Written by Margaret Hebert, Dawn Thierbach, and Jeff Thierbach
Arborists work with equipment utilizing hydraulics every day – chippers, chip dump beds, stump grinders, aerial lifts, and the list goes on. While accidents from hydraulic fluid leaks are rare, accounting for only 5% of all accidents within the tree care industry, they can result in serious injuries and even amputation.
So before we begin to talk about hydraulic injuries and how to prevent them, let’s look at some stats:
- The pressure needed to penetrate skin is only 100 psi.
- Chippers, chip dump beds, stump grinders, and other equipment arborists use daily can run at 4000 PSI or higher.
- Amputation rates for an injection injury with solvents involved are 50-80%.
- With pressures greater than 7000psi, the amputation rate is 100%.
High-pressure injection injuries occur when fluid under pressure is lost through a small hole in a hydraulic or other pressurized system and the pressurized fluid penetrates the skin of a victim. The injuries are characterized by a small puncture wound that can appear mild in the beginning, and they often get dismissed as minor. Hydraulic fuel injection injuries, however, are anything but minor. In fact, they are considered a surgical emergency. Hydraulic oils are highly toxic and they poison you and your body’s tissues. Immediate treatment is required to save the patient’s digit, limb, or life.
So, what happens after a hydraulic fuel injection injury? Let’s use an injury to the hand for example. First, the initial “strike” feels like a pin prick or bee sting, is seemingly harmless in appearance, and is often dismissed as nothing serious. Underneath the skin, however, the injectant begins damaging tissue, and pressure builds up in the hand and fingers. Within hours, the fluid can quickly spread to all areas of the hand, wrist, and forearm. The built up pressure damages tendons, nerves, arteries, vessels, and muscles. Unless pressure is relieved within hours of the injury, the victim risks amputation from lack of blood supply.
Surgery is always required for a hydraulic fuel injection injury. During the surgery, as much of the injectant as possible will be cleaned out, and dead (necrotic) tissue must be removed. Typically the wound must be left open to reduce the chance of infection and any further tissue damage, and a return visit to the operating room will be required within 24-48 hours.
Properly training your team is essential for avoiding or minimizing the severity of hydraulic injection injuries. Training should include:
- An overview on hydraulic pressure systems and basic functionality.
- A plan of action in case a leak occurs:
- Immediately shutting down the machine as soon as possible to avoid leaking fluid.
- Changing the hose after all stored energy has dissipated.
- Hydraulic fluid cleanup and remediation.
- A plan of action if a hydraulic injury occurs.
- First aid treatment to include:
- For pain management, if needed, use Tylenol. Avoid Ibuprofen, Aleve, and aspirin since they are mild blood thinners and there’s some chance of internal bleeding.
- Elevate the affected limb.
- DO NOT use compression wraps, tourniquets, or ice. All these increase the risk of amputation.
- DO NOT give the victim food or drink since they will be needing immediate surgery.
- Get the patient to a trauma center or hospital immediately! A trauma center is recommended due to rapid access to a surgeon, transfer capabilities to higher levels of care such as hand or vascular surgery, and immediate availability of X-ray and CT imaging. Early antibiotics (ideally within an hour) and early surgery (ideally within 10 hrs) are the keys to reducing the need for amputation.
- Inform medical personnel that it is a hydraulic pressure injury and provide them with the safety data sheet (SDS) for the fluid.
- If the facility does not have treatment capabilities, the patient will need to be transported quickly. In one incident we are aware of, the patient was air-lifted to the nearest hospital that had the ability to properly treat the injury.
- Notification of emergency personnel (911)
- Emphasis on never using your hands to check for leaks.
- Training on how to check and maintain your hoses regularly, with a frequency of at least once per week.
- Ensuring that replacement of old hoses occurs when the machine is turned off and stored energy has dissipated following proper lockout-tagout procedures.
Remember to keep the training fresh in your team’s memory by including it as a topic in tailgate meetings a few times each season.
If you need help adding in a hydraulic safety component to your overall safety program, enroll in ArboRisk’s Thrive Safety Package, to work one-on-one with one of our Thrive consultants. Together we all can get everyone home safe each night.