, it's crucial to follow a step-by-step approach to minimize damage and alleviate symptoms:
- Remove the patient from the contaminated area immediately to prevent further exposure.
- Have the patient remove contact lenses if present to ensure thorough irrigation of the eyes.
- Irrigate the eyes with copious amounts of normal saline or room temperature water for at least 15-20 minutes to help neutralize the effects of the mace.
- For skin exposure, wash thoroughly with soap and water, avoiding hot water which can worsen symptoms.
Symptomatic Treatment
Symptomatic treatment may include:
- Oral antihistamines like diphenhydramine (25-50mg every 6 hours) for itching.
- Topical steroids like hydrocortisone 1% cream for skin inflammation.
- Artificial tears or lubricating eye drops for ocular symptoms.
- Bronchodilators such as albuterol may be necessary for respiratory symptoms.
- Pain can be managed with acetaminophen or NSAIDs.
Important Considerations
Most symptoms resolve within 30-45 minutes, though eye irritation may persist longer. The active ingredient in mace, chloroacetophenone (CN), causes immediate burning sensations, lacrimation, and temporary blindness by irritating mucous membranes. Reassure patients that while extremely uncomfortable, exposure rarely causes permanent damage with proper decontamination.
Additional Guidance
For specific cases involving dental injuries, such as avulsed teeth, first aid guidelines recommend handling the tooth by the crown, not the root, and placing it in milk or clean water if milk is not available, before seeking immediate dental care 1. However, the primary focus in cases of mace exposure should be on immediate decontamination and symptom management.
From the Research
Emergency Department Treatment
- The provided studies do not directly address emergency department treatment for face-to-face interactions 2, 3, 4, 5, 6.
- However, one study discusses the primary assessment of patients in the emergency department, including the use of structured primary assessment tools such as the Emergency Severity Index (ESI) and the Manchester Triage System (MTS) 5.
- Another study mentions the use of amoxicillin-clavulanic acid in treating a patient with a severe wound infection, but this is not directly related to emergency department treatment for face-to-face interactions 3.
- The other studies focus on the properties, indications, and usage of oral amoxicillin and amoxicillin-clavulanic acid, as well as their role in outpatient therapy 2, 4, 6.
Face-to-Face Interactions in Emergency Departments
- There is no direct evidence in the provided studies to support the use of specific treatments for face-to-face interactions in emergency departments.
- The studies primarily focus on antibiotic treatments and primary assessment tools, rather than face-to-face interactions 2, 3, 4, 5, 6.
- Further research would be needed to determine the most effective treatments for face-to-face interactions in emergency departments.